MED Magazine September/October 2021

Making Sense of the Information Blocking Rule High-Tech Approach to Wounds in Brookings

BUILDING THE HOSPITAL OF THE FUTURE . . . NOW

Dr. Jeremy Cauwels

Dr. Luis Garcia

SANFORD’S BOLD VISION FOR RURAL HEALTHCARE

THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

SEPTEMBER OCTOBER

Convergent Ablation at Monument Health

VOL. 12 NO. 6

2021

When one number connects you to the region’s best pediatric specialists, Anything can be.

1.855.850.KIDS (5437) is your 24-hour link to pediatric specialists for physician-to-physician consults, referrals, admissions and transport.

Care

•

Advocacy

•

Research

•

Education

Naloxone can save lives.

Many overdose situations are unintentional.

Having access to naloxone is critical.

Promote naloxone education & make sure your patients know how to get it.

If your patients have opioids in their homes—they are at risk for overdose. Keeping naloxone on hand can reverse an overdose and save lives. The SD Standing Order makes it easy for your patients to get naloxone from participating pharmacies.

Encourage your patients to keep their families safe.

Help them understand:

• Naloxone is a safe medication used to reverse an opioid overdose.

• ANYONE can administer naloxone.

• There is no potential for abuse, and side effects are very rare.

• Naloxone is available statewide at participating pharmacies.

• If they can't afford naloxone, their pharmacy can help them

Refer your patients and their families to the

Resource Hotline 1-800-920-4343

It’s FREE, confidential, and available 24/7

get it for FREE!

For more information on naloxone, the State Standing Order, or key data, visit AvoidOpioidSD.com Brought to you by the South Dakota Department of Social Services. Funding made possible through a Substance Abuse and Mental Health Services Administration (SAMHSA) grant.

Nothing in this PSA constitutes a SAMHSA endorsement of content, services, or policies.

VO LU M E 12 , N O. 6

■ S E P T E M B E R / O C TO B E R 2021

Inside This Issue

CONTENTS PAGE 5 | The Information Blocking

Rule Understanding ONC's new rule about access to patient medical records ■ By Copic's Patient Safety & Risk Management Department PAGE 6 | [Sponsored Content]

ON THE COVER

BUILDING THE HOSPITAL OF THE FUTURE ...NOW ■

By Alex Strauss

Brookings Health System's Wound Center An all-encompassing, full-serve outpatient facility providing advanced wound care for patients presenting with a variety of non-healing wounds.

PAGE 8 | This Month Online

Upcoming events, SD's US News Ranking, Exclusive online articles, a local colorectal practice thriving in the wake of COVID PAGE 12 | NEWS & NOTES

Earlier this year, Sanford million initiative to

A comprehensive roundup of recent medical community news from around the region

transform the way health-

PAGE 22 | Convergent Ablation

care is delivered in rural

at Monument Health Heart and Vascular Institute Surgeons and electrophysiologists collaborate to offer a two-stage treatment for complex atrial fibrillation

Health rolled out a $300

areas and improve access to affordable, high-quality care for generations.

We speak with two top administrators about the health system's bold vision.

PAGE

10

Cover photo: Jeremy Cauwels, MD, Chief Physician at Sanford Health and Luis Garcia, MD, President of Sanford's Clinic Division outside the Sanford

FROM US TO YOU

Center in Sioux Falls.

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W

elcome to another e d iti o n of M E D Magazine, the South Dakota region’s premier publication for healthcare professionals.

In this issue, we bring you an in-depth interview on Sanford’s plans for a “virtual” care center and new training opportunities in support of rural healthcare. We also spoke with a cardiovascular specialist at Monument Health who’s leading one of the busiest convergent ablation programs in the country. And Brookings Health wants you to know about their advanced capabilities in the area of wound management.

Of course, our popular News & Notes makes up the bulk of this issue. As always, if you’d like to receive these news items in your Inbox and get early access to the digital issue of this publication, you’re invited to join the free VIP list at MidwestMedicalEdition.com.

See you in November!

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PO Box 90646, Sioux Falls, SD 57109

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The Information Blocking Rule

Understanding ONC’s new rule about access to patient medical records

BY COPIC’S PATIENT SAFETY AND RISK MANAGEMENT DEPARTMENT

WHAT IS “INFORMATION BLOCKING?”

WHO MUST COMPLY?

Information Blocking is the term adopted by the Office of the

Health Care Providers1, Health IT Developers, and

National Coordinator for Health Information Technology (ONC)

Health Information Networks/Exchanges. The

to address barriers to accessing electronically stored patient

Rule refers to these collectively as “Actors.”

information by providers, patients, and others entitled to it.

Examples include: ◆ A physician cannot receive records from a facility when needed ◆ An EHR cannot exchange data with an EHR from another vendor ◆ A patient cannot view their test results in a timely way The federal government has indicated a high degree of commitment to enforcing this Rule. As an indication, fines in 2019 for “delay in releasing patient records” under HIPAA averaged $85,000 per incident. While HIPAA generally took the approach of requiring processes to release information, the Information Blocking Rule requires specific justifications to withhold information. This is a major shift. Providers will need to comply with both HIPAA and the Cures Act Information Blocking Rules. The rules took effect on April 5, 2021.

