As is usually the case in American health care, there have been some pitfalls to this new system, in which patients get stuck with the full bill for their telehealth visits. But to therapists, even a moderate reassurance that they’ll be paid for their time is enough to get them to fire up Skype. “If you’re in a situation where all of your regular treatment models have been shut down, you’ve got to find a revenue source,” Nicolas Terry, the executive director of the Hall Center for Law and Health at Indiana University, told me. “So suddenly getting some money from telehealth doesn’t seem so bad.”
The other thing shrinks worried about prior to the pandemic was running afoul of a government medical-privacy rule called HIPAA. Because apps such as Skype and Zoom have some security vulnerabilities, they weren’t previously considered suitable for something as sensitive as psychotherapy. (Zoom also has a HIPAA-compliant platform, Zoom for Healthcare, though unlike the regular version, it is not free.)
But the federal government released another memo in March essentially saying it would turn a blind eye to medical providers who want to use popular videoconferencing apps for telehealth during the pandemic. Doctors should feel free, the government said, to use everything from FaceTime to Skype to treat patients. It specified, however, that they may not use TikTok. Seriously.
Suddenly, therapists didn’t have to scour obscure corners of the internet for a videochatting software that complied with arcane rules about patient records. And rather than download some clunky telehealth software, patients could now simply toggle between their work Zoom meetings and Zoom therapy. “Prior to COVID-19, if you were going to be providing telehealth, the expectation was you were going to really do your research; you were going to make sure that you have a product that meets the type of requirements to ensure privacy and security,” Bufka said. But with the start of the pandemic, “it was clear that requiring that level of vetting … was really going to slow down the transition and really disrupt continuity of care.”
But the rapid transition to telehealth hasn’t been entirely seamless. For patients who are cooped up with their family members, finding a quiet place to Zoom with a therapist—and potentially complain about those same family members—can be hard. Therapists may have trouble reading emotions over the phone, so they may risk not picking up on important cues about imminent crises. For some disorders, being in the same room as the therapist is part of the treatment. And some cybersecurity experts warned me that there’s a small but real risk that virtual-therapy sessions could be hacked and personal medical data could get stolen.
Read: Work from home is here to stay
It’s not clear whether the relaxation in payment and HIPAA rules for teletherapy will continue after the pandemic ends. Still, while it’s unlikely that all therapists will go fully remote once meeting face-to-face is safe again, there are a few signs that virtual therapy is here to stay. Like working from home, Zoom therapy is a perk that might be hard to claw back from people who have been enjoying it. And there might be more coronavirus-related shutdowns to come, so if the federal government rescinds the new telehealth rules, it might be forced to simply re-implement them. Some experts even envision a future in which telehealth “clinics” spring up that would let you see a therapist or any other doctor with just a few clicks. The explosion in virtual therapy could be “a beacon for what we could do post-pandemic, if we ever get there,” Terry told me.