MED-Midwest Medical Edition-April/May 2014

April / may

2014

Vol. 5 No. 3

Midwest Medical Edition

the

Area experts tackle…

EHR Issue

Next Generation Endoscopic Surgery in Sioux Falls

Help Kids with Your Donated Airline Miles

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Midwest Medical Edition

Contents Volume 5, No. 3 ■ April / May 2014

Regular Features 2 | From Us to You 3 | MED on the Web

Exclusive content on MidwestMedicalEdition.com

8 | N ews & Notes New doctors, certifications, clinics, and more 26 | New! Wine Marketplace

Brush up on your wine savvy with MED’s new wine column, sponsored by Cask & Cork, South Dakota’s only local distributor

In This Issue 4 | One Life Can Save Up to 60 Lives ■

By Dave Hewett

6 | How to Know When It’s Time to Change Providers With the coming implementation of ICD-10, it’s a great time to assess your systems for coding, billing and practice management to determine if you need a change.

Sponsored Feature

The federal program designed to incent physicians to use electronic health records has worked . . . but with mixed results. Many are frustrated with the costs and practical problems of converting from paper charts to computers. In this Special Section, we hear from and about some area professionals who are experts on the many issues surrounding the meaningful use of EHRs.

The

EHR 18

Next Generation Endoscopic Surgery in Sioux Falls

16

Help Kids With Your

26

NEW!

18 | Next Generation Endoscopic Surgery in Sioux Falls

The Surgical Institute of South Dakota’s Bradley Thaemert, MD, FACS, recently became the first surgeon in the region to use a new device designed to help surgeons get around what has been a major hurdle for endoscopic surgery.

11

Issue

16 | Yankton CEO to Retire After 17 Years Pamela Rezac reflects on her career and the future of healthcare

page

Donated Airline Miles

Wine Marketplace

Sponsored Feature

20 | Sanford’s New Moorhead Campus

First to Use Real-Time Operational Intelligencer

22 | Local Bio-Specimens Will Further Breast Cancer Research

24 | Prairie Lake Doctor Honored for Work in Haiti

28 | Survey Shows Growing Acceptance

of Integrated, Employed Physicians

On the

COver

From Us to You

Staying in Touch with MED

F

ew changes in medicine have hit home for large hospital systems and private practices alike like the mandated ‘meaningful use’ of Electronic Health Records. While some took a ‘wait and see’ attitude when national EHR implementation initiatives were first announced in 2009, others jumped on board quickly to avoid penalties. Whichever camp you fall into, chances are you have encountered some issues along the way. In this issue of MED, we explore some EHR issues and pitfalls, and bring you some sound advice from area professionals.

Also in this issue, we talk with a local physician about his experience with endoscopic suturing and we bring you an interview with retiring CEO Pam Rezac of Yankton. We welcome Cask & Cork, sponsors of MED’s newest feature, Wine Marketplace. As always, we bring you all the latest news from private practices and small towns to large health systems and cities in the multi-state area MED serves.

As we continue to expand our digital reach, we encourage you to watch for the red and black ‘MED on the Web’ emblem, an indication that more information is available online. This is also where you will find the continually updated MED Calendar (to which you can add your own events for free) and the digital issue of MED, formatted for easy reading on your iPad or Android device.

Are there other things you would like to see on the MED website? Or in the magazine? Let us know. We would love to talk to you.

—Alex & Steff

Publisher

MED Magazine, LLC Sioux Falls, South Dakota

VP Sales & Marketing Steffanie Liston-Holtrop Editor in Chief Alex Strauss

Design/Art Direction Corbo Design Photographer Kristi Shanks

Web Design Locable digital media director Jillian Lemons Copy Editor Hannah Steck

Steffanie Liston-Holtrop

Contributing Writers

Dave Hewett Rhoda Lagerquist Trish Lugtu Bryan O’Neal

Staff Writers

Liz Boyd Caroline Chenault John Knies

Alex Strauss

MED would like to congratulate Rosewood Homes’ of Sioux Falls on the success of their Building Miracles for Kids fundraiser for Sanford Children’s Hospital. By building and selling a “Miracle Home” this winter, Rosewood Homes raised just under $195,000 for the Children’s Miracle Network which they presented in March. (see photo) MED is proud to have been a sponsor of the Building Miracles effort.

Contact Information Steffanie Liston-Holtrop, VP Sales & Marketing 605-366-1479 Steff@MidwestMedicalEdition.com Alex Strauss, Editor in Chief 605-759-3295 Alex@MidwestMedicalEdition.com Fax 605-271-5486 Mailing Address PO Box 90646 Sioux Falls, SD 57109 Website MidwestMedicalEdition.com

2014 Advertising / Editorial Deadlines Jan/Feb Issue December 5

June Issue May 5

Sep/Oct Issue August 5

March Issue February 5

July/ August Issue June 5

November Issue October 5

April/May Issue March 5

December Issue November 5

Reproduction or use of the contents of this magazine is prohibited.

©2011 Midwest Medical Edition, LLC Midwest Medical Edition (MED Magazine) is committed to bringing our readership of 5000 South Dakota area physicians and healthcare professionals the very latest in regional medical news and information to enhance their lives and practices. MED is published 8 times a year by MED Magazine, LLC and strives to publish only accurate information, however Midwest Medical Edition, LLC cannot be held responsible for consequences resulting from errors or omissions. All material in this magazine is the property of MED Magazine, LLC and cannot be reproduced without permission of the publisher. We welcome article proposals, story suggestions and unsolicited articles and will consider all submissions for publication. Please send your thoughts, ideas and submissions to alex@midwestmedicaledition.com.

Magazine feedback and advertising and marketing inquiries, subscription requests and address changes can be sent to steff@midwestmedicaledition.com.

MED is produced eight times a year by MED Magazine, LLC which owns the rights to all content.

2

Midwest Medical Edition

Tom Stys, MD

Christopher Stanton, MD

Orvar Jonsson, MD

Kelly Steffen, DO

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One Life Can Save Up to 60 Lives

T

By Dave Hewett here is a 58% chance that your next adult patient is a registered organ, tissue and eye donor.

LifeSource is the federally designated organization to provide organ and tissue donation services in the states of South Dakota, North Dakota and Minnesota. SDAHO is partnering with LifeSource to promote donor designation in our state and to recognize those generous donors and their families who already made that choice to donate, but we need your help!

April is National Donate Life Month and hospitals throughout the state are partnering with LifeSource to participate in a campaign called “Let Life Bloom” focused on registering individuals to be donors. Donation saves lives and the need is great. Currently, there are over 300 South Dakotans waiting for a kidney and many more on dialysis. Donation also saves costs, as it’s estimated that a kidney transplant pays for itself in a little over 3 years. Increasing donor designation will increase donation and help all who are waiting for organs and tissues.

