The telehealth gold rush is over. The platforms that launched on venture capital and optimism in 2020 and 2021 have mostly merged, pivoted, or closed. What remains is a more stable market with clearer options — and clearer trade-offs.
For practitioners choosing a telehealth platform today, the decision is more straightforward than it was three years ago. It is also more consequential. The platforms that survived have larger installed bases, more entrenched workflows, and higher switching costs than their predecessors. Choosing badly means a more expensive and disruptive migration when you eventually decide to change.
The good news is that the consolidation has made the comparison easier. You are choosing between a smaller number of serious options, each with a documented track record. The bad news is that the marketing has gotten better as the product differences have gotten smaller. You need to know what actually matters.
What you actually need from a telehealth platform
Before comparing platforms, be precise about what a telehealth platform needs to do. The core requirement is simple: reliable video connection, HIPAA-compliant data handling, and a client experience that does not create unnecessary friction.
Everything else — waiting rooms, session recording, integrated scheduling, client messaging, wellness check-ins — is convenience, not necessity. The platforms that charge most for these features are often the ones whose core video quality is weakest. That is not a coincidence. It is a product strategy.
Fortinet’s analysis of HIPAA-compliant telehealth platforms identifies video quality and reliability as the essential baseline: crystal-clear video and audio with minimal lag, on a platform that handles data transmission securely. The AccountableHQ comparison of HIPAA-compliant telehealth tools adds that HIPAA compliance centers on administrative, technical, and physical safeguards backed by a signed Business Associate Agreement — not just a checkbox on the platform’s signup page.
Ask for the BAA before you sign up. Read it. Know what it covers.
A telehealth platform that drops connections is not a telehealth platform. It is a liability.
— Renata Lima, Business & Therapy
The platforms worth considering
SimplePractice Telehealth is the obvious choice if you are already using SimplePractice for practice management. The integration is seamless — scheduling, client communication, and video all live in the same system. The client experience is clean and requires minimal technical literacy from clients, which matters more than practitioners typically account for when evaluating platforms. Video quality is reliable.
The limitation is ecosystem lock-in. SimplePractice’s telehealth is integrated with its practice management system in ways that make separation difficult. If you ever decide to leave SimplePractice, you lose the telehealth integration and need to migrate both systems simultaneously. For practitioners who are confident they will stay in the SimplePractice ecosystem long-term, this is not a concern. For practitioners who are uncertain, it is worth weighing before committing.
Doxy.me remains the best standalone option for practitioners who want a simple, reliable video platform without practice management bundled in. Its free tier is genuinely functional for solo practitioners — not a crippled trial version, but a full HIPAA-compliant platform that covers the core use case without cost.
Sermo’s 2024 benchmark review awarded Doxy.me GHP’s best telemedicine platform of 2024, with users consistently citing HIPAA compliance and seamlessness as primary advantages. The free tier’s limitations — no custom waiting room, no session recording, basic branding — are real but rarely consequential for solo practitioners whose clients are primarily connecting for a single scheduled session.
The paid tiers add features that most solo practitioners do not need. If you are a solo practitioner who does not already have a practice management system with integrated telehealth, Doxy.me free tier is where to start.
Zoom Healthcare is worth considering for group practices that need to run multiple simultaneous sessions, have complex scheduling requirements, or need strong recorded session functionality. Its video infrastructure is the most battle-tested of any platform on this list — Zoom’s core technology handles more video traffic than any purpose-built telehealth platform. For group practices with multiple clinicians seeing clients concurrently, that infrastructure reliability matters.
The downside is complexity and cost. Zoom Healthcare is a more expensive and more complicated platform than most solo or small group practices need. The Curogram telehealth comparison positions it alongside Doxy.me and SimplePractice as a top-tier option, but notes that the right choice depends on practice size and scheduling complexity. For solo practitioners, it is almost always overkill.
What to avoid
Avoid platforms that bundle telehealth with clinical content libraries, coaching tools, or client-facing wellness apps. Actuvi’s definitive guide to telemedicine software makes this point directly: the bundling is almost always a sign that the core telehealth functionality is not strong enough to compete on its own. Bundled platforms are rarely best-in-class at either component.
Avoid platforms with per-session pricing if you have a consistent caseload. The math does not work in your favor once you are seeing more than eight to ten clients per week. Monthly flat-rate pricing is almost always the better structure for an established practice, and the per-session pricing model is designed to look attractive at low volume and become expensive at the volume a functioning practice actually requires.
Avoid any platform that is unclear about its BAA, data storage practices, or what happens to session recordings after they are processed. If the sales team cannot answer these questions clearly and specifically, the compliance team has not built the answers yet.
Evaluating what you cannot see in a demo
The demo is not the test. Every platform looks functional in a demo. The test is what happens at 3pm on a Tuesday when you have back-to-back sessions, your client is on a mobile connection, and the platform decides to update its software mid-session.
The questions to ask practitioners currently on the platform:
- How often do you experience dropped connections or video quality issues?
- How responsive is support when something goes wrong during a session?
- Has the platform made changes that disrupted your workflow without notice?
- What has pricing looked like over the past two years?
Ask these questions of practitioners who have been on the platform for at least eighteen months. Six-month users are still in the honeymoon period. Eighteen-month users have seen the platform under pressure.
The verdict
For solo practitioners: Doxy.me free tier if you do not have an existing EHR with integrated telehealth. SimplePractice Telehealth if you are already in the SimplePractice ecosystem and plan to stay there.
For group practices with complex scheduling needs: Zoom Healthcare.
For everyone else: do not overcomplicate it. The platform that works reliably and does not confuse your clients is the right platform. The feature list is secondary. The connection quality is primary.
The platform that drops connections is not saving you time. It is costing you therapeutic alliance.
Do you have additional information about telehealth platforms, reliability benchmarks, or HIPAA compliance requirements? We update our articles and research regularly. Contact our editorial team with corrections, updates, or sources.