Who’s really using telemedicine

When COVID-19 forced health care providers to rapidly pivot in March 2020, telemedicine transformed overnight from a niche service to a mainstream necessity. Virtual visits surged from less than 1% of all outpatient encounters to nearly 17% within weeks, fundamentally changing how patients access care.

Now, five years into this transformation, crucial questions emerge: Has telemedicine become a permanent fixture in health care delivery? Who benefits most from virtual care access? And perhaps more importantly, who is being left behind?

This analysis draws from a comprehensive telemedicine dataset—over 46 million patient encounters across a major health system from 2019 through 2024. The findings reveal a complex story of innovation shadowed by inequality. While telemedicine has stabilized at sustained levels well above pre-pandemic baselines, significant disparities persist across age, race, income, and geography.

For clinicians, understanding these patterns is critical. The patients who could benefit most from virtual care—older adults, those living far from medical facilities, individuals with complex health conditions—are often the least likely to access it. Addressing these gaps will determine whether telemedicine fulfills its promise of expanding healthcare access or deepens existing inequities.