The first time you may have encountered the concept of telehealth was during the COVID-19 pandemic. To curb the rapidly spreading virus, many healthcare providers–including doctors, speech therapists, occupational therapists, social workers, and hospitals–moved their outpatient services and appointments online. Indeed, at the height of the pandemic–between June and November 2020–three out of every ten healthcare visits were conducted virtually via a laptop or desktop computer, or a tablet. This transition offered a lifeline for patients recovering from acute health incidents to continue receiving care, including survivors of stroke and survivors of traumatic brain injury. 

Perhaps you’ve already experienced telehealth. If not, we’ve written this post to help you understand what it is, how it works, and whether virtual visits are as effective as office visits.

What is telehealth?

Telehealth is an umbrella term that encompasses all the various ways in which a clinician can deliver your care without seeing you in person. A surprisingly large proportion of health services can be effectively and efficiently delivered through virtual care. These include:

• Primary care
• Specialist referrals
• Follow-up visits
• Case management
• Mental health counseling
• Speech therapy
• Occupational therapy (OT)
• Physical therapy (PT)

What are the benefits of telehealth?

Even post-pandemic, there are many compelling reasons to continue using telehealth services. These critical benefits include:

• Transportation flexibility: Due to the virtual nature of telehealth, visits can be conducted right from your own home. This greatly reduces the mobility barriers that oftentimes prevent patients from accessing needed care. With telehealth, you can easily and independently connect with your doctor, speech therapist, occupational therapist or other provider. You only need a device with an active internet connection to get started.
• Lower costs: Individual telehealth visits cost significantly less on average than comparable in-person visits. One study found a 54 percent price difference, with in-person physician visits costing an average of $146, compared to $79 for virtual visits. The elimination of transportation fees further reduces the total cost of virtual visits for patients.
• Increased access: Telehealth removes the need for the patient and clinician to be physically in the same room. As a result, people living in medically underserved areas facing provider shortages, or individuals requiring culturally- or linguistically inclusive care, can access a wider pool of health professionals. Please note: In many states, the provider must be licensed to practice in the state where the patient is located during the telehealth visit.
• Reduced exposure to illness: If you have a health condition that puts you at greater risk of contracting a severe manifestation of COVID-19 or another disease, telehealth visits allow you better control over your exposure to illness. Instead of physically interacting with the provider, other patients, and support staff at an office, you can complete a telehealth visit without ever leaving your house.
• More caregiver involvement: If you choose to involve loved ones in your care, virtual visits can decrease the logistical hassle of getting everyone in the same place at the same time. Because each member of the care team can simply join the online visit from a convenient location, finding mutually feasible appointment times should prove far simpler.
• Fewer missed visits: Telehealth strongly reduces the logistical burdens on patients, since it doesn’t involve traveling distances or finding transportation. It is not surprising, therefore, that teletherapy has also been linked to fewer missed appointments than in-person visits. And fewer missed visits will allow you to keep progressing in your recovery.

How does telehealth work?

There are two main types of telehealth: synchronous and asynchronous. They function differently and are designed to work together to provide you the most comprehensive care possible. 

• Synchronous: This option is the closest to a traditional, in-person health care visit. Your provider will give you instructions for how to join your appointment using a laptop or desktop computer, or tablet, or smartphone when you schedule it. Usually, a website link will be sent to your email, texted to your phone, or will appear once you log into the provider’s app or patient portal. When it is close to your appointment time, you simply need to turn on your device–a smartphone, tablet, Chromebook, or computer–and click on the link. The link will connect you live to your provider over a video chat (one popular computer program used by many providers is Zoom). From the live video chat, your clinician will be able to evaluate and diagnose you and propose treatments accordingly. As with an in-office appointment, you will have a chance to seek clarification or ask any questions.
• Asynchronous: This telehealth method, on the other hand, allows you to communicate with your provider in-between visits. Your provider might give you a link to create an account on a website called a patient portal. You can then exchange written messages or photos via this platform. This is not a live method of communicating like the “synchronous” method described above. It is similar to emailing or calling your provider’s office with questions and waiting to receive an answer back–just more secure.

Yes, telehealth is as effective as in-person care!

Given the practical benefits of virtual therapy outlined above, you might wonder whether telehealth is as effective as in-person visits. The answer is a resounding yes! Many studies about the effectiveness of telehealth were conducted over the past year, as the pandemic forced medical visits out of the office and onto online platforms. Writing in 2020 about the increase in virtual health care, the CDC said: “telehealth… can improve health care access outcomes, particularly for chronic disease treatment and vulnerable groups.” 