WHAT ACTIVITIES ARE CONSIDERED INFORMATION BLOCKING? Information blocking can be any practice that interferes with access, exchange or use of EHI, unless an exception applies. For example: ◆ Restricting access that is otherwise authorized or permissible by applicable law. ◆ Nonstandard technology that increases the complexity or burden of access, exchange or use. ◆ Disabling or restricting a technical capability to share EHI for legally permissible purposes. ◆ Limiting technology in ways that make export, exchange or transitions between

WHAT INFORMATION MUST NOT BE BLOCKED?

IT systems more difficult; including charging

The information covered by the Rule is very broad. Initially, it

unreasonable fees.

comprises most electronic health information (EHI—in HIPAA

Some “high risk” activities that are likely to

terms, ePHI—used interchangeably).

be reported as violations include limiting or

Until October 6, 2022, this will consist of the data elements of the US Core Data for Interoperability (USCDI) v.1 standard.

These are: Allergies and intolerances, Assessment and Plan, Care

Team Members, Clinical Notes, Goals, Health Concerns, Immunizations, Laboratory, Medications, Patient Demographics, Problems, Procedures, Provenance, Smoking Status, Unique Device Identifiers and Vital Signs.

NOT: Medical imaging studies themselves; only the reports.

After October 6, 2022, the definition of EHI becomes broader to include all: 1. Medical records and billing records about individuals

delaying: ◆ Patients’ access to their own information, including lab and test results. ◆ Providers’ access to information for treatment or quality improvement. ◆ Payers’ access to clinical information for payment purposes. ◆ Access for safety and public health purposes.

2. Other records used, in whole or in part, by physicians to make decisions about individuals. This probably includes medical imaging files. (If a provider or a patient would use it for medical decision making, and it’s stored electronically, it’s included.)

September / October

❱ What are the exceptions and what does all of this mean for providers? You’ll find a detailed discussion as well as links to helpful resources in the full version of this article on our website.

5

[ SPONSORED ]

Brookings Health System’s Wound Center AN ALL-ENCOMPASSING, FULL-SERVICE OUTPATIENT FACILITY PROVIDING ADVANCED WOUND CARE FOR PATIENTS PRESENTING WITH A VARIETY OF NON-HEALING WOUNDS.

Brookings Health System’s Wound Care Team (left to right) Back row: Karen Weber, Kim Long, Amber Norton, Derick Johnson, Erica Sanderson, Meghan Handegard, Ashley Vander Pol Front row: Katie Jones, Jackie Nielsen, Janie Isham, Tonya Buchholz

C

ERTAIN KINDS OF NON-HEALING WOUNDS, such as diabetic foot ulcers, venous ulcers, pressure ulcers, non-healing post-operative surgical wounds and other types of recalcitrant wounds can require care beyond the topical treatments typically provided in the primary practice setting.

Our wound center offers the comprehensive wound care and advanced treatment modalities needed to successfully re-establish healing at the cellular level by augmenting granulation tissue formation and achieving eventual re-epithelialization.

6

MidwestMedicalEdition.com

The Wound Center is staffed by a multidisciplinary team of providers and technicians with advanced training in wound care, who will customize the most effective treatment plan to stimulate healing.

The team is dedicated to providing the most advanced healing options to patients, allowing them to recover as quickly and completely as possible.

Utilizing evidence-based clinical protocols, the goal is to achieve desired clinical results in the shortest period of time possible, enabling patients to return to their daily life and achieve a high level of patient satisfaction.

Upon admission to the center, the wound healing team conducts a comprehensive patient assessment.

The assessment results are used to develop an individualized care plan, which may include one or a combination of the following: • vascular studies • surgical intervention/ debridement

Tonya Buchholz, CNP, and Meghan Handegard, RT-HBO Tech, prepare a patient for hyperbaric oxygen therapy.

oxygen, which stimulates angiogenesis and fights infection.

Hyperbaric oxygen (HBO) therapy may be used as an important adjunctive therapy for several approved indications, including, but not limited to, the following:

• dressings/compression wraps

• Diabetic wounds of the lower extremities

• advance wound care dressings

• Chronic refractory osteomyelitis

• cellular-based tissue products

• Delayed radiation injury (soft tissue

•n egative pressure wound therapy • offloading • nutritional/diabetic education & counseling

and bony necrosis) • Osteoradionecrosis • Preparation or preservation of compromised skin grafts • Compromised flaps • Crush injuries

For patients with certain wound types, hyperbaric oxygen (HBO) therapy is an advanced treatment modality that has been proven to enhance the body’s natural ability to heal. HBO delivers 100% oxygen inside a chamber that is pressurized at two to three times greater than atmospheric pressure. This causes an increase in plasma and tissue

September / October

The center is committed to keeping its physician partners informed of their patients’ progress with regular updates and strongly encourages patients to continue their regular appointments.

Physicians may refer their patients to Brookings Health System’s Wound Center by calling the center at (605) 6968068 or faxing referrals to (605) 696-8814. The team is available to address referring physician’s needs and assist in helping with their patients. ❖

7

THIS MONTH ONLINE Highlighting content and opportunities available exclusively at MidwestMedicalEdition.com

Upcoming

EVENTS September 1 – 3

September 22 – 24

11:00 am, Wednesday 11:30 am Friday SDMGMA 2021 Fall Conference

8:00 am – 5:00 pm SDAHO Annual Convention

Location: Cedar Shore Resort, Oacoma, SD

September 10 7:00 am – 5:00 pm 5th Annual Immunize South Dakota Conference Location: Sioux Falls Convention Center

September 10 7:30 am – 7:00 pm Avera Research Integrity Conference Location: Hilton Garden Inn Downtown, Sioux Falls

September 11 5:30 pm BASH 2021 (Prairie Lakes Healthcare Foundation) Location: The Watertown Event Center

Location: Sioux Falls Convention Center

September 24 8:00 am – 4:00 pm CNOS Orthopaedic & Sports Medicine Symposium Location: Holiday Inn Express, Dakota Dunes, SD

October 1 8:00 am – 4:00 pm Avera Cancer Institute Oncology Symposium Location: Virtual (WebEx or Zoom)

Location: Arrowwood Resort at Cedar Shore, Oacoma, SD

8

But Minnesota & Iowa rank even higher

Personal finance website WalletHub has once again named South Dakota 10th out of the 50 states in 44 key measures of healthcare cost, accessibility, and outcomes. The data set ranges from the average monthly insurance premium to physicians per capita to the share of insured population.

