Various forms of digital health care have been available in Canada for several years, but I’d argue nothing has accelerated the awareness, need and adoption of these services more than the current coronavirus pandemic.
No one has been untouched by this pandemic, which has compelled us to rethink our previous ways of doing things in the interest of public health and for our own health and safety.
Traditionally, we’ve treated our physical and mental-health issues in silos. If we’re having digestive difficulties, we see a doctor; if we have mental-health issues, we see a psychologist or psychiatrist. But the mind and body are so interconnected that an issue with one can impact the other. Most people are aware that chronic medical conditions and pain often impact one’s mental health, but it also goes the other way. Something that starts primarily as a mental or emotional issue can actually manifest as physical symptoms in the body ranging the gamut from skin irritations to back pain.
There’s mounting evidence suggesting that Canadians are being overprescribed medications, which sometimes cause side-effect symptoms requiring even more medication. Many patients want a quick fix without any effort, but chronic disease management and recovery often requires a multifaceted approach. According to the Mental Health Commission of Canada, about 25 to 50 percent of people living with a chronic illness will also suffer from depression.
Chronic disease management often requires an approach consisting of mental-health support, a healthy diet, regular exercise, reducing alcohol and drug use, meditation and other behavioural changes in addition to medication. Mental-health support in chronic disease management is key because patients who have anxiety or depression are often less motivated to focus on critical self-care practices. Even primary care physicians who are adept at treating the whole patient with these different modalities are challenged to coordinate the treatment required on a timely basis.
Some digital health service providers are developing concierge-like solutions to treat the whole patient, not just the presenting symptoms. These providers are bundling virtual health care with mental-health support, employee assistance plans, internet cognitive behavioural therapy, mindfulness, meditation and more — all facilitated by one central point of contact.
Let’s say a patient makes an initial contact with a virtual health service because they have a persistent skin irritation. During the course of the consult, the doctor asks if the patient is dealing with any other stress or issues that may be exacerbating the symptom. The patient reveals they have been dealing with a marital breakdown and also experiencing bouts of depression and insomnia. The treating physician or nurse practitioner is able to prescribe medication to help alleviate the skin irritation and also refer the patent to a psychologist, EAP or iCBT, which is all part of the same service provided by their employer.
The patient isn’t only able to get some relief from the initial presenting symptom, but they’re also able to start getting help for the root cause (depression and insomnia) that may have otherwise gone untreated and lead to work performance challenges, absences, disabilities and other health problems.
While these all-encompassing digital health services do require an investment from employers, they provide employees and their families with a holistic approach that goes beyond the traditional health-care models to treat all that ails them, not just what’s bubbling up on the surface.