What is the Best Telemedicine Platform for Therapy? Here’s What Our Survey Says

Shortly after the COVID-19 pandemic began I started asking colleagues across the country to share their teletherapy experiences by taking a simple survey that let them rate telehealth platforms they had used in terms of reliability, usability and features. I invited therapists from my personal network, as well as those from local and national Reddit and Facebook groups, to participate. Eventually, 46 brave souls answered the call, providing a total of 68 reviews about 16 different telehealth platforms.

Anyone who has taken a graduate level statistics course can tell you that these results lack statistical significance, based on sample size and the non-random selection of participants. (Basically, the better you know me, the more likely you were to take part!) However, this data is valuable and interesting if you treat it as quantified feedback from a test lab/focus group of working therapists who field tested these platforms.

Evaluated Platforms

In an effort to ensure that every telehealth platform evaluated receives some level of collective feedback, this analysis considers only those platforms that were reviewed by at least two survey participants. To view the full survey data, including information about platforms that reviewed by only one participant, see Full COVID-19 Teletherapy Survey Results.

Here are the platforms included in this evaluation of survey results, separating the free and paid versions of platforms where both are available:

• Doxy/Free
• Doxy/Paid
• Google Meet/Free
• Microsoft Teams/Free
• Microsoft Teams/Paid
• SimplePractice/Paid
• thera-LINK/Paid
• VSee/Paid
• Zoom/Free
• Zoom/Paid

Who Participated in the Survey?

The 46 survey participants are all from the United States and practice in eight different states: Ketucky, New Hampshire, New York, North Carolina, Ohio, Pennsylvania, Tennessee and Illinois. The large majority, 38, practice in Kentucky, where I live and work. The participating therapists represent a diverse range of professional licensing, as shown in Chart A.

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Reliability

Survey Question Asked
How reliable has this telehealth platform been in terms of availability and stability when you try to use it?

Participants answered this questions on a 1-to-5 scale, with 1 indicating the lowest level of reliability, and 5 indicating the highest level possible. (Can you tell this survey was designed by a therapist?) When it came to reliability, Google Meet was the winner, with an average rating of 4.5. Right behind, however, was a three-way tie for second at 4.33, with the paid versions of Doxy and thera-LINK, plus the free version of Microsoft Teams. Interestingly, the paid version of Teams was next at 4.25. The lowest rated platform was the free version of Doxy. All of the average reliability rankings are shown in Chart B below.

Audio-Video Quality

Survey Question Asked
How would you rate the average audio and video quality of this telehealth platform when you use it?

Participants answered this question on another 1-to-5 scale, with 1 indicating the lowest average level of audio-video quality, and 5 indicating the highest and most consistent quality. The free version of Microsoft Teams was the winner here, with an average rating of 4.67. Again, Teams’ paid version finished behind its free sibling, coming in fourth with an average rating of 4.25. The free version of Google Meet came in second at 4.5, and thera-LINK was third at 4.33. Doxy’s free product finished last again, at 2.86. Chart C below shows where all the platforms finished.

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Observations and Interpretations

Some interesting themes emerge from these first two questions, both of which address the impact of a platform’s Internet infrastructure, meaning the computers, other hardware, and Internet bandwidth that the provider is dedicating to the service, on the user experience of clinicians and clients. First of all, the ratings suggest that Google, Microsoft and thera-LINK have their acts together when it comes to technology infrastructure. On the other end of the spectrum, you get what you pay for when you sign up for a free Doxy account. While it looks like Doxy might be skimping on the resources dedicated to its free offering, the paid version of Doxy has significantly higher ratings in both areas than its free sibling, suggesting that Doxy puts more technological muscle into serving its paying clients. Also worth noting are the solid scores of SimplePractice in both of these technology-driven scores. Although it didn’t finish at the top of either category, it did have relatively strong scores of 4.0 and 4.14 in each. Zoom, on the other hand, finished lower in both categories, which may be due to its technology infrastructure being overwhelmed by the huge traffic hitting it during the pandemic.

Ease of Use for Clinicians and Clients

Survey Questions Asked
How easy is the telehealth platform for you, as a clinician, to set up and use?
How easy do you think the telehealth platform is for your clients to set up and use?

Both of these questions asked participants to answer them on a 1-to-5 scale, with 1 indicating the lowest ease of use and 5 indicating the highest ease of use. Charts D and E present the average ratings in these areas.

As you can see, the paid versions of Doxy led the way in both these areas. This perceived ease of use for both clinicians and clients probably stems from the fact that Doxy is a product built from the ground up for telehealth, as opposed to an online meeting or collaboration platform being adapted for its use. Not surprisingly, the free version of Doxy finishes far behind its paid sibling, as many features are turned off in the free version, which would likely make it feel less easy to use. SimplePractice proves its mettle again, finishing strong in both usability categories. Also, thera-LINK rates highly for clinician’s ease of use but does not fare so well under client ease of use.

Platform Features

Survey Question Asked
How would you rate the features provided by this telehealth platform? (Client/clinician login, text chat, screen sharing, video background effects, file sharing, device management, etc.)

This question also used a 1-to-5 scale for its answers, with 1 representing a limited, poorly designed feature set and 5 indicating a full, strong body of features. Table F shows the results.

Not surprisingly, two platforms designed specifically for telehealth/teletherapy finish at the top of the feature ratings, with thera-Link checking in at 5.0 and the paid version of Doxy registering a 4.67. Zoom shows its maturity as a full-featured online meeting platform with a 4.14 rating. At the bottom end of the ratings, the stripped down, free version of Doxy finishes in last place, with a 2.79 rating.

Remember that in the world of Internet products, features and functionality are constantly evolving. Since the pandemic elevated the importance of online meetings, Microsoft and Google have been rolling out new features for Teams and Meet on what seems like a weekly basis. However, most of that new functionality is aimed at improving online business meetings, not online therapy sessions.

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Overall/Combined Score

Combining all the scores for the five individual categories produces a highest possible overall score of 25. And the overall winner is… Well, take a look at Chart G to see the winner and how all the platforms stacked up in terms of combined scores.

As you can see, the overall winner was the paid version of Doxy, with thera-LINK close behind. These are two products designed specifically for the job at hand, and both are mature enough to have had time for their feature sets to evolve. At the other end of the list is VSee, itself a paid telehealth platform that does not appear to have grown as strong as its competitors.

Conclusion/Recommendations

According to the experiences reported by our survey participants, both Doxy and thera-LINK provide reliable, full-featured and easy-to-use teletherapy platforms. Of course, you’ll have to pay for either of these options. Doxy offers a $35/month plan for individual clinicians and a more expensive “Clinic” plan that provides a fully customized and “branded” presentation to clients at a price that scales according to the number of clinicians. On the other hand, thera-LINK offers multiple plans, including a basic single-clinician plan for $30/month, as well as several individual and group plans that include other practice management features. If you are looking for teletherapy only, Doxy is probably your best bet from a price perspective.

If you want a free platform you might consider Zoom or Google Meet, which will remain options as long as the HIPPA restrictions concerning telemedicine remain loosened during the pandemic. However, when the government resumes enforcing those aspects of HIPPA, you will once again need a teletherapy platform that is HIPPA compliant, and the free version of Doxy may once again be the only game in town. After HIPPA tightens up again, you might also consider Microsoft Teams if you subscribe to Microsoft 365 (formerly known as Office 365). The Microsoft 365 product, which includes Teams as a component, is HIPPA compliant.