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Introduction: It's Your Health Radio, a special podcast series presented by Henry Mayo Newhall Hospital. Here's Melanie Cole.

Melanie Cole: As a result of the pandemic and with the advancement of technology, we've seen incredible changes in the way patients and providers are able to manage healthcare. Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole and joining me today is Dr. Jordan Michelena. He's a Family Medicine Physician and a member of the medical staff at Henry Mayo Newhall Urgent Care. Dr. Michelena, it's a pleasure to have you with us. And this is such a great topic during the pandemic. There's been a big shift to telehealth. How are you and your team evolving care for your patients during this pandemic? And how has the pandemic made you more innovative, creative, and transformed the way you offer care to patients?

Dr. Michelena: So with the pandemic, you know, people have been, you know, more afraid of coming out, rightfully you know, being concerned that they could contract COVID or be exposed to it and then expose their family members to a disease that can be fatal at times. And so here at Henry Mayo Newhall Urgent Care, we've tried to alleviate those fears by providing an additional service of telemedicine, which is a visit and much like a visit with your doctor or the urgent care doctor in the clinic, but utilizing a video telecommunications, to be able to have a face to face visit with a doctor here at the clinic. And that has allowed us to help make diagnoses of COVID-19. It's also allowed us to see patients who are at most risk for contracting that disease. And then also to see people who have just needed routine medical care and who just have difficulty coming to the doctor due to being, you know, an essential worker or not having the opportunity to come because of some other risk factor in their medical health.

Host: So urgent care versus the ER and people aren't really sure when it's appropriate to schedule a telehealth appointment. And it may even keep some people from going to the ER, when they need emergent care, tell us what is appropriate for telehealth.

Dr. Michelena: Yeah. So as you may be aware, you know, there's a difference between emergency and urgency. Emergencies are things are life threatening, you know, heart attacks, strokes, appendicitis, you know, sepsis, those types of things where the emergency department would be a better choice for you. And you really need to have that face to face, you know, direct physician contact, whereas an urgent care, we try to deal more with things that you would probably otherwise see your primary care doctor for. And, but it needs to be addressed sooner than you can get an appointment with your primary care doctor, telemedicine, things that are more appropriate for that would be kind of those same things for urgent care, but things that you don't necessarily need to be face to face with the patient, or you don't have to be in direct contact with them. You know, it's difficult to look inside somebody's ears through a television monitor, or it's difficult to, you know, push on somebody's abdomen to rule out appendicitis. So those things are probably best to be seen in urgent care, but things like colds or urinary tract infections that you've had before, or refills of medicines, you know, those things we can evaluate through a telemedicine visit.

Host: So tell us how someone would prepare suppose they're calling you because they think they have pink eye or something. Does this require tech savvy? What kind of device is good to use? Tell us a little bit about how the process works?

Dr. Michelena: Right. So over here, Henry Newhall Urgent Care. What we do is we use an app that is usually done through something like an iPad or through your phone. And it just requires you to have a camera on the application. So it could be a web cam through your computer. It could be the camera on your phone. It could be the you know, camera on your iPad or other electronic device. As long as you're savvy with those things, then it should not be difficult. What we have you do here is through our website, you're able to click on request a telemedicine visit, and then our front office staff help to walk you through that process. Usually what we require is a form of identification and then your insurance card. So those need to be uploaded to our program to make sure that you're in an insurance carrier that we accept here. Otherwise we can do cash visits as well, for telemedicine. And then the next step would be to download the application and then click on the link in your email to start the visit. But the nice thing about having it through our office is that you can call our number at any time, if you get stuck throughout the process, it does help a little bit. You know, if you're somebody who has a hard time with technology, it does help to have somebody there though, who is a little bit more familiar with how to navigate through emails and to navigate through downloading applications onto, you know, your phone or onto an iPad or something like that.

Host: Well, that certainly is true. And it's also offered some unexpected benefits. Dr. Michelena such as treating non high risk COVID patients, maybe screening. You can increase the physician supply through geographic load balancing. Tell us a little bit about something that you found unexpected as a benefit of utilizing telehealth now.