Health Care in South Dakota (1=Best; 25=Avg.): 7th – Hospital Beds per Capita 18th – Dentists per Capita 27th – % of At-Risk Adults with No Routine Doctor Visit in Past Two Years 20th – % of Adults with No Dental Visit in Past Year 21st – % of Medical Residents Retained 25th – % of Residents Age 12+ Initiating Vaccination

VISIT THE WEBSITE for a link to the full report.

October 21 7:30 am – 5:00 pm Monument Health 23rd Annual Cardiovascular Disease and Wellness Symposium Location: The Monument, Rapid City

September 14 – 15 10:00 am, Tuesday 3:00 pm, Wednesday South Dakota Statewide Trauma Conference

SD is 2021’s 10th Best State for Healthcare

For details on these and other upcoming events, visit MED's online calendar.

ARE YOU ON THE LIST? MED VIPs get exclusive access to the digital version of this magazine (up to two weeks ahead of print) as well as a bi-monthly compilation of curated local healthcare news and events.

It’s FREE to join!

Learn more and sign up at MidwestMedicalEdition.com /join-the-vip-list

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There’s More ONLINE!

EXCLUSIVE ONLINE ARTICLES Act Early resources make developmental surveillance easy.

Reflection on the “Year of the Nurse”.

Delays and disabilities among children are common. Yet commonly overlooked. CDC’s “Learn the Signs. Act Early.” resources, including a handy Milestone Tracker app, provide guidance to anyone working with young children to improve early identification of developmental disabilities and delays, including autism, so children and their families can get the services and support they need as early as possible.

Digital Digital Partners Partners

“Never before has the importance of nurses been highlighted in such a drastic way,” says Heather CasperMclay, an adult nurse practitioner and instructor at the University of South Dakota’s Sioux Falls campus on the role of nursing during the pandemic.

Learn more about how USD’s Nursing program has evolved its curriculum in response to COVID-19.

Dr. Jesse Guardado’s Colorectal Practice Thriving in the Wake of COVID

I

t’s been almost two years since Jesse Guardado, MD, joined Surgical Institute of South Dakota as the only fellowship-trained colorectal surgeon on the Avera Campus in Sioux Falls.

Dr. Guardado inherited a full and busy practice from his predecessor. And in early 2020, that practice was growing quickly with a variety of both cancer and non-cancer colorectal surgeries.

“Right before COVID hit, I was in full swing,”

says Dr. Guardado “Unfortunately, that took a big hit from March to June 2020.”

Fortunately, it did not take the practice long to recover. As soon as he got the “green light” to begin performing elective surgeries again, Dr. Guardado’s schedule was once again full. As his practice has grown, so has his comfort level with robotics, in which he was already well-trained.

“I had good exposure to robotics in my training but, of the 400 to 500 colon resections I did, 35 of them were robotic. The rest were laparoscopic,” says Guardado. “So when I came here, I was still doing certain things laparoscopically. This year, I have moved almost

January / February 2019

exclusively to robotics.”

Guardado has now performed more than 200 robotic colorectal surgeries locally. As his confidence has grown, he says he sees fewer situations that might once have prompted him to revert to an open procedure. His patients have had good outcomes and reasonable hospital stays and the incidence of surgical wound infections is well below

NURSING

Rapid City • Sioux Falls Vermillion • Online

the national average.

Read more about Dr. Guardado and his involvement with the National Accreditation Program for Rectal Cancer in the extended version of this article on our website.

9

The 60,000 square foot Virtual Care Center will be built near the Sanford Sports Complex off of I-29 and Benson Road in Sioux Falls.

BUILDING THE HOSPITAL OF THE FUTURE . . . NOW Sanford’s Bold Vision for Rural Healthcare

BY ALEX STRAUSS

E

ARLIER THIS YEAR, Sanford Health rolled out a $300 million initiative it hopes will transform the way healthcare is delivered in rural areas and improve access to affordable, high-quality care for generations.

In addition to a significant investment in community health through an expansion of the Sanford Sports Complex in Sioux Falls, the initiative will create eight new residencies and fellowships in critical specialty areas

and help build a 60,000 square foot facility that will be the headquarters of a new virtual care center.

We invited hospitalist Jeremy Cauwels, MD, chief physician at Sanford Health, and surgeon Luis Garcia, MD,

president of Sanford Health’s clinic division, to tell us more about how Sanford plans to roll out its bold vision.

