We ran through a helpful post-COVID strategy planning session at work recently and it made me wonder to what extent telehealth will continue its moment as we adjust to the new normal. Google search queries provide close to real-time data and can serve as a helpful proxy.
The HHS Office for Civil Rights (OCR) made its announcement regarding HIPAA-compliance for telehealth communications tools on Tuesday March 17th, which coincides with the peak for “telehealth” searches – on that same day, the “telehealth” query hit 100 indicating peak popularity for the term during the search period (I limited the search to two weeks prior to and two weeks following OCR’s announcement).
Perhaps unsurprisingly, “telehealth” and “telemedicine’ search terms were popular in more rural states, with the top four being Wyoming, North Dakota, Idaho and Maine. In 2017, the President of the state’s Medical Society noted that Wyoming had already laid much of the groundwork for telehealth despite minimal government investment ($80,000 in 2017).
Prior to COVID, most of WY’s telemedicine was being used for mental health counseling. In 2017, only 1,287 patients received care through telemedicine from 71 providers. More than 80% of those cases were mental health or addiction treatment related. Given the sharp rise in unemployment and subsequent loss of employer-based health insurance, it wouldn’t be surprising if the high proportion of mental health televisits continues or even increases in the near-term.
Ahead of the OCR announcement, Teladoc and American Well were most searched, in line with the company’s revenues (Teladoc reported ~$420M in 2018 revenues; Doxy.me, which offers a free HIPAA compliant telemedicine platform saw its searches take off after March 21st. A press release from March 17th noted the company had removed barriers to its telemedicine platform, touting the ability to onboard providers in minutes. By the end of March, Doxy.me seems to reach peak popularity (among a limited set of competitors), overshadowing Teladoc and AmWell who led the pack at the start.
Given Doxy.me’s headquarters in Rochester, NY, it isn’t surprising to see the most search queries coming from neighboring Vermont (or from Maine and Connecticut). Montana was a bit of a surprise, and interesting that VSee (another telehealth startup) also popped up there as well as South Dakota. Perhaps providers in these states were looking to respond quickly to an increase in demand for telehealth and may have been drawn by the lower-cost and easier to use offerings.
Finally, I was curious about interest in some of the non-traditional (non HIPAA compliant) platforms being used for telehealth purposes during the pandemic. The OCR noted that non-public facing remote communications platforms, including Facebook Messenger, Skype, Apple FaceTime, Google Hangouts, and Zoom, would not be subject to HIPAA violations or enforcement. Public-facing (such as TikTok) platforms would not be allowed. Thankfully, there seem to be few queries for TikTok as a telehealth platform.
I’ll be interested to see which platforms will come out to lead the pack in “the new normal” as the pandemic comes under control. I am also curious how telehealth implementation will shift from rapid firefighting to focused innovation and, eventually (and hopefully) into a centerpiece of hospital network and provider group’s strategy. Finally, will non-traditional players (Facebook, Apple, Zoom) work towards HIPAA compliance for their video conferencing tools once OCR eventually and inevitably rescinds its lenient stance towards non-HIPAA compliant platform usage for telehealth visits? Let’s find out.