As employees continue to drive the conversation around benefits and care in the wake of COVID-19, one trend is proving its staying power: telemedicine.

In 2019, 69% of businesses with more than 50 employees offered telemedicine benefits, according to the Lively 2019 Wellness and Wealth report. At the same time, just 11% of consumers were utilizing telehealth prior to COVID-19, according to McKinsey.

When COVID hit, everything changed. In the last week of March 2020, telemedicine visits spiked by 154% compared to the same period in 2019, according to data from the Centers for Disease Control and Prevention. Those meteoric highs declined somewhat in the following months, but demand for telemedicine services remained higher than pre-pandemic levels, according to data from the Employee Benefit Research Institute (EBRI), which recently examined the trends in telemedicine between 2016 and 2020.

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“Even after stay-at-home orders were lifted and health care providers resumed conducting in-person visits, telemedicine engagements remained above their pre-pandemic trend,” Jake Spiegel, EBRI research associate, said in the report. “This could be evidence of a transformational effect of the COVID pandemic regarding how Americans seek out and receive care.”

Telemedicine users tend to be older and female, according to the EBRI research. Additionally, the majority of telemedicine users had less than three virtual visits with a healthcare provider, an indicator that people use telemedicine services to deal with acute needs or as a bridge for patients with chronic conditions. The research also found that patients were more likely to use telemedicine services to deal with respiratory, and mental health issues.

The EBRI report examined telemedicine usage through two lenses: as a service and as a medium. Telemedicine as a service utilizes third party providers such as Teladoc, Doctor On Demand and MDlive. Telemedicine as a medium is when patients use video conferencing tools to connect with their existing doctors and care providers.

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Telemedicine as a service saw a spike in demand of 87% in February of 2020. As the pandemic stretched on, telemedicine as a medium became the more popular choice. Visits in April 2020 were 50 times higher than those in February.

“These results have important implications for employers,” Spiegel said. “Telemedicine tended to attract patients seeking care for acute, low-intensity, and often self-limited needs. In interviews of benefits executives conducted by EBRI, several interviewees noted that they believed telemedicine could potentially lower their firm’s total health care expenditures.”