BACKGROUND

Telehealth use in the United States grew significantly within the first three months of the COVID-19 pandemic (January–March 2020), providing access to critical health services, enabling communication between health care providers and patients, and remote monitoring of conditions through the use of synchronous, real-time modalities via audio-only or internet-based video on mobile phones and digital devices as well as asynchronous methods (eg, store and forward and patient portals). 5, 6

Telehealth use in the last half of 2020 remained high, accounting for 30.2% of all health center visits during June–November 2020, according to one study. 7 By April 2021, the national telehealth utilization rate among adults ages 18 years and older was at 27%, which is lower than early pandemic telehealth use, but then declined to 22% by mid-late 2021 based on an earlier ASPE study. 1 Analyses of commercial claims have shown that telehealth services were mostly rendered by social workers and primary care and psychiatry/psychology clinicians, with more than a quarter (26%) of claims for psychotherapy delivered through telehealth. 8 However, while evidence on patient preferences regarding modality and the impact of telehealth on quality of care and patient outcomes is still being explored, equitable access to telehealth services–particularly synchronous, real-time video telehealth–remains a significant concern and potential barrier to health care during the pandemic. 9