Digital health is a catchall term for online medical applications such as telemedicine and telehealth; and, with the onset of COVID-19, patients and providers have had to rely on digital modes of practice as clinics closed and in-person appointments were limited.The change to digital was necessary to reduce staff exposure to ill people, preserve personal protective equipment and minimize the impact on facilities because of an influx of patient services, according to the Centers for Disease Control and Prevention website. Telehealth services helped provide necessary care to patients, while minimizing the transmission risk of COVID-19 to health care personnel and patients.Dr. Ari Melmed, medical director of telehealth at Kaiser Permanente, said they have been offering video visits, phone chats and emails to communicate with physicians since the 1990s. He said COVID-19 changed what the health care system imagined they could do virtually, as providers and members were challenged to figure out how to make things work via phone, email and video.Melmed said they saw an explosive growth in all of those care channels. ìNow that we hit the high water mark and things are receding, weíre trying to figure out what we want to keep, what makes the most sense and what provides the most value to our members,î he said.There are two categories where telehealth provides a great deal of value, Melmed said.One includes health conditions with low-level symptoms; many times a diagnosis can be determined virtually, along with prescribed treatment for the problem. He said there still might be occasions when the provider needs to take a closer look or†order labs for the patient.†The second category includes patients who arenít quite sure if and how soon they need to be seen for something like a lingering cough, Melmed said. They often have questions about the seriousness of the cough, etc. Should they go to the emergency room? Can they wait for an appointment? Input from a medical professional at that moment is invaluable, Melmed said. People sometimes underestimate the severity of their symptoms, and it is always worth having a conversation with their provider even if it turns out to be non-threatening, he said.The medical field has tight security standards to control virtual medical information, Melmed said. ìWe take that very seriously; and therefore have our own secure platform built into the health care app and web page that connects doctors and patients in a secure video connection,î he said.They found that younger people tend to prefer video and chat, while older folks prefer email and phone, although people of all ages use all modalities, Melmed said. There is also a strong predominance of women who use telehealth, which is a national trend, he said. ìWe donít completely understand it, but thatís the way it breaks down; other Kaiser regions and telehealth organizations have also reported an almost two-thirds to one-third breakdown of women to men,î Melmed said.There is still a strong preference of phone over video, which creates a disadvantage. Visual cues that a provider can get from a virtual visit is valuable. A personís physical cues can help a provider make the most accurate assessment, he said.Providers are also incorporating information from digital health wearables such as the Fitbit, which can monitor glucose, and home pulse oximeters and so on. He said they are finding that the accuracy of those devices is significant.Telehealth has been a greater value for members who live in rural communities than possibly any other group of people, Melmed said. It not only saves them driving time, but they can find out from their home whether their symptoms are an acute concern with a need to make a follow-up appointment.ìThe other thing to remember during a virtual visit is the possible co-pay because patients are getting professional advice during a professional encounter, just like an in-person visit,î he said.Melmed said they encourage patients to try telehealth if they havenít already.Sheryl Salter of Falcon said telehealth allowed her family to continue with appointments that could not have occurred during the pandemic. Plus, it saves on travel time when the office is on the other side of town, she said. ìThe biggest issue we have faced is the actual technology of it; some of the platforms are more user-friendly, some providers are more tech savvy than others, and some internets handle it better,î Salter said. ìItís not an ideal replacement for visiting the doctorís office, but itís a great supplement.îìWhatís not to love about telehealth,î said Angela Bissell of Black Forest. She said she used telehealth a couple of times pre-COVID, and has continued to meet with her providers via virtual appointments or phone, especially since the onset of COVID. ìIt was the only way I felt comfortable meeting with my doctors,î Bissell said. She said the pros of telehealth include a lesser financial costs, no emergency or wait times, the absence of exposure to contagions ó and the ìappointmentî can take place anywhere there is internet access. About cons of using telehealth, Bissell said, ìHonestly, there just arenít any I can think of.î
