Technology allowing Carson City doctors to continue seeing patients

Widespread use of telemedicine is letting Carson City’s medical community continue to see patients during the coronavirus crisis.

Physicians and other medical personnel with Carson Tahoe Health, Carson Medical Group and Nevada Health Centers — the city’s major medical practices — are all keeping up their appointment schedules by seeing patients remotely whenever possible.

“When the news of the coronavirus or COVID-19 hit, we were inundated with calls from patients initially wanting to cancel,” said Dr. Susan Knowles, a rheumatologist with Carson Tahoe Health.

Many of Knowles’ patients are elderly and some use medicines that suppress their immune systems so they were, understandably, worried about being exposed to the virus if they went to a physician’s office.

Two weeks ago, Carson Tahoe Health turned to telemedicine and to Zoom, an application for videoconferencing on the web.

“We were able to get up and running in two or three days,” said Don Hemerson, practice manager for Carson Tahoe Health’s Eagle Medical Center and its endocrinology and rheumatology practices. “We’ve seen 1,600 patients by telehealth appointment in the last two weeks.”

Most practices are rescheduling routine annual exams for patients without medicines to the summer and relying on remote visits, both via the web and by phone, for patients whose conditions require monitoring.

“If they’re diabetic or have high blood pressure or other chronic conditions we need to see them,” said Ally Rogers, RN supervisor with the Carson Tahoe Health practice.

Patients speak to the office by phone and are then sent a link by email to install Zoom. At the time of the appointment, the patient works with a medical assistant first to ensure the technology is working and to take down medical information just like during an office visit.

The technology obviously has its limitations. Certain vital signs can’t be taken and physicians can’t always administer the type of exam they would in the office.

“I can’t touch their joints, but it’s actually been very efficient and easier in some ways,” said Knowles.

Some of her patients come from Hawthorne and Lovelock and this has been more convenient for them.

The technology also allows multiple people to conference in which means family members can be involved when they might not have been otherwise.

“A great example is a dementia patient in assisted living,” said Rogers. “The assisted living tech can Zoom in and family members, too.”

Nevada Health Centers was already using telemedicine in its offices, where patients could see a remote doctor using a telehealth station, so the practice was able to launch home visits immediately.

“We were getting ready to launch home-based telehealth about the same time COVID-19 broke out. So, fortunately we were able to get it live very quickly,” said Corie Nieto, director of telehealth services.

Physicians and medical assistants there are now remotely seeing about 60 patients who are at home per day.

“Patients are extremely happy with the service,” said Nieto.

Medicare has strict guidelines for telemedicine use but in early March, as part of the federal legislation to address the coronavirus emergency, the U.S. Congress allowed Medicare to waive rules about locations and phone use.

No one knows if Medicare plans to loosen the rules after the coronavirus emergency is over.

“There is a place for this after the crisis,” said Hemerson. “We’ve seen the benefit of how we can best serve the patient.”