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By Capital Blue Cross

Telehealth is hardly new – the idea of patients consulting with their doctors remotely arose shortly after the telephone was patented – but its use has rapidly accelerated during the COVID-19 pandemic.

The evolution of technology means people can now connect with a medical professional by smartphone, tablet, or computer in real time 24 hours a day, seven days a week. J.D. Power recently described telehealth amid the global pandemic as “a bright spot in the ‘new normal.’”

“Even in challenging times such as these, some silver linings can emerge,” said Dr. Jennifer Chambers, chief medical officer at Capital BlueCross. “During the pandemic, social distancing has pushed innovation that has allowed doctors and patients – even those who were previously hesitant to do so – to connect virtually. This means continued care for patients, and that’s a good thing for all of us.”

The American Medical Association reports that doctors during COVID-19 have seen between 50 and 175 times more patients via telehealth than they did prior to the pandemic.

And use of Capital BlueCross’ Virtual Care app has increased 278% during the pandemic. That’s only a snapshot of Capital BlueCross’ surge in telehealth claims and visits, since the app represents only 2% of the insurer’s total telehealth use.

Suited for mental health

If virtual healthcare is riding a wave, behavioral telehealth is riding a tsunami. Mental health visits via Capital BlueCross’ Virtual Care app are up 439%, a jump mirrored nationwide.

According to the technology platform company Kareo, the majority of mental health providers it surveyed in June attributed much of their surges in 2020 patient visits to telehealth. In all, 97% of those practices told Kareo they now use telehealth, versus 22% who did in 2019.

Capital BlueCross Director of Behavioral Health Karie Batzler said her regard for behavioral telehealth has risen during the pandemic.

“My answer may have been different before the pandemic,” Batzler said. “So much of behavioral health is the face-to-face nature of the work: reading body language, being able to match the body language with the word choice. That’s kind of been baked into behavioral health all along.”

Now, she said, she and much of the industry have come to recognize that behavioral telehealth appointments ensure safe social distancing, increase patient access, and ease some stubborn stigmas still connected to in-person therapy. “In the pandemic, many patients can either receive behavioral healthcare telephonically or virtually, or they are not going to receive it at all unless it’s an emergency,” Batzler said. “It’s put our industry into a position of having to rethink, ‘Where does telehealth fit into the behavioral health continuum?’”

Batzler cautioned that immediate crisis situations related to mental wellness might not be suited to telehealth, but the technology is otherwise serving patients fairly well.

“Now that we’ve been forced past the initial uncomfortableness and are more accustomed to either telephonic or visual virtual care, we’re recognizing the value and adjusting the techniques required to perform the service,” she said. “It’s a more convenient and accessible way to receive outpatient behavioral health services.”

Advantages for children’s therapy

Virtual care also has swept across children’s behavioral health during the pandemic, said Steffi Devine, a child therapist with Comprehensive Care Counseling, LLC, of Harrisburg, Pa.

“Since telehealth has been allowed (by the Pennsylvania Legislature), and is being reimbursed by insurance companies, it has skyrocketed,” Devine said.

Devine said virtual sessions offer several benefits to children’s therapy:

• Parents, often pulled in multiple directions, sometimes struggle to get children to in-person appointments.

• Kids are generally more comfortable in their home.

• Children are more accustomed to, and at ease with, the virtual atmosphere than adults.

• Therapists get to see a sliver of the child’s home environment.

“For us, the vast majority of the children have felt comfortable, and it’s actually enhanced the therapeutic process for a lot of the kids,” Devine said. “And I get to see an aspect of their lives I wouldn’t have been able to see in the counseling room.”

There are challenges, of course. Devine said telehealth appointments can become a restraint or source of anxiety for those children already in challenging home environments. She also said some children who attend school virtually may feel as if a telehealth therapy session is just one more person on one more screen.

“With kids who really struggle with emotional regulation, they really benefit from being in person and allowed to process all the emotions and feelings that haven’t come forth,” Devine said. “They really need space in the therapy room to act that all out.”

After COVID-19

While post-pandemic telehealth may not match its current volume, early indications are that it will remain popular.

A new survey by telehealth provider Amwell says 62% of mental health patients “would actually prefer to see a doctor virtually, even after it is safe to visit a doctor’s office in person.”

In the Kareo survey, 88% of all responding practices and 67% of mental health providers said they plan to continue using telehealth after COVID-19, while 53% of the mental health respondents said the changes they made to telehealth during the pandemic likely will be permanent.

The Business Group on Health predicts that telehealth will continue to intensify its focus on mental wellness as the pandemic has pushed employers to find new strategies to meet behavioral health needs. 

“I think it’s really a necessity,” Devine said. “So many of the children I see are dependent on their parents, and parents really sometimes have trouble getting to appointments for a variety of reasons. Telehealth also allows for consistency that builds a trusting relationship with the therapist long-term, and that really benefits the children.”

Capital BlueCross’ Batzler predicts some post-pandemic drop from telehealth’s current levels, but also expects the platform to gain permanent ground from its 2020 surge. She foresees roughly half of behavioral health visits eventually being done via telehealth.

“I think the bottom line is that if it means more people are accessing behavioral healthcare, then we’ve all won,” Batzler said. “We’ve all benefited.”|   

For more than 80 years, Capital BlueCross has served Central Pennsylvania and the Lehigh Valley by offering health insurance products, services, and technology solutions that provide peace of mind to consumers and promote health and wellness for its members. The company delivers innovative solutions through a family of diversified businesses to create healthier futures and lower healthcare costs. Additionally, the Capital Blue Connect health and wellness centers provide in-person service and inspiration to help people reach their health goals. Capital BlueCross is an independent licensee of the BlueCross BlueShield Association.