South Dakota’s 58% donor designation rate is much higher than the national average of 45% and yet still does not match our neighboring states of North Dakota at 68% and Minnesota at 63%. Great strides have been made including significant legislation passed last year that allows individuals to register online, makes the registration

form at the DMV easier and provides opportunity for individuals to promote donation with a special Donate Life license plate sticker.

As physicians, you are the most trusted source of healthcare information for your patients. If they ask you about organ and tissue donation you can reference LifeSource and direct them to www. life-source.org. The website provides general information, personal stories about donation and transplantation and an opportunity to register to be a donor. There is also a Professional Partners section on the site to provide a more clinical view of donation and resources to help promote donation in hospitals and clinics. One of the most interesting things I learned about being a donor is that age is not a factor! Your age or health should not prevent you from registering to be an organ or tissue donor. Most health conditions do not prevent donation and age is not a factor–the oldest organ donor was 92!

We’re proud at SDAHO to team up with LifeSource along with donation and transplantation hospitals across the state to promote the “Let Life Bloom” campaign. Please join us in this effort to effect change and increase South Dakota’s number of registered donors.

It takes just minutes. You can sign up to become a donor at https:// apps.sd.gov/ps09onlinerenewal/organdonorupdate.aspx. ■ Dave Hewett is President and CEO of the South Dakota Association of Health Care Organizations (SDAHO)

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Midwest Medical Edition

on the

MidwestMedicalEdition.com

Now More than a Magazine, A Medical Community Hub

Enhance your MED experience!

MED offers continually updated news and calendar events between issues on our website, as well as an expanding FREE directory of area practices and businesses.

Here is some of what you’ll find exclusively online this month.

Log on Now! Online Directory

Best Practices: Reducing the Risk of Healthcare Associated Infections (HAIs) through Effective Environmental Cleaning Processes With worries about hospital-acquired infections and “superbugs” on the rise, never before has the importance of environment service staff been recognized in healthcare as it is today. This article from the experts at ABM reviews the essential elements of a quality EVS program.

The Path to Omnibus Compliance: One Year Wiser It seems like just yesterday that the Department of Health and Human Services (HHS) announced an update to the HIPAA Omnibus rule. Over the past year, covered entities (CEs) and business associates (BAs) have worked to make sense of the nuances embedded within those pages, adjust their HIPAA programs, and rework information management processes to ensure compliance. But we’re not done with HIPAA yet.

Attention Would-Be Bloggers!

MED is actively seeking physicians and other healthcare professionals to share their insights and opinions with our growing website audience. Are you interested in joining the conversation? Let Med on the Web help you reach the online community.

Contact us at info@MidwestMedicalEdition.com to find out how.

Using MED’s online Directory, powered by Locable, you can find and connect with area businesses that cater to healthcare providers. It’s easy and free for businesses and providers to be included in the Directory. With ongoing updates to our business identity solution tools, we make it simple to get the most out of the constantly-changing online environment. Being a part of MED online allows you to engage the online community in new ways and put the web to work for your practice.

Online Calendar Our online Calendar feature makes it easy to find and share local events specifically for heathcare professionals, so you will never miss a meeting or course you wanted to attend.

You can even list your own upcoming event – such as an office open house or a presentation for colleagues – for free.

Don’t forget to take your MED . . . wherever you go!

Download your free digital issue of MED and read it on your iPad or Android tablet.

Find links to these articles and more on the MED homepage.

April / May 2014

MidwestMedicalEdition.com

5

Medical Practice Management:

How to Know When It’s Time to Change Providers With the coming implementation

experiences with consulting companies,

of ICD-10, medical practices

DT-Trak was willing to learn the clinic’s exist-

nationwide are taking a serious

ing electronic medical records system and

look at how they do billing and

truly streamline procedures, making coding

coding. It’s a great time to assess

more accurate and improving billing ser-

your systems for coding, billing

vices to patients, said Dr. Kidman. DT-Trak

and practice management, to

helped the clinic recover income that was

determine if you need a change.

lost in the past, but also works with the

Having a system in place that is effi-

clinic, using their existing software and

cient, accurate and able to handle the

training staff to make everything more

revenue generation cycle is more important

efficient.

than ever, says Natalie Bertsch, co-owner

“They worked out the snags that prior

of DT-Trak Consulting. Since 2002, her com-

to this were causing a fair amount of patient

pany has worked to improve and pioneer

dissatisfaction,” said Dr. Kidman. “We worry

new technology in medical records, staying

less about the finances, giving us more of a

on the forefront of an ever-evolving field.

presence of mind to be with the patient.”

“When a clinic can improve its business

Jewel Kopfmann, co-owner of DT-Trak,

and financial wellness,

says one of the latest services provided by

everyone can focus on

DT-Trak is DT-Tester for hospital and clinic

the health and well-

coder, tools that can be used to help prepare

ness of the patients,”

coding staff for ICD-10 compliance. DT-Trak

said Bertsch. “If that’s

has created compliance auditing tools that

not happening, it’s

can be used in-person or online, to provide

time to think about

individual feedback for staff members to

change.”

improve their compliance accuracy.

Jewel Kopfmann

Natalie Bertsch

6

5

Five Reasons to Think about Making a Change 1.

I s your practice prepared for the implementation of ICD-10?

2. Do you spend too much time and effort on claims and payments?

3. I s your billing process bringing in the revenue you need?

4. Are your billing consultants

responsive and able to work with your practice’s unique situation?

5. Does your provider offer ongoing training to educate your staff on what they really need to know to keep your practice efficient and effective?

In the nine years

DT-Trak can do in-person sessions or

that Destiny Family

offer online software tools that can be

management with consistency, says Lornell

Medical Clinic has

issued to medical practice staff for individu-

Hansen, owner and medical director of

been open, the clinic

alized online sessions using actual medical

Physicians Vein Clinics.

had tried managing

charts. Staff can have a chance to try out

Dr. Hansen says that his staff is confi-

their own billing and

their skills in a testing scenario, which

dent about their work because of the

credentialing before

allows them to make improvements in a

training and credentialing, and consistent,

turning the services

safe setting.

quick response they get from DT-Trak. He

over to two different

“It’s a really nice way to educate

can concentrate on growing his medical

companies, says clinic

individuals who have many other duties to

practice, because he gets a consistent

owner Brian Kidman.

carry out,” says Kopfmann. “Everyone

response with insurance pre-authorization,

But, unsatisfied with

who works in a medical practice can learn

billing and financial follow-ups.

their results, they

and keep up with change in a way that is

turned to DT-Trak

convenient and positive.”

about 18 months ago.