MED: Why is it important

farms. Part of our job, if we want to be the premier rural

to make this investment in rural healthcare now, when so many Americans are moving to larger cities?

health provider in the US, is to find ways to reach out and

JC: I think it’s important to

LG: The reality is that about 20 percent of the US population

realize that while some

still lives in rural areas. There are numerous studies that

towns are shrinking, other

show a health gap between rural and urban situations.

towns and other ways to

Rural Americans are more likely to die from the four lead-

earn a living in those areas

ing causes of death in this country: heart disease, cancer,

are absolutely growing. We

stroke, and injury. Most of these deaths are preventable

are always going to have

with better access to care. While the attention tends to

smaller communities. We

turn toward urban settings, one fifth of our population is

are always going to have

still living in rural areas.

deliver premium care to those patients, whether they live 7 miles away from a medical center or 70 miles. That is our mission.

Jeremy Cauwels, MD 10

MidwestMedicalEdition.com

MED: Why are new graduate programs such a big

treatment before we con-

part of this initiative?

sider transporting them.

LG: The Association of American Medical Colleges

ple is a provider whose

predicts a nationwide shortage of 140,000 physicians

child recently needed

by 2043. Some of those shortages are going to be in

pediatric

areas of high medical expertise because we have a

care. The closest special-

deficit in training physicians in some of these areas.

ist was 4.5 hours away

So that presents a recruitment issue.

with a six week wait

But we also know that people tend to stay close to

Another great exam-

psychiatric

time. We were able to

where they receive their education. So, in addition to

connect

engaging in recruitment like everyone else, we are

remotely and have that

taking the next step and developing our own

visit done in less than 72

high-level training programs with the expectation

hours. That, to me, is the

that a portion of the people who train here are going

power of a virtual care

to stay and practice in the rural setting.

center.

MED: The first two training programs will be a

LG: For us it is about improving access to care, magni-

hematology/oncology fellowship and a neurology residency, both starting in Fargo next summer. How is Sanford deciding which specialty areas are most critical?

fying convenience for our patients, and enhancing

JC: We have done a wonderful job of building up our

that

family

Luis Garcia, MD

efficiencies in situations of dire need or emergency situations. We have had the technology available for a number of years. But we have been held back by the business model of healthcare and the need for coding and reimbursement.

primary care base with the first eighteen training pro-

One thing that COVID has taught us is that that needs

grams that we have developed here along with our

to change and this initiative will allow us to not have

education partners. We keep about 40 percent of those

to wait for those changes before we do something mean-

residents to maintain the primary care in our region.

ingful. In the past, we couldn’t do a virtual visit because

Now what we need to do is bring in people who can help

we didn’t have a code for it. This allows us to say we are

the folks who need things like cancer specialty care,

just going to do it.

specialty care for strokes, etc. That’s why we have picked these areas first to help round out the primary care.

LG:

MED: If the care is virtual, how will the new building be used?

The next ones we choose will be in other areas of

high expertise that would otherwise go to an urban

JC: The building will serve as a place to house all of the

setting. These will be residencies and fellowships that

data, hardware, and people we need to implement this

are typically difficult to get into and hard to recruit for.

on a large scale. Along with Dakota State University, we

From our perspective, this is also about impacting our

are building a facility that will bring us to the forefront

communities by leaving a legacy. We deeply value the

in terms of how we provide digital care. That facility

relationships we have with the academic institutions

will give us not only the ability to reach out to patients,

we work with. Creating new educational opportunities

but also to help train physicians to diagnose and treat

not only has an impact on direct patient care, but also

patients in the virtual world. We expect to need a dozen

on communities.

or so physicians and support staff along with advanced

MED: What is a ‘virtual care center’?

JC: The virtual care center concept is really about how

practice providers, nurses, physical therapists, pharmacists, etc. Plus all of the IT and other professionals that are needed to run all of this. This building is going to come with a fleet of people.

you access and receive your care. In that sense, it is

The entire initiative brings us back to the promise

separate from a building. If a patient is having a stroke

that we will deliver the same quality of healthcare in a

in a rural town, there is a good chance that the hospital

small South Dakota town that we would deliver if you

will not have a neurologist present. But that hospital

were sitting in an office in Sioux Falls. The same services

can connect to a center that does have a neurologist,

that you can get in one office should be the same as

allowing us to both diagnose the stroke and start

another. ❖

September / October

11

Happenings around the region

News & Notes

South Dakota | Southwest Minnesota | Northwest Iowa | Northeast Nebraska

AVERA Avera recently announced the region’s largest philanthropic campaign to support behavioral health services in the area.

The Light the Way Campaign will help fund the $28 million expansion of the Avera Behavioral Health Center in Sioux Falls.

Thanks to gifts from families, foundations and organizations, construction on the four-story wing is underway and adds capacity to serve more children, adolescents and at-risk adults; residential addiction care for youth; 24/7 psychiatric urgent care; and partial hospitalization space. The facility is on schedule to open in late spring of 2022.

DANIEL PETEREIT

Aquiline Capital Partners has acquired Avera eCare, Avera Health’s telemedicine services. Aquiline Capital Partners is a private investment firm based in New York and London. As part of the acquisition, the company will be renamed Avel eCare. “The time is right for us to fulfill this piece of our strategic plan so Avel eCare can scale and help even more people,” said Bob Sutton, President and CEO of Avera Health.

Avera eCare’s more than 230 employees will continue to work for Avel eCare, and its headquarters will remain in Sioux Falls. Closing is expected to occur in the fourth quarter of 2021.

12

Walking Forward, a community research program of Avera, has received a new $95,000 donation from the Irving A. Hansen Memorial Foundation. The foundation has already provided $150,000 to help fund low-dose CT screenings to patients at risk for lung cancer. Walking Forward was developed by Daniel Petereit, MD, a radiation oncologist at Monument Health. It provides tribal communities with access to a variety of cancer-related services including cancer education and screening, earlier diagnosis and access to clinical trials. Cancer is the leading cause of death among South Dakota American Indians.