A survey of clinicians and patients by The American Journal of Managed Care similarly found that a majority (52.5 percent) of clinicians reported higher efficiency for virtual appointments. Patients reported no loss of quality of care, and in fact said that virtual visits were vastly preferred to office visits for their logistical convenience. The study concluded that “telemedicine will continue to gain adoption and become a staple of modern-day patient care, post-pandemic.” 

Research on virtual therapies, like speech therapy, OT, and PT, is also ongoing. To date, a comprehensive review of multiple studies indicated that virtual speech therapy is effective at treating a range of conditions, including aphasia, Parkinson’s disease, dysphasia, and stuttering. New research that analyzed data collected between October 2020 and March 2021 reached a similar conclusion, demonstrating that telehealth is at least as, if not more, effective than in-person therapy. It revealed that 80 percent of patients who completed all speech therapy virtually reported progress, compared with a slightly lower 79.9 percent of patients who completed all speech therapy in person (Figure 1). The data also showed that a significant percentage of patients averaging one weekly speech therapy session chose virtual care (69.4 percent) over office visits (49.3 percent). This further confirms that the shift toward telehealth is popular with patients and here to stay. 

Figure 1. This figure shows that 80 percent of patients who completed all speech therapy virtually reported progress, compared to a slightly lower 79.9 percent of patients who completed all speech therapy in person. These findings support the conclusion that teletherapy is at least as, if not more, effective than in-person therapy. Source: ASHA (American Speech-Language-Hearing Association)

Figure 2. This graph shows that, among patients averaging one weekly speech therapy session, significantly more received their care virtually (69.4 percent) than in-person (49.3 percent). This suggests that the shift toward teletherapy is popular with patients and here to stay. Source: ASHA (American Speech-Language-Hearing Association)

The takeaway

Telehealth allows you to enrich your health by focusing on what really matters. Instead of spending hours of time on the phone arranging transportation for office visits and in the car shuttling to and from appointments, you can access the care you need from the comfort of your own home. Given the far greater ease of attending virtual appointments, the likelihood of sticking with treatment and making progress also increases. Just as important, without the geographic constraints of traditional office visits, you can work with the clinician best suited to your particular needs, even if you live in a medically underserved area. All of these advantages work together to optimize your recovery journey. And best of all, a wave of new research confirms that you won’t sacrifice anything in the quality of care you receive by opting for telehealth–in fact, your treatment outcomes might actually benefit from it! 

For additional resources, check out the following:

• American Speech-Language-Hearing Association. (2021, June 7). Outpatient SLP services show the highest telepractice uptake. ASHAWire. https://leader.pubs.asha.org/do/10.1044/leader.NOMS.26062021.44/full/.
• Ashwood, J. S., Mehrotra, A., Cowling, D., & Uscher-Pines, L. (2017). Direct-To-Consumer Telehealth May Increase Access To Care But Does Not Decrease Spending. Health Affairs, 36(3), 485–491. doi:10.1377/hlthaff.2016.1130
• Centers for Disease Control and Prevention. (2021, February 18). Trends in use of Telehealth among health centers during the Covid-19 Pandemic – United STATES, June 26–November 6, 2020. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/70/wr/mm7007a3.htm.
• Centers for Disease Control and Prevention. (n.d.). Using telehealth to expand access to essential health services during the Covid-19 pandemic. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html.
• Covert, L. T., Slevin, J. T., & Hatterman, J. (2018). The Effect of Telerehabilitation on Missed Appointment Rates. International Journal of Telerehabilitation, 10(2), 65–72. doi:10.5195/ijt.2018.6258
• Donelan, K., Barreto, E. Sossong, S., Michael, C., Estrada, J., Cohen, A.,…Schwamm, L. (2019). Patient and Clinician Experiences with Telehealth Follow-up Care. The American Journal of Managed Care, 25 (1), 40-44. https://pubmed.ncbi.nlm.nih.gov/30667610/
• U.S. National Library of Medicine. (n.d.). Patient portals – an online tool for your health: Medlineplus medical encyclopedia. MedlinePlus. https://medlineplus.gov/ency/patientinstructions/000880.htm. 

Kate Ying is an intern at Constant Therapy Health. She is a student at Columbia University.