Dr. Michelena: Yeah, so I mean, it is helpful, and especially here in Santa Clarita, where a lot of times our population of patients, especially at an urgent care isn't always, you know, within a five or 10 minute drive, you know, a lot of times we'll see people from Frasier Parker, we'll see people from Palmdale or even from Ventura and, you know, rather than them having to drive all the way over here to get a refill on their blood pressure medicine or for them to get screened for COVID-19, you know, at an hour that may not be able for them to do it otherwise. I found that, you know, a lot of times we'll have people from, you know, 60 minute drive away who will utilize that surface and really prefer it over having to come in for very basic you know evaluations that can be done face to face through a telecommunications outlet like we use here.

Host: I think so, too. And do you think in your own personal opinion, Dr. Michelena that you'll see that this will stay as a form of healthcare now that as you say, some people who didn't want to make an hour drive were able to utilize a telehealth visit, get the care that they need, perfectly satisfied without having to come in and do the whole thing. Do you think that this is something that'll stick around?

Dr. Michelena: I think so. I think even before we had COVID-19 people were utilizing telecommunications, they were using, you know, other forms, even their insurance carriers we're advertising that even before this to just make things more convenient. And I think with the way that our society is where it was such a high pace, and people are having a hard time just sticking to that nine to five kind of schedule that their primary care doctor maybe having. And then they have a hard time getting to a facility just because of where they live, the remoteness of it or something. I think that they're going to more often than not push towards this type of medium, a little more than the face to face. Obviously, if you have a laceration or if you have something like that, yeah. You do need to come to the urgent care to get that fixed up. But you know, a lot of times we can deal with things over the video telecommunications, which, you know, sometimes people confuse that with the telephone. It's not, you know, the telephone is okay, but a lot of times you really just need to see the other person face to face to get an idea as to the illness and the sickness and what's going on with them.

Host: It's really amazing the way that healthcare providers have become more innovative. So wrap it up for us, Dr. Michelena and let people know about telehealth at Henry Mayo Newhall Hospital. And when you feel it's really appropriate that they can use it, if their parents and their kids are worried about, you know, like I said before, pink guy, or they've got a little rash or something wrong with their toe, whatever it is, the things that they can use telehealth for.

Dr. Michelena: Yeah. I think it's I think it's just another toll in our arsenal, I think is how I would put it. You know, you have the emergency room, you have urgent cares. You have your primary care office. You have, you know, telehealth, you have, you know, nurse hotlines. I think the nurse hotlines are okay, but I think telemedicine visit is kind of that next step above that, where you can talk directly to a provider and they can tell you, you know, I really think you need to be seen or, you know, this is something that we can treat over the phone. A lot of times, you know, things that you can visually see through a monitor, a work really well. So like rashes, like you said, you know, conjunctivitis, sometimes even sore throat. So you can see into the back of the throat, abdominal pains, you know, a lot of times what the doctor receives through your history, it helps to define where we need to go from there. You know 70% of the time, what you tell the doctor is what's going to help formulate the diagnosis. And then the further 30% of the time it's by laying hands on the patient. And so, you know, if somebody is good at providing a good thorough history, then that really makes it easier for telehealth to be the source for you. But like you said, rashes, conjunctivitis, things that are visual, those are probably the best things for telehealth.

Host: Absolutely. And thank you so much, Dr. Michelena for joining us today and telling us about telehealth and urgent care at Henry Mayo Newhall Hospital. To schedule a telehealth visit at Henry Mayo Newhall Urgent Care, please visit HenryMayourgentcare.com. You can also call (661) 200-2500. That wraps up this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. If you have concerns, we encourage you to check the Henry Mayo website at henrymayo.com and click on the virus link at the top of the page for more info. Please remember to subscribe, rate and review this podcast, and all the other Henry Mayo Newhall Hospital podcasts. I'm Melanie Cole.