Avera Health has appointed new board members. Current board member Gary Gaspar, an owner and CEO of Interstate Office Products in Sioux Falls, has been named new Gaspar Bingham board chair for a two-year term. Sr. Penny Bingham, a member of the Benedictine Sisters of Yankton and a staff member at the Benedictine Peace Center in Yankton, will serve as vice chair. Sr. Seifert Wang Roxanne Seifert and Katherine Wang, MD, are new to the board. Sr. Seifert is a member of the Presentation Sisters of Aberdeen and is Vice President of Mission Integration at Avera Queen of Peace Hospital in Mitchell. Dr. Wang is a neonatologist with Avera Medical Group in Sioux Falls.

Avera broke ground in June on a new Avera Medical Group Family Health Center in the Dawley Farm development in eastern Sioux Falls. The $34 million 86,000-square-foot building will offer family medicine, urgent care, obstetrics/ gynecology, pediatrics, internal medicine and dermatology.

Also on site will be Avera’s second free-standing emergency department, similar to the ED at the Marion Road location, as well as laboratory and imaging services, including CT, X-ray and ultrasound. Estimated completion date is January 2023.

MidwestMedicalEdition.com

Committed to Making Your Workplace Safer

Friedman

Reindl

Bunkers

Avera McKennan Hospital & University Health Center has appointed three new members to its Board of Trustees. Their terms started July 1. Emergency physician Jared Friedman, MD, is the new Chief of Staff at Avera McKennan, and serves on the board as a representative of Avera McKennan medical providers. Alisa Reindl, MD, is a family medicine practitioner with Avera Medical Group McGreevy 7th Avenue and a clinical assistant professor of family medicine at USD. Jennifer Bunkers, a partner in the Boyce Law Firm, is the incoming chair of the Avera McKennan Regional Philanthropy Council.

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BLACK HILLS Monument Health partnered with the SD Health Department to provide free antigen COVID-19 test kits to visitors during the Sturgis Motorcycle Rally in August. People who had COVID-19 symptoms and a negative antigen test could choose to follow up with a PCR test at one of Monument Health’s drive-through locations in Custer, Lead-Deadwood, Rapid City, Spearfish or Sturgis.

The Monument Health Nurse Triage Line, created during the COVID-19 pandemic as a way people could discuss their symptoms and schedule COVID-19 tests, is taking on a new role. Now, patients with non-COVID-19 illnesses can talk directly to an RN to determine the urgency of their case and direct them to the most appropriate care. At the height of the pandemic, nurses were fielding as many as 600 calls a day from people experiencing COVID-19 symptoms or who had been exposed to someone with the virus.

September / October

13

• Happenings around the region

News & Notes

Happenings around the region

LUIS HERNANDEZ Cardiologist Luis Hernandez, MD, has joined the Monument Health Heart and Vascular Institute.

Dr. Hernandez earned his MD from the National Autonomous University of Honduras. He completed his residency with the Presence Saint Joseph Hospital Internal Medicine Residency Program, and his Cardiovascular Disease fellowship at Cleveland Clinic, Florida, where he was chief fellow. He specializes in general cardiology with a focus on heart failure, heart transplantation and heart pumps.

AVERY SIDES Family Medicine Physician Avery Sides, MD, recently joined Monument Health Custer Hospital and Clinic. Dr. Sides is a Nebraska native who has been practicing family medicine in the Black Hills since 2014. She was previously with Fall River Health Services. During medical school and her residency in Omaha, Dr. Sides worked in underserved urban communities. However, her ultimate goal was to care for patients, families and communities in underserved rural areas.

For the 10th straight year, Monument Health Rapid City Hospital and the Heart and Vascular Institute have received the American College of Cardiology’s NCDR Chest Pain-MI Registry Platinum Performance Achievement Award.

Monument Health is one of only 212 hospitals nationwide to receive the honor this year, and one of just 57 to receive the annual award 10 times.

The award recognizes the hospital’s commitment and success in implementing a higher standard of care for heart attack patients.

Why Pork?

Did you know that eating 20-30g of protein per meal may help you feel fuller and more satisfied?1

2

14

https://pubmed.ncbi.nlm.nih.gov/25926512/ U.S. Department of Agriculture Nutrient Database Release 18, 2006 Revised USDA Nutrient Data Set for Fresh Pork

Marcia Taylor, RN, a Clinical Experience Coach at Monument Health Rapid City Hospital, has been named winner of South Dakota Healthcare Human Resources Association’s Spirit of Service Award.

Taylor has been with Monument Health system for 47 years. During the COVID-19 pandemic, Taylor has been a tireless advocate for patients and their families. When face-to-face visits were not possible, she helped create a program that placed 200 iPads in patient rooms. Taylor will be recognized during the SDAHO convention in September.

Black Hills Surgical Hospital is the first in the region to offer Mako SmartRobotics™. This advancement in joint replacement surgery transforms the way total knee, partial knee and total hip replacements are performed, by helping surgeons know more and cut less. Mako SmartRobotics™ combines three key components, 3D CT-based planning, AccuStop haptic technology, and insightful data analytics into one platform that has shown better outcomes for total knee, total hip and partial knee patients.

SANFORD

Pork is packed with protein and the essential amino acids, vitamins and minerals you need.