Clinics considering a change, should

Unlike their earlier

seriously look for a medical claims

“I know they’ll give me the information I need to grow my practice,” said Dr. Hansen. “It’s one of the things that I know that I can count on.” ■

Sponsored Feature

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Happenings around the region

South Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska

News & Notes Avera

Avera McKennan Hospital & University Health Center has

again been named one of the nation’s 100 Top Hospitals by Truven Health Analytics. The 100 Top Hospitals scorecard measures hospital performance across 10 areas: mortality; inpatient complications; patient safety; average patient stay; expenses; profitability; patient satisfaction; adherence to clinical standards of care; and post-discharge mortality and readmission rates for acute myocardial infarction (heart attack), heart failure, and pneumonia. Avera McKennan is the only hospital in Sioux Falls and South Dakota to be named to the list.

Officials at Avera Sacred Heart Hospital are announcing plans for a new $11.5 million dollar replacement facility for Avera Yankton Care Center with plans

for a separate six-bed hospice facility. The new facility will be built as two new “neighborhoods” of Avera Sister James Care Center at the Majestic Bluffs campus with the hospice facility separate, but attached. Groundbreaking for the project at Avera Sacred Heart Majestic Bluffs is planned for late April.

8

The Avera McKennan Fitness Center has become a certified medical fitness facility by the Medical Fitness Association, the

country’s leading organization dedicated solely to medically integrated outcomes and accountability-based fitness facilities. The certification process is the first and only certification offered specifically to facilities in the medical fitness industry. Avera McKennan is the only health and fitness center in the Dakotas, Minnesota, Iowa, Nebraska or Wyoming to have passed this certification process.

April K. Willman, MD, Avera Medical Group Pediatrics, recently received FAAP designation.

Pediatricians who maintain their FAAP designation have obtained board certification in pediatrics and made an ongoing commitment to lifelong learning and advocacy for children. Dr. Willman completed her residency in pediatrics at the University of Missouri in Columbia and received her medical degree from USDSM. Dr. Willman and her husband, Dave, are the parents of two children and reside in Mitchell.

Clinical Psychologist Matthew D. Christiansen, PhD, has joined Avera Medical Group in Mitchell. Dr.

Christiansen earned his PhD in Clinical Psychology from the University of South Dakota and served a Psychology Internship at Wasatch Mental Health in Provo, UT. He completed a Psychology Residency at Dakota Counseling Institute in Mitchell in 2003 and currently serves as an Adjunct Professor of Psychology at Dakota Wesleyan University.

Dr. Christiansen has extensive experience in counseling children.

Mary Lynn Mains, RN, BSN, CCRN, at Avera Sacred Heart Hospital in Yankton recently received national recognition for reaching a significant milestone in the nursing profession. Since 1983, she has

consistently maintained CCRN certification offered through the American Association of Critical Care Nurses (AACN) Certification Corporation. Mains is one of 360 CCRNs being honored this year by AACN for 30 years of continuous certification.

Avera Brady Health and Rehab in Mitchell has received the highest possible overall rating of five stars in U.S. News & World Report’s sixth annual Best Nursing Homes. The Best

Nursing Homes 2014 ratings highlight the top nursing homes in each city and state, out of nearly 16,000 facilities nationwide.

Black Hills

Wall Clinic officially joined the Regional Health system in March. The clinic provides

primary care, home health, medical imaging, laboratory and electrocardiogram services to residents and those from the surrounding area. Regional Health has managed Wall Clinic for 18 years. The Wall location is now known as Wall Regional Medical Clinic.

The International Board of Lactation Consultant Examiners (IBLCE) and the International Lactation Consultant Association (ILCA) have recognized Rapid City Regional Hospital (RCRH) for excellence in lactation care.

The hospital was recognized for staffing professionals with IBCLE certification, providing breastfeeding training for nurses who work with new families, and for providing a lactation program five to seven days a week for breastfeeding families.

Kyle Richards, MPA, LNHA, CPHQ, is the new Chief Operating Officer of Regional Health Network. Richards comes to

Regional Health from the Waverly Health Center in Waverly, Iowa, where he served as CEO since August 2011. He also has many years of work experience with Sanford Health.

Midwest Medical Edition

Sanford Foot and ankle specialist James Johnston, DPM, has joined the Sanford Aberdeen orthopedics and sports medicine team. Dr. Johnston

specializes in foot and ankle trauma and surgery, diabetic wound care, and diabetic limb salvage. He received his medical degree from the California School of Podiatric Medicine at Samuel Merritt University, Oakland, California and completed residency at the UCSF San Francisco VA Medical Center.

Sanford Heart Hospital and Sanford Pulmonary Medicine Clinic are working together to launch Sanford Pulmonary Hypertension Clinic. This new service focuses

on a multidisciplinary approach consisting of a pulmonologist, a cardiologist, specially trained nurses, respiratory therapists and pharmacists. Sanford Heart cardiologist Dr. Orvar Jonsson and Sanford Health pulmonologist Dr. John Yu will lead the team to create individualized care plans.

Sanford Health now provides a personalized program for patients who choose to have spinal surgery. The Sanford

Center for Spine Success relies on a multidisciplinary team including surgeons, anesthesiologists, pharmacists, physical and occupational therapists, nurses, and case managers. The team collaborates to develop individualized treatment plans for the best post-surgical outcomes, including pain management unique to each patient’s needs.

April / May 2014

James Ford, MD, a medical oncologist and geneticist at Stanford University, has joined the Edith Sanford Breast Cancer team as its national genomic oncology advisor. Dr. Ford will

help develop and launch clinical trials in genomics and provide technical expertise to physicians based on the interpretation of genomic data gathered from those clinical trials. Dr. Ford is currently an associate professor of medicine (oncology) and genetics and director of the Stanford Cancer Genetics Clinic and the Cancer Genomics Program at Stanford University Medical Center. He is a graduate of Yale School of Medicine.

The Sanford Moorhead Campus in Moorhead, Minnesota opened its doors on March 3rd. The $17 million facility sits

on a 28-acre piece of land. The 49,000-square-foot clinic is three times the size of the previous Moorhead Clinic and is equipped with 52 clinic exam rooms and has space for future expansion.

In addition to existing services (family medicine, internal medicine, geriatric medicine, medical home, pharmacy, x-ray, behavioral health and lab), the campus will add pediatrics, obstetrics & gynecology, and outreach services for specialty care, along with advanced imaging, and a pharmacy.

Dakota Hospital Foundation (DHF) in Vermillion, South Dakota announced in February that Sanford Health will make a $12 million investment in Sanford Vermillion’s medical facilities over the next five years. The agreement also means

Sanford Health will assume ownership for the infrastructure, including building projects and technology, at the conclusion of the project.

Sanford Aberdeen has been awarded Level IV trauma certification from the American College of Surgeons and has been designated as a trauma hospital through the state of South Dakota’s trauma system.

After being operational for another year, Sanford Aberdeen will be eligible to undergo evaluation for designation as a Level III trauma center.

Siouxland Mercy Medical Center has been named a Blue Zones worksite.

The Blue Zones program recognizes area work environments that promote and encourage employee wellness. A quarter of Mercy Medical Center employees signed up for the program. Mercy was recognized for things like its physical environment, creation of social networks, and wellness policies.

