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TMS&Covid-19 case story from Texas: More patients than ever

Salience TMS Neuro Solutions continues to provide TMS treatment during Covid-19

salience quote sidebox Joseph Kriske

Salience TMS Neuro Solutions is a large group of psychiatric practices based in Texas, USA. TMS therapy constitutes the core of their treatment platform for depression patients. Salience TMS Neuro Solutions have now, as a direct result of the Covid-19 pandemic outbreak, promptly introduced a wide range of procedures in order to continue providing treatment as safely as possible for both the staff and the patients they care for.

Joseph Kriske, Director of Clinical Research and Development, and based in Plano, Texas, here explains the Covid-19 precautions taken by Salience TMS Neuro Solutions thus far.

Extended sanitizing procedures

First and foremost, Salience TMS Neuro Solutions have implemented a range of extensive sanitary procedures: This means that the treatment room and all surfaces are sanitized between each patient, including the tablet which the patient uses for filling out surveys. All electronics like keyboards, touch screens, etc. sanitized frequently even per user. Cleaners used are mainly virucides/bleach of CDC grade (Centers for Disease Control and Prevention). He mentions, that a tight coordination and management of PPE and sanitation supplies to maintain these procedures for both a foreseeable and unforeseeable future has been vital.

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Pre-screening of patients

When screening patients, the Salience TMS Neuro Solutions staff wears face and eye protection, gloves, and keeps the required distance. All patients, both new and daily, must undertake thorough pre-screening before admission to the clinic. This include screening for possible symptoms and travels. Temperature checks are conducted for any new and daily patients using infrared/noncontact thermometers. New patients are pre-screened over the phone before they even travel over.

Treatment without waiting

– When patients arrive to the clinic, they no longer wait in lobby, says Joseph Kriske. – Instead, they are taken directly to a dedicated sink or sanitizing station, and then from there to the TMS treatment room. Most of our facilities may have a dedicated separate TMS entrance to limit overall exposure. During treatment, all staff wear gloves and face mask and the patients wear face masks. Staff changes out gloves after sanitation between each patient and dispose all used PPE and sanitization supplies accordingly. Doors are propped open where possible to limit surface touching/exposure. Patients are asked not to touch any surfaces but the treatment chair and tablet for surveys.

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Online-based patient-information

– In order to limit physical interaction while at the same time still being available for our patients and our partners, we now offer teleconsultations for patient education, tele-evaluations by providers for TMS, and online psychiatry in general which are now all commonly used for day to day appointments, says Joseph Kriske. He further adds that patient information is now only shared digitally which means that printed matters such as pamphlets or guidebooks are no longer handed out physically. Patient education to discuss and answer patient questions on Covid-19 and how to respond to such enquiries have also been developed, for instance with a dedicated Covid-19 information center on the website.

Staff screenings

A series of procedures for staff members have also been implemented. – All our staff gets a temperature screening twice a day and must confirm that they do not have symptoms. A staff member showing any signs of any symptoms, even unrelated to Covid-19, must be sent home and cleared by physician before returning, or following all CDC guidelines of course, says Joseph Kriske. Joseph Kriske further points out that that providers who themselves may be at increased risk due to age or being immunocompromised have had their motor threshold mappings adjusted to minimize risk like wearing face shields, gloves, N95 face masks, and maintain as much distance from patient as allowed for accurate measurements. Mappings are often now done in only our largest rooms and no longer allow the patient’s spouse or therapy partner during the doctor portion.

Very positive patient feedback

The patient feedback from these changes have so far been “overwhelmingly positive”, according to Joseph Kriske, who stresses that patients, providers, and staff will continue to receive regular updates on covid-19 related issues. He is optimistic that it will be possible to stay open throughout the pandemic:

– We’re doing all we can to maximize staff and patient safety and the patients see that clearly. We’ve seen many more patients than usual and they thank us for our ability to treat them through their difficult journey and appreciate our enhancements to remain open. Patients now often comment about how TMS is one of the biggest factors to help them better cope with the stress and isolation the pandemic brings. There are of course many concerns about what the future holds for the pandemic becoming a bigger mental health crisis, but our team and centers across Dallas and Houston remain focused on achieving functional remission and minimizing possible suicides and community loss, concludes Joseph Kriske.

Salience TMS Network

  • Etablished: 2011
  • Number of TMS clinics: 14 (all based in Texas)
  • Number of employees: 95
  • # of TMS treatments to date: 250,000+ (May '20)
  • Response rates: >70%
  • More information:


The views and opinions expressed in this article do not necessarily reflect the official policy or position of MagVenture or any of its affiliates. The usage of rTMS for any other purpose than the cleared indication, in the country in which the product is intended to be used, is considered investigational.

Covid-19|Corona: Please follow the guidelines from your local government and/or health authorities.

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