For example, every 3 oz. serving of pork tenderloin provides 22g of protein.2

1

MARCIA TAYLOR

© Copyright 2021. National Pork Board, Des Moines, Iowa USA. This message funded

by America’s Pork Checkoff Program.

Sanford Research found a 79 percent reduction in head impacts after studying a youth football team for eight consecutive seasons. The manuscript, “Head Impact Exposure of a Youth Football Team over Eight Consecutive Seasons,” was recently published in Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine. Dr. Thayne Munce of Sanford Research was the principal investigator of the study. Helmet-mounted impact monitors were used to measure the number of head impacts players experienced as well as the severity of the impacts.

MidwestMedicalEdition.com

Sanford Health is requiring all employees to get a COVID-19 vaccination by November 1. This includes employees at all of its Good Samaritan Society locations.

More than 90% of clinicians and 70% of nurses were already fully vaccinated as of mid-July when the policy was announced.

Profile by Sanford, an evidence-based, comprehensive behavioral weight management program, and HealthPartners, the largest consumer-governed, non-profit healthcare organization in the country, recently announced the results of a 12-month cohort longitudinal study on the impact of a health system-sponsored employee weight management program. In total, 140 participants enrolled in the study with Profile. Participants lost an average of 8% in body weight after 3 months and maintained through 12 months of joining Profile. Employees also reported improvements in emotional health, higher life satisfaction, and more energy.

B i g & F a l l

B o l d

The kids going back to school and the cooler nights remind us that fall is here! Now is the time

to

sip

on

some

of

those

bigger

red

wines we all love. In the USA, Cabernet is

Three new members were recently elected to the Board of Directors for the Evangelical Lutheran Good Samaritan Society. They include Rev. Linda Norman who serves as the chief financial officer and vice president of administration at Mission Investment Fund of the ELCA; Helen Melland, former Dean of the College of Nursing at Montana State University, and Traci Woolfolk, who is a Good Samaritan Society administrator for home and community-based services in Fort Worth, Texas.

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TRACY ROTH Tracy Roth is the new Director of Laboratory Services at Pioneer Memorial Hospital & Health Services. Roth is a graduate of USD. After completing the Sanford Medical Laboratory Science (MLS) Internship in 2004, she accepted an MLS position as a generalist working in Chemistry, Hematology, and Blood Bank.

In October 2008, she accepted the MLS Chemistry Instructor position at Sanford in Sioux Falls and held that position until coming to Pioneer Memorial.

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September / October

15

• Happenings around the region

News & Notes

Happenings around the region

Pioneer Memorial Nursing Home announced in June that it had vaccinated 81 percent of its staff, surpassing the national benchmark set by the American Health Care Association. The AHCA wanted to see 75 percent of the nation’s 1.5 million nursing home staff vaccinated by June 30.

NATHAN SKELLEY Sioux Falls Orthopedic surgeon Nathan Skelley, MD, of Sanford Health was recently selected by his peers to be the South Dakota representative for the American Orthopaedic Society for Sports Medicine council of delegates. Dr. Skelley will serve three years as the South Dakota representative and will be an ambassador for sports medicine education, research, communication and fellowship.

PATRICK KELLY Patrick Kelly, MD, vascular surgeon with Sanford Health in Sioux Falls, has invented a minimally invasive pulmonary embolism catheter. This device is designed to transform treatment for life-threatening pulmonary embolisms.

Charlottesville, Virginia- based Liquet Medical Inc, has licensed Dr. Kelly’s product with plans to commercialize it. They hope to have FDA clearance for the new device by late 2022 or early 2023.

U.S. News & World Report’s Best Hospitals for 2021–2022 ranked Sanford Medical Center Fargo the No. 1 hospital in North Dakota and Sanford USD Medical Center the No. 1 hospital in South Dakota. U.S. News evaluates data on nearly 5,000 hospitals in 16 adult specialties, 9 adult procedures and conditions, and 10 pediatric specialties. Sanford USD Medical Center received high-performing rankings in three adult specialty areas, including gastroenterology and gastroenterology surgery, orthopedics, and pulmonology & lung surgery. Sanford Medical Center Fargo ranked high-performing in urology.

Educational Resource Library For Healthcare Professionals Check out a variety of educational resources focused on a broad range of beef-related topics. Some of these complimentary educational opportunities are eligible for continuing professional education units (CPEUs) by the Commission on Dietetic Registration (CDR) and the American College of Sports Medicine (ACSM).

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SIOUXLAND UnityPoint Health is requiring its more than 33,000 team members to be vaccinated against COVID-19 by November 1. The mandate applies whether or not employees provide direct patient care.

UnityPoint Health–St. Luke’s is launching a new social services resource called “Together We Care” to help individuals find assistance with food, housing, transportation, employment and more. The online tool connects individuals to organizations in their area offering free and reduced-cost social services and programs. The resource is free and can be accessed by visiting TogetherWeCare.UnityPoint.org. Providers can also use the tool to easily and quickly make referrals for patients, connecting them with programs and services they need.

12/7/2020 4:35:37 PM

MidwestMedicalEdition.com

MercyOne Siouxland Medical Center unveiled its newly-renovated emergency department in August. Fast Track, open 3–11 pm, gives patients rapid access to the right experts in 90 minutes or less. The Fast Track team assesses and treats less-severe emergencies in a separate waiting area and private patient rooms. The updated emergency department also includes improvements to the waiting area, additional private patient rooms, enhanced security, and enhanced provider coverage.