Sioux City is one of 19 Blue Zones demonstration sites in Iowa.

MidwestMedicalEdition.com

Board-certified family physician Laura Danis, DO, has joined UnityPoint Clinic Family Medicine at Sergeant Bluff.

Danis received a BA from Northwestern University, an MA from the College of William and Mary in Williamsburg, Virginia, and a DO from West Virginia School of Osteopathic Medicine.

After completing her residency in family medicine in Largo, Florida, she most recently worked in New London, Connecticut. She and her husband, Peter, have two children.

The June E. Nylen Cancer Center’s 16th Annual Winter Benefit held at Bev’s Hilton Garden Inn Saturday, February 22 raised nearly $138,000 with 300+ people attending.

Community volunteers Tom Baurichter and Virginia Anderson co-chaired the event. The money raised this year will help purchase new radiation technology.

Stay up-to-date with new medical community news between issues.

Log on!

9

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10

Midwest Medical Edition

On one hand, the federal program designed to incent physicians to buy and “meaningfully use” an electronic health record (EHR)system has been a tremendous success.

According to CMS, as of January 2014, 347,000 healthcare providers had received payment for participating in the program.

EHR “Copy/Paste” Fraud Risk Page 12

Pulling the Plug Page 13

When I.T. Fails Page 14

South Dakota Doctors Among First to be Certified in Clinical Informatics Page 15

On the other hand, many of these providers also admit to having annoying – and often costly – “issues” with EHR systems that they may have chosen too quickly or were inadequately prepared to use. At the same time, many of the EHR companies that sold them those systems are so overwhelmed by the influx of new users, that their customer and technology support may be compromised.

Is it any wonder that a recent Medical Economics survey found that 45 percent of physicians say patient care has suffered since they implemented their EHR? Even providers who agree that EHRs will improve care over time have found themselves frustrated by the realities of implementation. In this Special Section, we bring you advice from and about area professionals who are experts on . . .

The

EHR

Issue 11

By Rhoda Lagerquist, Eide Bailly, LLP

EHR “Copy/Paste” Fraud Risk Did you know that «copy/paste» in Electronic Health Records (EHR) could pose a fraud risk? The Office of Inspector General (OIG) is looking at copy/paste and has identified it as a potential fraud vulnerability.

The OIG released two reports regarding

Concerned about the risk for EHR fraud in your office? Get Rhoda’s tips for preventing copy/paste issues. Log on!

12

EHR vulnerabilities and fraud safeguards: “Not all recommended fraud safeguards have been implemented in hospital EHR technology” OEI-01-11-00570 December 2013; and “CMS and its contractors have adopted few program integrity practices to address vulnerabilities in EHRS” OEI-01-11-00571 January 2014. If the OIG is looking at copy/paste in EHRs, your facility should ensure that policies have been implemented regarding the use of the copy/paste feature in your EHR software to prevent potential misuse and fraud.

The OIG recommends that the CMS direct its various contractors to dig into the audit data, and to give these contractors more guidance in general on spotting EHR-enabled fraud. These contractors include Medicare Administrative Contractors (MAC), Zone Program Integrity Contractors (ZPIC), and Recovery Audit Contractors (RAC).

The OIG has also recommended that the Office of National Coordinator (ONC) develop a plan to address EHR fraud vulnerabilities.

Copy/paste or “cloning” may allow a provider to take information from one source and insert it at a different location. This information may or

may not be clarified for accuracy and relevancy to the patient’s current medical status. If the copied information is not clarified, nor relevant, it could be used to fraudulently bill a higher level of care or influence the care given to a patient because of inaccurate medical information on the patient’s current condition. Kathleen Sebelius, HHS Secretary, stated: “False documentation of care is not just bad patient care; it’s illegal.”

Identify if Copy/Paste is Being Misused How can you tell if the copy/paste function is being inappropriately used at your facility? Do you see the same information repeated over and over again? Is the same physical exam in the H&P, progress notes and/or discharge summary? Or is the same progress note repeated over a number of days? If so, your facility may be at risk.

Watch for CMS guidelines on the proper use of copy/paste features of EHRs to ensure that this feature is used appropriately for enhancing clinical efficiency. ● Rhoda Lagerquist is a Healthcare Consulting Manager with Eide Bailly, LLP.

Midwest Medical Edition

By Trish Lugtu, MMIC

Pulling the Plug As you transition to new technology, take care how you decommission your legacy IT. Meaningful Use incentives have moti-

vated hundreds of software vendors to rush to market to compete for a piece of the health care pie — ready or not. The influx of electronic health record (EHR) systems with varying levels of maturity and cost has created an overwhelming number of options for a market of inexperienced buyers. Complicating matters, providers often choose to pull practice management along in the conversion wake.

And now, with the federal EHR incentive program in its third year, we are bearing witness to a growing number of EHR replacement sales due to unsatisfied providers and EHR vendors’ inability to meet increased certification criteria. In all cases, a certain amount of data transitions from one system to another.

And once converted, the old systems are decommissioned.

Whichever scenario applies, consider the following factors before pulling the plug on any legacy system.

Record Retention Have you analyzed the impact of your new system on your legal health record, i.e., your organization’s official record of health care services delivered for a patient? The legal health record is defined by organizational policy regarding what information may be released

April / May 2014

upon authorization. If you unplug your legacy system, will you still be able to follow your retention policies and make records available for authorized requests? If you are not converting all data to your new system, how will you make legacy data accessible as needed for the duration of those retention requirements?

Remember to assess your policies against the record retention laws set in your state.

Integrity If you are converting data, how will you ensure accuracy of the data through the conversion process? Don’t turn off your legacy system until you’ve thoroughly verified conversion results, and remember to document your process.

Not just for EHRs The designated record set includes both medical and billing records of patients used for access and amendment under the HIPAA Privacy Rule. Records may include enrollment, payment and claims adjudication. Have you analyzed the impact of decommissioning system data on retention requirements for HIPAA, such as accounting of disclosures?

What about Medicare and Medicaid retention requirements? Do you have any information requiring retention in support of Medicare or Medicaid inquiries or investigations? When

MidwestMedicalEdition.com

decommissioning technology, be sure to consider all types of information that must be preserved.

Litigation Holds Are you under a litigation hold? If so, your organization could receive sanctions if you destroy data before or during litigation.

Remember that your systems hold electronically stored information that may be subject to discovery. Be sure to consult with your attorney before decommissioning systems if any litigation is pending.

Security Lastly, if you store data from your old system, remember that archived data must also be protected. Assess its administrative, physical and technical safeguards during risk analysis.

If you are destroying data, remember to consult your security policies and procedures for data destruction and sanitation. ● Trish Lugtu, BS, CPHIMS, CHP, CHSS is a Research and Development Manager with MMIC in Minneapolis.

