Telemedecine has come to Eastern Plumas Health Care. That means a step forward in terms of patient care in this small, rural community. The video screen is, in effect, a window to the world, with the patient on one end and the psychiatrist, diabetes health educator, pediatric intensivist, or other medical specialist on the other. But, what does this mean to the patient, who is used to being seen by a human being?

Lucie Kreth, an EPHC Board Member, decided to try the telemedicine option when her Endocrinologist retired. She’s sharing her experience so that other patients might feel at ease in choosing a telemedicine health care provider.

Kreth was tired of traveling to Reno to see her doctor; she was “in the market,” she said, “looking for someone new. It’s definitely nice to stay close. I hate going to appointments in Reno.” Kreth has been seeing an Endocrinologist for nearly 30 years as part of her continuing care after thyroid removal. Previously, her thyroid has grown back and she needed follow up surgery.

Currently she has a nodule, which she believed indicated that her thyroid had grown back again. Her new telemedicine Endocrinologist, Dr. Nelson Madrilejo, was provided with her recent biopsy results and her medical record. Cindy Korkeila, EPHC’s former Telemedicine Coordinator, scheduled the appointment, made sure Dr. Madrilejo had Kreth’s patient information, and set up the telemedicine cart and equipment for her appointment.

Kreth wondered how her new Endocrinologist would compare to her old, in the flesh doctor in Reno. First of all, Kreth said there was some adjusting of the telemedicine equipment (both doctor and patient had a technician with them who was trained on the equipment), but once things were in place, she was amazed how she was able to hear him as clearly and interact with him as well as if he was in the room.

Dr. Madrilejo wanted to look at her throat, said Kreth. “He zoomed the camera in on my throat to see the swelling.” He confirmed her thyroid had grown back. Kreth said he had the ultrasound report in front of him, so he knew how big the nodule was. “He just wanted to see it for himself,” she added. “And, he knew what he was looking for.” In fact, she said the exam was very similar to one her old Endocrinologist would have done.

Afterwards, Dr. Madrilejo ordered lab work, which is sent via a secure internet connection and becomes part of her electronic medical record. It also shows up as a pending order in EPHC’s Portola lab, so she can have it her lab work done close to home, as well.

Kreth said Madrilejo was very friendly and really took his time with her. This helped to put her at ease. He “asked me all the same questions the old guy used to ask,” she said. “It’s not formidable, nothing scary. It’s just a computer screen—looks like a robot.”

She felt quite comfortable with both the doctor and the process. “It was an interesting experience,” she said. “I’d definitely do it again.” Kreth said she’d like to know where her doctor is located physically, however, as would help her feel more connected to him.

Thanks to Kreth’s suggestion, EPHC’s Telemedicine Coordinator, Mark Schweyer, plans to create laminated biography cards with a photograph and the medical background of each telemedicine physician. It will include their physical location. For example: Dr. Nelson Madrilejo, Endocrinologist, has been in practice for over twenty years. He has completed fellowships in Diabetes and Endocrinology at the University of Southern California (USC). Madrilejo works for Clinicians Telemed in Bakersfield, CA.

Patients are referred for telemedicine appointments by their primary care provider. For more information and to have questions answered regarding telemedicine at EPHC, patients may call 530.832.6605.