The adoption of telemedicine shifted into hyper-drive over the past month, with virtual health-care interactions on pace to top 1 billion by year’s end, according to analysts at Forrester Research. That would represent a massive expansion from telemedicine usage before the coronavirus pandemic.

“There were three barriers that impacted the lack of adoption, or the slowness of adoption, before the pandemic hit. We saw cost … availability … and then we also saw relationships playing a factor,” said Forrester analyst Arielle Trzcinski. “If a patient was able to see their existing provider, they were much more likely to use the service.”

Those barriers collapsed dramatically last month after President Donald Trump declared a national state of emergency after the COVID-19 outbreak hit the U.S. The administration also strongly urged doctors and patients to avoid in-person visits and instead use telehealth visits to help prevent the spread of the virus.

“President Trump talking about the benefits of virtual care, I think, helped reduce one of those barriers that we found in our research of awareness,” said Trzcinksi.

March telehealth visits surged 50%, according to research from Frost and Sullivan consultants. Telemedicine providers such as Teladoc reported a spike in video requests to more than 15,000 per day.

Forrester analysts estimate coronavirus-related virtual visits could top 900 million this year, based on current projections for COVID-19 infections in the U.S. Analysts now expect general medical care visits to top 200 million this year, up sharply from their original expectation of 36 million visits for all of 2020.

Health insurers and hospitals have made a strong push for patients who have milder symptoms to use their telehealth platforms during the crisis to help alleviate the strain on emergency rooms and doctors’ offices.

The Trump administration also reduced a major cost barrier for telemedicine adoption by smaller physician practices as it declared Medicare and Medicaid would pay the same rates for virtual visits as for in-office appointments. The administration also temporarily eased regulations to allow the use of their mobile devices for virtual visits.

“It’s a profound change, and it’s faster than anything I’ve ever seen,” said Dr. Bob Murry, chief medical information officer at telehealth-platform provider NextGen Healthcare. 

In areas hard-hit by COVID-19, such as New York and New Jersey, doctor’s offices have had to offer virtual appointments only as their states enacted shelter-in-place orders and asked physicians to curtail nonessential office visits.

Murry, who holds office hours once a week at a small family practice in New Jersey, has switched his own office appointments to virtual-only.

“These virtual visits are literally a lifeline for the business of the practice, and then the real lifeline for the patients, because otherwise those people would not be able to be seen,” said Murry.

For smaller practices, telehealth reimbursement rates rules will be a big factor in determining whether they continue with the trend. There may be pressure on Washington to maintain higher rates for telehealth once the emergency has passed.

Right now, accommodating the new flood of patients seeking virtual care remains a challenge for both small practitioners and larger telemedicine providers alike.

“They are seeing high demand, they’re not necessarily able to provide the supply necessary, and so we’re seeing long wait times … to try and get to a provider,” said Trzcinksi.

Ironically, those logjams are putting telemedicine very much on the same footing as in-office visits, where patients often experience long waits to get appointments.