Thinking of decommissioning your EHR system? Make sure you’re doing it safely. Log on for Trish’s extended article.

13

Bryan O’Neal, Golden West Technologies

When IT Fails . . .

How Costly is Downtime for Healthcare Organizations? $7,900 per minute.

That’s how much unplanned downtime costs healthcare organizations, according to a recent survey conducted by Ponemon Institute and Emerson Network Power. With an average incident lasting just under 80 minutes, healthcare organizations lost $627,418 per incident from computer network outages in 2013.

That’s a lot of money to lose. I think we’d all agree we’d want to protect ourselves from that kind of loss. But would your organization, here in the Midwest, really lose $7,900 per minute? Should we believe that downtime is that much of a risk?

First, let’s define what downtime is.

Downtime is a period of time in which a system is unavailable and can be planned (for maintenance) or unplanned. I’ll be referring to “downtime” as unplanned in this article. Downtime may affect a single application, such as your EMR. It can also be system-wide, such as a server crash or loss of Internet connection.

Now consider what your organization would do without access to patient history,

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charting, scheduling, billing software, or phones. How many people would be unable to perform their jobs? Consider the costs of additional personnel needed to see patients, inefficient paper-based downtime procedures, and data entry that must be performed once the system resumes operations. Additionally, there are intangible costs of diminished patient and employee satisfaction to think about. Your actual cost will vary based on size of the organization, patient load, specialties, and which phase of Meaningful Use you’ve attested to.

No matter your size or location, downtime will cost you and will only get more expensive.

How can you address this risk without breaking the bank? To start, evaluate which of your practice’s critical workflows are supported by your Information Technology (IT). Typically, this includes your scheduling, charting, prescriptions, billing and accounting (including payroll!). Determine the impact to organization if these services are not available or lost. How long can you survive without the information? What

potential fines for HIPAA violations could you be subject to?

Evaluate the likelihood of the threats from the most probable, such as hardware failure, to the extreme, such as natural disasters. The National Institute of Standards and Technology (NIST) has published a brief overview of the most common threats in its handbook. They include:

• Errors and Omissions • Fraud and Theft • Employee Sabotage • Loss of Physical and Infrastructure Support • Malicious Hackers With this information in mind, assess your current situation. Where is the central location of your critical data and what redundancies exist? Where and how are the servers and storage at your location backed up and how quickly could you restore that information? Also consider how quickly a replacement server could be installed. If you have your data hosted, how redundant

Midwest Medical Edition

South Dakota Doctors Among First to be Certified in Clinical Informatics David Basel, MD, and Scott Eccarius, MD,

is your connection (i.e. Internet or dedicated connection)? Does the risk of downtime warrant a second-failover connection?

Unfortunately, you can’t completely eliminate downtime from happening.

Hardware can fail unexpectedly, malicious hacking continues to rise, and natural disasters are out of our control.

But by performing a thorough evaluation and investing in a solid continuity plan, you can prevent downtime from truly costing your organization. ● Bryan O’Neal is a healthcare technology consultant at Golden West Technologies in Rapid City, SD.

Want to find out what downtime might be costing your practice?

Log on!

April / May 2014

are among a select group of physicians across the US and Canada to pass the first-ever Board Certification exam in Clinical Informatics which was administered by the American Board of Preventive Medicine (ABPM) last October. Clinical Informatics promotes the understanding, integration and application of information technology in healthcare settings. In January, Drs. Basel and Eccarius received their Clinical Informatics certification along with an internationally select group of pioneering clinicians.

Clinical Informatics has evolved gradually over years of pioneering work by many to get the profession to the point at which specialty board certification is a reality.

Dr. Basel has been the Medical Director of Avera Medical Group Quality for Avera Medical Group in Sioux Falls, SD since 2013 and is board certified in internal medicine and pediatrics since 2003. Dr. Eccarius is board certified in ophthalmology and has practiced private practice ophthalmology in Rapid City since 1991. Since 2007, he has been the Chief Medical Informatics Officer (CMIO) for Regional Health in Rapid City, SD. Drs. Basel and Eccarius have also been recognized by South Dakota’s Regional Extension Center (REC), HealthPOINT at Dakota State University, as members of the Meaningful Use Vanguards (MUV). The MUVer program was established by the Office of the National Coordinator and Regional Extension Centers as a way to recognize and honor an exclusive group of leaders, committed to driving the most important transformation in the US healthcare system in decades. The program recognizes those who champion the Meaningful Use effort in their organizations. Meaningful Use means Log on to read more about healthcare providers use a certified Electronic Health Drs. Basel and Eccarius and learn Record (EHR) technology in ways that can measure qualwhat the CI Certification requires. ity, quantity and to provide better health, better health care and at lower cost. ●

MidwestMedicalEdition.com

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Yankton CEO to

Retire After 17 Years Pamela J. Rezac, EdD., President and CEO of Avera Sacred Heart Hospital recently announced her plans to retire this June after 17 years at the helm in Yankton and 34 years in healthcare leadership.

Rezac has overseen many changes since taking over leadership of the Avera Sacred Heart region, which encompasses 15 counties in southeast South Dakota and northeast Nebraska and serves more than 150,000 people.

In that time, Avera Sacred Heart has grown its presence from five communities with seven facilities to 13 communities with more than 20 facilities – ensuring access to high quality healthcare throughout the region.

We spoke with Rezac about her time at Avera Sacred Heart, her plans for the future, and her thoughts about the future of rural healthcare

programs, new technology and new people we are able to serve, that feels very good. The other thing is that we have aspired to high patient satisfaction and high clinical outcomes and we have gotten recognition that we are on the right track in both of those areas.

MED: A lot of your career has been spent working with the medical staff and with medical education. Why? PR: First, I understood that if we concentrated on clinical quality we would achieve greatness and improve clinical collaboration and we have been recognized as a top performer. As for education, over half of our medical staff are either graduates o f USDSM or are teaching there now. We want to ensure the future of the 3rd year training program here so that new doctors can continue to see what it means to live and work in this rural community.

“ It is going to be important for future leaders to recognize the need for continued collaboration . . .”

MED: What would you say has been the best part about your time in Yankton?

PR: Working with people is always at the top of my list of things that I have loved. That is what has energized me from day to day. Not just patients, but also our physicians, administrators, our board, the community. This is all based on the fact that we are here to improve the health of the people that we serve.

That’s a unifying thing.

MED: What are you proudest of?

PR: When I got here in 1980, Avera Sacred Heart was one building on the south side of the campus and a second building was under construction.

Today, when I look out across this campus and see the things we have built, and I think about all of the new

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MED: What are your plans for the future?

PR: I have made it known that I don’t intend to completely leave healthcare. I feel that I need to do something where I can have an impact on the health of people. In the more immediate future, we took our kids to Czechoslovakia when they were in high school (Rezac is 100% Czech), so we may take a trip back there.