INDEPENDENTS JACKIE LAKE Jackie Lake, Physical Therapist with Prairie Lakes Rehabilitation Services, has completed a certification to enhance her practice treating patients with vestibular dysfunctions. The Certificate of Competency in Vestibular Rehabilitation (CCVR) Course required her to demonstrate her elevated skills over a period of six months. Lake has practiced PT for 21 years with the past 10 years specializing in therapy for vestibular dysfunctions.

PAUL MACEK Paul Macek is the new Interim CEO of Prairie Lakes Healthcare System.

Macek has over 35 years of experience as a hospital and health system CEO and for the past 5 years has served as an independent consultant to hospitals and health systems through his firm, PEM Advisors LLC. The PLHS Board of DIrectors made the announcement in August.

September / October

ALWAYS MOVING. Always improving.

We wake up every day to serve in the towns and places you call home. We’ve expanded our innovative care, expertise and access to always keep your patients moving. Because forward is the only direction we know.

REFER TO 605-217-2667, OPTION 7.

CNOS.NET

17

• Happenings around the region

News & Notes

Happenings around the region

TAMMY DAVIS

JONATHAN OVIATT

The Prairie Lakes Healthcare System Board of Directors elected new board members at its annual meeting in May. New board members Tammy Davis and Jonathan Oviatt were elected to serve three year terms. Davis has 25 years of experience in human resources and is currently the Senior Human Resource Manager at Wurth Electronics Midcom Inc. Oviatt served Mayo Clinic for over 25 years in key legal, administrative, and regulatory roles. He is now retired.

CHELSEY SUNDBERG Nurse Practitioner Chelsey Sundberg has joined Prairie Lakes Nephrology in the care of clinic and dialysis patients. Sundberg earned her BS from Presentation College and completed her Master’s Degree under the Nurse Practitioner Program at the University of Cincinnati. She is board certified as a Family Practice Nurse Practitioner and Adults/Gerontological Nurse Practitioner.

Prairie Lakes Healthcare System’s 24th Annual Hospital Hill Run raised funds for the Prairie Lakes Healthcare Foundation’s Caring Club House this summer. A donation of $3,000 was donated to the Caring Club House.

The Caring Club House is a home away from home for out-of-town patients, families, and caregivers receiving services through Prairie Lakes.

Shown presenting the check are members of the Hospital Hill Run Committee: Dr. Dan Reiffenberger, presenting the check to Lisa Dahl, Executive Director Prairie Lakes Healthcare Foundation, Jessi Eidson.

Middle Row: Bonnie Cordell and Sarah Bruning.

Back Row: Jennifer Bender.

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KEEGAN MAXWELL Board-certified urologist Dr. Keegan Maxwell has joined Prairie Lakes Specialty Clinic. Dr. Maxwell received his medical degree from the University of Washington in Seattle, Washington. Dr. Maxwell completed his Urologic Surgery Residency and Minimally Invasive Urology and Laparoscopy Fellowship at Washington University St. Louis School of Medicine in St. Louis, Missouri. He has been practicing for the past 13 years in St. Cloud, Minnesota.

BECKY MCMANUS Becky McManus is the new CEO of Yankton Medical Clinic, PC. McManus most recently served as the chief operating officer.

McManus graduated from Mount Marty University with a BS in healthcare administration and completed her MS in administrative studies at USD. Her prior experience in healthcare includes director of operations at Vermillion Medical Clinic and administrator of Sunset Manor in Irene, South Dakota and Wakonda Heritage Manor in Wakonda, South Dakota.

ELIZABETH NICHOLAS Board certified family medicine physician Elizabeth Nicholas, MD, has joined Yankton Medical Clinic. She graduated from the USD Sanford School of Medicine and completed her family medicine residency at the University of New Mexico. Dr. Nicholas joins Drs. McKenzie Hanson, Carrissa Pietz, Abigail Reynolds, Jordan Schild, Scott Weber and CNP Jennifer McGinnis.

ROBERT NICHOLAS Dr. Nicholas’ husband Robert Nicholas, MD, has also joined YMC. He is a graduate of the USD Sanford School of Medicine and specializes in otolaryngology. He completed a head and neck surgery residency at the University of New Mexico. Dr. R. Nicholas joins Drs. David Abbott and Micah Likness at the Yankton Medical Clinic, PC–Ear, Nose & Throat location.

September / October

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• Happenings around the region

News & Notes

Happenings around the region

ALAN SPANEL Dr. Alan Spanel, an internal medicine specialist, joined YMC in September. Dr. Spanel graduated from and completed a residency in internal medicine/primary care at the University of Nebraska Medical Center in Omaha, Nebraska. He will practice in the Norfolk clinic along with Dr. Charles Harper and Certified Nurse Practitioner Kelly Jueden.

Children’s Hospital & Medical Center in Omaha has named 10 regional non-profit organizations as Preventing Childhood Obesity (PCO) Community Grant winners for 2021-2022. The program supports evidence-based efforts to reduce childhood obesity. The PCO grant selection process supports health equity by selecting programs that reach at-risk children from low-income, racial or ethnic minority groups or other marginalized populations. Each organization receives $25,000 to support new or existing programs.

The American Academy of Pediatrics (AAP) recently introduced new national guidance to help pediatricians detect risks of sudden cardiac arrest or death in children and teens. Christopher Erickson, MD, a pediatric cardiologist at Omaha Children’s, is lead author of the paper, “Sudden Death in the Young: Information for the Primary Care Provider,” published in the July 2021 edition of AAP’s journal Pediatrics.

