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Author's profile photo Rebecca Hughes

How the Pandemic Took Telehealth Mainstream in the US

In July this year I became the industry marketing lead for healthcare (and also wholesale distribution) in the Global Marketing organization, and I’ve had the opportunity to learn even more about the challenges – and opportunities – presented by the changing healthcare landscape, especially in the US.

With 320 million people and 3.8 million square miles (9.8 million square km) of land, there’s no one-size-fits-all solution to healthcare delivery – but the pandemic created a unique environment that took telehealth from the exception to what for many is now the standard.

In the United States, much has been written in the past decade about the dramatic loss of rural healthcare resources, both facilities and staff. Faced with huge distances between cities and towns, shrinking rural populations, and a disproportionately large elderly population, services were becoming more scarce even before the pandemic.

At the same time, due to the lack of national intranet infrastructure, the digital divide (i.e., people lacking access to the internet) wasn’t limited to rural areas – it was also affecting urban populations, and as I started looking at the data, the number of people without access to home internet often exceeded that in rural areas.

Families often relied on public libraries for access to high speed internet, while children accessed the internet through school computers. When the pandemic happened, libraries and schools were shut down, which had an immediate impact on the local communities. The federal government took action, in collaboration with internet providers, schools, and telecommunications providers, to provide rapid, free and low-cost access to internet at home for millions of residents who’d depended on those public resources.

A key benefit to enabling that access was providing access to public telehealth services to the millions of Americans who rely on national healthcare systems, especially the healthcare service known as Medicare, used by Americans aged 65 and over. According to the non-profit Bipartisan Policy Center,

“Dramatic policy changes during the pandemic paved the way for a huge increase in the utilization of telehealth services—from less than 1% of Medicare services before the pandemic to a peak of more than 32% of Medicare claims in April 2020 (leveling off to between 13% and 17% by July 2021). In the first year of the pandemic, 44% of continuously enrolled Medicare fee-for-service beneficiaries had a telehealth visit, accounting for more than 45 million visits.” (

That’s an astonishing increase in remote healthcare utilization – an increase of ~15x compared to pre-pandemic. And nearly half of senior citizens enrolled in the government healthcare program used the remote health services in 2020 alone. But it wasn’t just physical healthcare that a large number of people suddenly needed to receive remotely.

“The significant expansion of telehealth disproportionately increased access to care in urban communities. In addition, tele-behavioral health services can address problems associated with the paucity of behavioral health providers and help patients overcome the stigma related to these services, especially in more rural, tight-knit communities. In 2021, more than one-third of Americans (37%) lived in areas with shortages of mental health professionals.” (

My husband and I live outside Washington, D.C., where there are no shortage of world-class healthcare service providers and specialists, including mental health professionals. But for the majority of people, choices are more limited.

The US healthcare model is somewhat unique among industrialized nations. With an emphasis on profitability, a telehealth visit is cheaper for both than an in-person visit, so in a rare ‘planetary alignment’ in the US healthcare universe, the insurance companies, hospitals, government, and citizens all sought the same outcome: how to reduce in-person encounters for mental and physical health care, while improving patient outcomes.

The long-term impact of this overnight shift hopefully will be that millions of people who previously might have skipped a doctors’ appointment because they have mobility issues or no longer can drive, or because they have to take several hours out of their day to take a complex connection on public transportation to reach a doctor’s office – or even drive hours to reach a provider – now have access to tens of thousands of providers, specialists, counselors, and content they never dreamed would be possible as the new year 2020 dawned.

Certainly, it’s not perfect. Post-pandemic, some of the programs that facilitated telehealth access during 2020 in particular ended. But the bigger issue – the willingness of people to use telehealth services; to seek them out and see the benefit – that didn’t end, and either did widespread availability of affordable smart phones and low-cost data plans. All at once, five generations – from those born digital to Boomers – experienced a sea change in access to health care.

The proliferation of telehealth during the pandemic opened the eyes and minds of millions to viewing ‘health tech’ not only as Apple watches and FitBits reserved for a small percentage of the population, but as a public service as normal as getting an annual physical.

The ripple effect remains to be seen, but working at SAP, and believing in the power of technology to help the world run better and, very literally, improve peoples lives, I’m excited to see what the coming years bring and how telehealth will help improve patient outcomes across all walks of life, urban and rural, regardless of income level or physical and mental health needs.

There’s not a single thing good about a pandemic. But if it’s inevitable, it’s also hopeful that we took the opportunity to make a huge leap forward in remote healthcare that will positively impact all members of society for years to come.

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