MED: And what about the future of medicine in the region, going forward?

PR: It is going to be important for future leaders to recognize the need for continued collaboration . . . the hospital, the clinics, the durable medical equipment . . . We have begun to understand that we have to work together and be more concerned about the total coordination of care for every patient, before, during and after their hospitalization.

There has to be that continuity. ■

For more on Rezac’s retirement and the progress made at Yankton Sacred Heart during her tenure, read the full press release.

Donated Airline Miles Help Wishes Take Flight Make-A-Wish South Dakota

raised more than 1.7 million unused airline miles during its statewide Wishes in Flight campaign in February. The miles will help to make travel wishes come true for kids facing life-threatening medical conditions across the state.

Unused airline miles are accepted year-round from Delta, United and U.S. Airways.

There is a minimum donation of 500 United miles and 1,000 from Delta or U.S. Airways.

Once donated to Make-A-Wish, the miles will never expire.

“This is a unique way to help us make travel wishes come true,” Make-A-Wish South Dakota President and CEO Paul Krueger said. “Every mile donated makes a difference and helps us toward our vision of granting every eligible child’s wish.”

Make-A-Wish estimates the miles donated so far will purchase nearly 35 plane tickets and save the chapter more than $17,000 in airfare. Each year, more than 65 percent of wishes involve travel. Besides the wish child, parents and immediate siblings living at home typically go on the trips, as well.

The statewide effort was made possible by KSFY TV, Midco Connections, Midcontinent Communications, and NewsCenter1. ■ To donate your miles, call 800-640-9198 or give online at southdakota.wish.org.

Midwest Medical Edition

April / May 2014

MidwestMedicalEdition.com

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By Alex Strauss

The Surgical Institute of South Dakota’s Bradley Thaemert, MD, FACS, recently became the first surgeon in the region to use a new device designed to help surgeons get around what has been a major hurdle for endoscopic surgery.

“One of the things that had held us back, as far as endoscopy goes, is that we have not had the ability to suture,” says Dr. Thaemert, a general surgeon with expertise in Single Incision Laparoscopic Surgery (SILS) and other minimally invasive techniques. “Until this device, there has really not been a good way to do surgery with the endoscope. This is what the Apollo OverStitch has brought us.”

Flexible Design The OverStitch Endoscopic Suturing System from Apollo Endoscopy, purchased last summer by Avera McKennan, gives Dr. Thaemert (the only local surgeon currently trained in the use of the system) the opportunity to use the endoscope for a much wider range of applications. The system, which mounts on existing endoscope platforms, makes it possible to place full-thickness sutures through the endoscope, controlling the depth with a special curved-needle design.

“The technique is really something that we surgeons have been anticipating for years,” says Dr. Thaemert, for whom the system represents the latest stage in the evolution of minimally invasive surgery. “We started out doing open procedures, moved to less invasive laparoscopic surgery to scarless single incision surgery. Now, with this system, we are looking at surgery with no scars at all.”

The OverStitch system was designed for maximum surgical flexibility, allowing surgeons to deploy both running and interrupted stitches. It can be used with one hand and requires only one operator. Suture material is available in both absorbable and non-absorbable varieties (2-0 Polypropylene and 2-0 Polydioxanone). The addition of a corkscrew-shaped helix attachment

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Photo by Zeke Hanson

Surgical Institute Physician First to Offer Next-Generation Endoscopic Surgery

The Apollo OverStitch device allows the surgeon, for the first time, to install single or running sutures internally using only an endoscope for guidance.

easily anchors the device into tissue, enabling precise suture placement and depth control with minimal trauma to the underlying tissue.

“You are using a dual lumen, so you have two channels that you are working through,” explains Dr. Thaemert. “It’s like having an extra port.” At the close of the procedure, the cinch design means Dr. Thaemert’s stitches will be held in place without the need for him to tie a complex surgical knot. To ensure maximum patient safety, the device is packaged for individual use.

Multiple Uses “My goal with this system was to start out with the basics, doing non-emergency procedures to fix various kinds of holes,” explains Dr. Thaemert. An example is the gastrogastric fistula, which can be a complication of gastric bypass surgery. “In the old days, the only option was to do an open surgery to take down those fistulas. With the OverStitch, we can offer an alternative, minimally invasive surgery through the mouth. So that is where we started.”

As with any new tool, new uses for the OverStitch have surfaced as Dr. Thaemert has become more familiar with it. (“Now that we have the technology, we have the hammer and we are looking for the nails,” he says.) Recently, he has begun using the system to close down openings in the stomach that have become too large after gastric bypass surgery. During the outpatient procedure, Dr. Thaemert uses the OverStitch to help restore the original level of restriction so patients continue to get the maximum benefit from their gastric bypass.

For patients who have had the sleeve gastrectomy procedure for weight loss, Dr. Thaemert has used the device to repair small leaks along the staple line. Bleeding following esophageal cancer resection or removal of large polyps in the colon can both be repaired with the OverStitch. In non-resectable esophageal cancer cases where a stent has been placed, the OverStitch has allowed Dr. Thaemert to suture the stent in place, preventing shifting.

Sponsored Feature

Dr. Thaemert is using the Apollo OverStitch system a couple times a month right now, but expects that uses for the tool with continue to expand. Eventually, he anticipates that, rather than merely fixing complications of weight loss surgeries, the device may be used to offer a completely new kind of weight loss procedure. One that can even be performed on an outpatient basis.

“The OverStitch device will make it possible to offer a stand-alone restrictive procedure instead of sleeve gastrectomy or lap band surgery. Essentially, you would just be stitching the stomach together from the inside,” explains Dr. Thaemert. Unlike more invasive weight loss surgeries, a weight loss procedure with the OverStitch system can be performed with little or no pain, no lost work time, and no scarring.

For the time being, Dr. Thaemert says the OverStitch remains an increasingly important surgical ‘problem solver’. “This does not replace resectional surgery, but it can help us get out of trouble and protect patients from needing much more invasive procedures to fix problems. That is what is really exciting about this device… its ability to get people out of problems. This is here to stay, there’s no doubt.”

About Dr. Thaemert Bradley C. Thaemert, MD, FACS is a board certified general surgeon General Surgery. He is a member of the American Society of Bariatric Surgeons and the Society of Laparoscopic Surgeons. Dr. Thaemert serves as the South Dakota Chairman of the Committee on Trauma for the American College of Surgeons.

He has also served as the past Chairman of the Department of Surgery as well as a past member of the Board of Trustees at Avera McKennan Hospital. ■ A cork-screw shaped helix on the end of the OverStitch Endoscopic Suturing tool allows Dr. Thaemert to securely ‘grab’ onto and manipulate tissue as needed.