Children’s Division Chief of Pediatric Sports Medicine, Kody Moffatt, MD, also contributed to the research and recommendations.

Children’s Hospital & Medical Center has been recognized by the American Nurses Credentialing Center’s Magnet Recognition for high-quality nursing practice. This credential is the highest national honor for professional nursing practice. It is the fourth time that Children’s has received Magnet recognition. Only 2% of hospitals nationwide have received four consecutive Magnet designations.

The University of South Dakota will offer a Doctor of Nurse Anesthesia Practice degree program in Sioux Falls to help build and grow the healthcare workforce in South Dakota. The DNAP degree prepares registered nurses to become Certified Registered Nurse Anesthetists (CRNAs). USD is the only public university in the state to offer this degree. The approved program will begin admitting students as early as summer 2023.

The American Academy of Pediatrics is offering a free, six-unit online course to support pediatric healthcare professionals in providing preventive, acute, and chronic telehealth and distant care services. Three of the six units, all of which can be taken at any time, are specifically focused on enhancing telehealth care for children and youth with special healthcare needs.

Read more and register at https://shop.aap.org/ providing-telehealth-and-distant-careservices-in-pediatrics

SHAWN FREWALDT Rise Custom Solutions in Sioux Falls recently welcomed Physical Therapist Shawn Frewaldt, MS PT, ATP/SMS, as DME (Durable Medical Equipment) Clinical Specialist. Frewaldt is RESNA-Certified as an Assistive Technology Professional (ATP) and a Seating & Mobility Specialist (SMS). She has been a PT at RISE parent organization, LifeScape, since 2003, and has served on their seating and positioning team. In her new role, Frewaldt will evaluate patients to determine the best wheelchair or other durable medical equipment, as well as optimal customization and assistive technology resources.

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September / October

21

Convergent Ablation at Monument Health Heart and Vascular Institute Two-stage treatment for complex atrial fibrillation

BY ALEX STRAUSS

E

IGHT TO TEN MILLION Americans

the back side left atrium. Under direct visualization,

suffer from atrial fibrillation, the

he performs RF ablation on the back wall of the heart.

most common type of arrhythmia.

Afterwards, Dr. Mungara uses a clip to seal off the left

Afib can cause symptoms ranging

atrial appendage, reducing the risk of stroke from blood

from shortness of breath to fatigue to

clots formed there to near zero.

palpitations and even stroke. People

The second stage of convergent ablation happens

with long-standing Afib may develop

four to six weeks later, after these areas have begun

tachycardia-induced cardiomyopathy.

“Many are well managed on medical therapy.

But there are a large number of patients who don’t do well on the blood thinners,” says Charan Mungara, MD, a Cardiovascular Surgeon at Monument Health Heart and Vascular Institute. “These are the patients that we start thinking of other interventions.”

Endocardial ablation, which ablates the portion of the back wall of the heart from inside using a catheter, is one treatment option. But some patients with more complex or intermittent Afib — especially those for whom the condition has lasted longer than six months — may get better results with a multidisciplinary intervention called convergent ablation.

“It’s called ‘convergent’ because the surgical

a catheter from the groin to the inside of the heart and “touches up” any areas that were unreachable during the surgical portion of the procedure.

“We are working from outside to inside and our electrophysiology colleagues are working from the inside to the outside, so we meet in the middle,” says Dr Mungara. More than 70 percent of patients are cured of their Afib with the convergent approach.

This summer, the FDA approved AtriCure’s EPi-Sense System for convergent ablation as the standard of care for long-standing Afib.

Convergent ablation has been available at Monument since last October and Dr. Mungara expects

team and EP colleagues collaborate to provide the

to complete 60 to 70 cases by year’s end, making

best thing for these patients,” says Dr. Mungara.

Monument’s program one of the busiest convergent

The convergent ablation procedure is a hybrid approach, involving both a minimally-invasive epicardial procedure and endocardial ablation.

22

to heal. At this point, an electrophysiologist threads

programs in the country.

“This is because we have really collaborative physicians who understand that this is the best

In the first stage, Dr. Mungara makes a small

approach for our patients,” says Dr. Mungara. “You

incision below the breast bone through which a

don’t see this kind of collaboration in a lot of other

cannula and camera are inserted and positioned on

programs, where everyone is in their own silos.” ❖

MidwestMedicalEdition.com

CHARAN MUNGARA, M.D. Cardiothoracic and Vascular Surgery

KALYAN VUNNAMADALA, M.D. Cardiothoracic and Vascular Surgery

The Monument Health Cardiothoracic Surgery Program is continuously working to advance patient care options including expansion of left atrial appendage exclusion treatments, complex lower extremity revascularization and convergent hybrid ablation. The program excels at complex aortic procedures, mitral valve repairs, beating heart surgery and high risk CABGs. While offering the full spectrum of cardiothoracic and cardiovascular care, the program is outperforming like groups in the following categories of the Society of Thoracic Surgeons quality database: • Operative mortality

• Renal failure

• In-hospital mortality

• Reoperation

• Major complications

• Infection complications

• Prolonged ventilation

• New onset atrial fibrillation

605-755-4300 www.monument.health/heart

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At Sanford Health, our specialized cancer team delivers the most advanced procedures and treatments at home in Sioux Falls. The best medical minds work together for your patients — using cutting-edge science to lead the way to breakthroughs in cancer care.

Refer a patient at (844) 851-1515 or sanfordhealth.org/referral-center.

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