Kaitlyn Ennis, who started a new job this week as a program assistant in the University of Florida dean of students’ office, appreciates that her physician offers telehealth visits most evenings.
“I really like it,” said Ennis, 22, of Southwest Gainesville, who graduated with a bachelor’s degree in psychology from UF in 2019. “I prefer it to actually going in person to the doctor’s office, and I do not have to miss out on work.”
While telehealth, or telemedicine, is not new, it is much more common due to COVID-19.
According to the Centers for Disease Control and Prevention, telehealth visits increased by 50% in January to March compared to the same period in 2019. Most of those appointments were not related to COVID-19, but by the end of March pandemic-related visits had increased 154%.
Florida Blue, an affiliate of Blue Cross Blue Shield Association, has seen 600% – or seven times as many – more telehealth usage among its members since March, Toni Woods, a senior communications official with the company, wrote in an email.
Access to telehealth services has also become a greater focus in Florida public schools. In September, Florida first lady Casey DeSantis announced that the state Department of Education would spend $2 million to support the services in 18 rural school districts.
Healthcare centers are also receiving more support to make telehealth more accessible.
The Federal Communications Commission recently awarded nearly $1 million to the UF College of Medicine’s pediatric department to help by equipment needed for telemedicine appointments.
Two reasons for increased telehealth demand: The quest for socially distanced appointments and the COVID-related economic downturn costing many people their jobs or healthcare insurance.
Daniela Shillington, 40, is a licensed nurse practitioner in Gainesville who lost her job early during the pandemic. From April through the summer, she offered free telemedicine to those who needed it. Many came to her for medication refills, she said.
“Most people were actually really healthy,” said Shillington, who in September reduced her free services to the last Friday of each month. “They were stable and managed on medications. They just needed to continue their medications before very detrimental things could happen.”
Despite its convenience, telehealth should not replace in-person healthcare indefinitely, she said.
“When you see someone in person, you get a lot of information … you get a lot of nonverbal cues,” Shillington said.
Palm Beach County saw over 50% of its resident Medicare patients using telehealth visits at least once during 2020. In April, there were about 350 telemedicine visits per 1,000 Medicare recipients, the most the county has seen during the pandemic through September.
The Florida Department of Health office in Bradford County said its clinic there had 296 telehealth visits from April to July. Only 5% of its patients use telemedicine services, according to spokesperson for the department.
All 50 states and the District of Columbia offer some form of Medicaid reimbursement for telehealth appointments. There are some variations, but all help cover for live video sessions.
Some states have telehealth parity laws, which require private payers or insurance providers to cover telehealth services the same way they cover in-person healthcare. Florida does not require private payers to cover telehealth costs.
Some providers choose to independently reimburse people for these expenses.
“Prior to the pandemic, we were actively working to expand our virtual care options by January 2021, and COVID-19 accelerated that timeline,” Woods wrote on behalf of Florida Blue.
Dr. Michael Haller, professor and chief of pediatric endocrinology at UF, said his department switched almost completely to telemedicine for a while in March and April. Haller said his unit has created equipment packages for parents to perform telehealth physicals for their children, and wireless enabled iPads have also been distributed to families who cannot afford them.
“I am a parent and I have two kids,” he said. “I personally much prefer to do their visits through telemedicine. Telemedicine is here to stay.”
Haller said the pediatrics department recently agreed to help the Alachua County Public Schools district provide telemedicine to its students. A pilot program targeting schools with high Medicaid populations has begun, the doctor said.
“If we can coordinate their clinical visits through their school, it creates huge efficiencies throughout the system,” Haller said.
Shillington said she hopes patients and providers find a balance between in-person and telehealth.
“We have now seen, ‘OK, yeah, we can use telemedicine,’” she said. “There is a role for it.”
Ennis had not used telehealth before the pandemic but will visit a doctor’s office when it needed.
“For different things like checkups for my anxiety disorder, I think it’s perfect,” she said. “For anything more serious, I would probably go in person to get checked out.”