April / May 2014

MidwestMedicalEdition.com

Photo courtesy Apollo Endoscopy

Photo by Zeke Hanson

Future Applications

Dr. Bradley Thaemert performing the first endoscopic suturing procedure with the Apollo device. The surgery took place at Avera McKennan in Sioux Falls.

When you need it.

Sanford’s New Moorhead Campus

First to Use Real-Time Operational Intelligence

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When the new Sanford Health Moorhead Campus opened its doors in early March, it became the first Sanford location to go live with the new InSites model of patient care. In this new model, patients arriving at the clinic will bypass the waiting room and go directly to their assigned exam room where nurses, physicians, and lab technicians come to them versus them making their way around to different service locations.

Sanford Health has selected Fargo-based Intelligent InSites to develop a real-time, enterprise-wide solution to help improve operational efficiency, quality and patient experience.

The $30 million solution supports Sanford’s objectives to decrease operational costs, reduce delays in patient care, and increase clinical efficiencies and staffing productivity over the next several years.

InSites will deliver real-time, in-the-moment information at all steps of the patient care experience.

Sanford’s implementation of the Intelligent InSites software takes in real-time location data and uses it to provide intelligence in the form of tasks and notifications, visualized locations of people and equipment on map views, and in-depth analytics and reporting showing utilization, duration of equipment or people in various statuses, and so on. This data will provide Sanford with

unprecedented visibility, analytics, and intelligence into its operational processes. Initial uses include asset management, temperature monitoring, ambulatory workflow, and operating room workflow. Future uses may include emergency department workflow, hand hygiene monitoring, and inpatient workflows.

In the hospital, initially the focus will be on asset management, temperature monitoring and patient flow. Eventually, the technology will be integrated into the day-to-day activities.

This might include personalized mobile apps to help caregivers prioritize rounds and track progress against department goals like time at bedside or call light responsiveness.

For hospital patients, it could include automatically-updated view boards that show them their care team, tell them what to expect for the day, and even let them know when the lunch cart arrives on the floor.For the majority of Sanford staff, this technology is “hands-free,” meaning it doesn’t require entering information on a keyboard.

The InSites system is being installed over the next several months at the Fargo and Sioux Falls Medical Centers. Others will begin in late spring.

Additional locations added in later phases will include Thief River Falls, Bismarck, Bemidji, Worthington, Dickinson, and Aberdeen. ■

Midwest Medical Edition

April / May 2014

MidwestMedicalEdition.com

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Photo courtesy Avera

On Your Mark . . .

26th Annual Avera Race

Set for May 10

The 26th annual Avera Race Against Breast Cancer

will be Saturday, May 10, at the Avera McKennan Fitness Center in Sioux Falls.

Each year, the Avera Race brings together family, friends, cancer survivors and others – all racing toward a common goal: to enhance cancer care for people in Sioux Falls and surrounding communities.

This event funds programs and services that benefit local cancer patients, including: ❤ All Women Count Program ❤ Avera Cancer Institute Resource Library ❤ BRCA genetic testing ❤ Breast Cancer support groups ❤ Cancer Fitness Program ❤ Genetic research for the breast cancer registry ❤ Integrative medicine ❤ Breast imaging navigator ❤ Wigs for cancer patients Last year, this event raised more than $400,000 and gathered 6,800 participants. Participants can choose their own pace: 10K run, 5K run, 3 mile walk, 1.5 mile family fun walk. The 10K/5K runs are competitive, official, chip-timed events. Online registration is $30.

Offline registration is $35 and race day registration is $40. Registration for the 10K/5K runs will close on Friday, May 9, at 5 p.m. Runners who register on race day may participate, but will not be timed. ■

Visit MED’s online calendar for more race information and registration.

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Local Bio Specimens Will Further Breast Cancer Research Genetic analysis of 3,000 women could identify cancer risk Three-thousand bio specimens from women will be analyzed as part of the ongoing collaboration between Edith Sanford Breast Cancer and Athena Breast Health Network to determine whether certain genetic variants could be indicators of breast cancer, officials from both organizations announced today.

The effort aims to gather information that will impact prevention strategies and more precisely identify risk levels of developing breast cancer. As part of the study, 1,500 women at elevated risk and 1,500 women at average risk for breast cancer will be genotyped.

“We believe this to be one of the largest groups of women to ever be studied to determine breast cancer risk levels,” said Gene Hoyme, MD, president of Sanford Research. “If an elevated risk is identified, care teams can improve the likelihood of lifestyle changes and implement preventative treatments when appropriate.”

In November, Edith Sanford Breast Cancer and Athena Breast Health Network announced a partnership in which Sanford Health became a clinical partner with the Athena Breast Health Network, positioning the health system to begin providing patients with a comprehensive breast cancer risk assessment at the time of mammography screening. Additionally, the program will offer patients the opportunity to participate in research aimed at gaining a better understanding of breast cancer and its risk factors, ultimately raising the standard of care for women everywhere.

To analyze each sample from the 3,000 women, AKESOgen, an Atlanta-based biomarker and genetics company selected by Edith Sanford and Athena, will utilize Oncochip technology. Data gathered and studied by Edith Sanford and Athena could positively influence the risk-assessment tool and care plans.

Athena Breast Health Network is a collaboration among the five University of California medical centers. Edith Sanford Breast Cancer is its first partner outside of California and was selected because of its expertise in breast cancer genomics and its ability to integrate the risk assessment into patient care. ■

Midwest Medical Edition

MINNEHAHA COUNTRY CLUB | MONDAY, MAY 19TH 2014 Shotgun Start at 1pm | Lunch Included

To register, become a sponsor or for tournament information visit www.SDLETB.org/golf or call Heidi at (605) 978-6077

Prairie Lakes Doctor

Honored for Work in Haiti

Dr. Henri Lanctin, a urologist

at Prairie Lakes Healthcare System in Watertown, SD, was honored on February 22, 2014, in Brooklyn, NY, by the Aesclepius Medical Society for his work to improve urological care in Haiti.

“Dr. Lanctin was selected because of the outstanding medical care he has been providing to the indigenous population of Pignon, Haiti, for the past few years,” said Nicole Francis of the Aesclepius Medical Society. “Dr. Lanctin is instrumental in the practical medical education of the urology residents of the Faculty of Medicine and he has worked diligently to bridge the gap between the different foreign medical entities providing urological services in Haiti.”

Dr. Lanctin has been actively involved in Project Haiti, a nonprofit organization committed to improving the quality of life for the people of Haiti, for 3.5 years. In addition to sending teams to the area to provide medical care for the community, Project Haiti puts a strong emphasis on providing medical education to Haiti’s own healthcare workers. Dr. Lanctin has organized and led many urology teams to Pignon, Haiti, where team members work sideby-side with Haitian urologists.

“Haiti has 26 urologists,” said Dr. Lanctin. “The goal of our work in Haiti is to work with these urologists—teaching them, supporting them and increasing their knowledge of urological care.”

In November 2013, an international committee was formed to try to coordinate urological care efforts in Haiti. Dr. Lanctin is part of this committee, which includes both administrators and doctors from America and Haiti. The committee’s goal is get a bigger return on the efforts to improve urological care in Haiti.

“This award was very unexpected,” said Dr. Lanctin. “I do not do this work for personal accolades. I do it for the love of the Haitian people.”

About the Aesclepius Medical Society: Part of the Aesclepius Medical Society’s mission is to provide dedicated clinical care in diverse areas of Haiti. The Aesclepius Medical Society Medical Missions provide the opportunity for healthcare professionals to serve in Haiti two to three times a year. The purpose of these short-term missions is to provide medical aid and education to the people in Port-au-Prince, Delmas, provincial villages and distressed rural areas, with little or no access to professional healthcare. ■

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Midwest Medical Edition

Introducing Dan Duley, Clinical Equipment Specialist Dan Duley, BS-BioE, ATP, RET, has joined the staff of Rehabilitation Medical Supply as Clinical Equipment Specialist. He serves patients in clinic and outreach settings, working closely with the seating teams and rehab technicians in Sioux Falls and Rapid City.

Bachelor of Science degree in bioengineering from the University of Illinois

RESNA-Certified (Rehabilitation Engineering and Assistive Technology Society of North America) Assistive Technology ■ Over twenty years experience in rehabilitation equipment Professional / Rehabilitation Engineering Technologist evaluation and fitting ■

■

For more information or to schedule an appointment, call (605) 444-9700.

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Wine

Wine Marketplace Sponsored by Cask & Cork

S o m m e l ie r ’ s c o r ne r

Region’s First Introductory Sommelier Course Offered in Sioux Falls

Wine Facts In ancient Greece, a dinner host would take the first sip of wine to assure guests the wine was not poisoned, hence the phrase “drinking to one’s health.”

Fifty area wine lovers are taking advantage of the area’s first ever introductory sommelier course April 8th and 9th at the Carnival Brazilian Grill in Sioux Falls. Sponsored by Cask & Cork, the course is offered by the Court of Master Sommeliers, the examining body for one of the world’s most exclusive distinctions, the Master Sommelier.

According to the Court of Master Sommeliers, “The Court’s intensive educational program guides aspiring Masters through four increasingly rigorous levels of coursework and examination, culminating in the Master Sommelier Diploma Examination, which only 214 individuals worldwide have completed successfully.”

Just to take the introductory course, which takes place from 8:00 am to 5:30 pm on two consecutive days, the Court recommends at least three years in the wine service industry. Participants who pass the multiple choice theory exam at the end of the course will be eligible to move forward toward becoming a Certified Sommelier, the second rung on the four-level Master Sommelier ladder.

“They have agreed to offer the course here for the first time because they know what we are doing for the wine business in the Midwest,” says Cask & Cork President Dennis Aanenson.

One-on-One with Cask & Cork President Dave Aanenson Q: How did you get into the wine business?

Wine to Watch Sean Minor Napa Valley Red Blend This deep ruby-colored red blend features aromas of ripe blueberry, dark cherry, cassis and vanilla. The soft tannins and sweet oak balance coat the palate and lead to a long and lingering finish.

Look for it at the upcoming The Big Grape event!

Recommended pairing: Meat, Poultry, Salmon (or other oily fish)

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A: W hen I would travel around the world, I would often taste wines that I liked, but when I tried to get big distributors to bring them in, they wouldn’t. I like nice ‘boutiquey’ wines sometimes, so I set up the company especially to work with small, entrepreneurial operations.

Q: W hat unique products have you been able to bring in, as the area’s only locally-owned distributor?

A: W e bring in wines from all over the world. Some of the French and Italian wines, from small family-owned vineyards, might make only 50 or 100 cases. We might bring in 15 or 2 or the whole stock.

We can pretty much get whatever anyone wants, if it is available.

Q: A ren’t these kinds of boutique wines very expensive?

A: Not necessarily. Often they are produced by wineries where the land has been in the family for centuries. They produce wine because they have a passion for it and don’t have the kind of overhead that the big Napa Valley outfits often have. So you can get a great, unique product for the same or less than you could get through a corporation.

Midwest Medical Edition

Survey Shows Growing Acceptance of Integrated, Employed Physicians The current move toward an integrated physician model appears to be winning the approval of both healthcare leaders and many of the physicians they employ, according to a survey conducted by the American College of Physician Executives (ACPE).

According to those who responded positively to the survey, the benefits of the new model include improved communication, greater transparency, better physician job satisfaction and a more patient-centered focus.

Peter Angood, MD, President and CEO of ACPE, says it’s a promising sign for the healthcare industry as a whole.

“This is a strong and important trend that is essential for healthcare to become more successful in delivering what the public actually wants,” Angood said. “The ultimate goal is higher quality, safer care that’s more efficient, more personalized and

is really customer-focused as an industry.”

The survey, which was sent electronically to ACPE members and completed by 617, found that 80 percent of participants either agreed or strongly agreed that the employed physicians within their healthcare organization were satisfied with the current integrated physician model.

When asked to gauge the feelings of administrators, the results were nearly identical, with 85 percent either agreeing or strongly agreeing that administrators were satisfied.

The trend toward physician employment exploded back in the 1990s but it was shortlived. Many physicians disliked the model, primarily because they didn’t want to give up their autonomy and found they could earn more money on their own. As the need for team-based care grows with the move toward value-based payment and population health

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management, hospitals are once again acquiring a growing number of physician practices.

But not all of the ACPE survey participants were enthusiastic supporters of the employed physician model. Some said there were still some serious flaws, particularly in the areas of physician engagement and alignment. A slim majority, 53 percent, said employed physicians were fully integrated into their hospital or health system, while 47 percent said they were not.

Likewise, when asked whether their organization had an incentive plan to encourage and reward physicians for being engaged in practice performance initiatives, the results were nearly evenly split, with 51 percent saying “yes” and 49 percent answering “no.”

Survey respondents were also asked to name the elements essential for success as an employed physician model. The answers named most frequently were appropriate IT support, aligned incentives and, most notably, strong physician leadership.

“The C-suite needs to bring physicians to the table (employed and voluntary) and discuss performance improvement and financial success and have the physicians share ideas,” wrote Patrice Hirning, MD, an internal medicine physician from Salt Lake City, UT. Paul Gausman, DO, a family physician from Erie, PA, added, “Healthcare is changing rapidly and decisions are being made about it by people who do not interact with patients. Physician leaders provide insight across that divide and successful organizations will be the ones listening to them.” ■

Log on for a link to complete survey results, and video responses from physician leaders.

To join the Peace of Mind Movement, give us a call at 1.800.328.5532 or visit MMICgroup.com.

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Midwest Medical Edition

Learning Opportunities

April – June April 11 8:30 am – 5:00 pm Avera McKennan Diabetes Conference

40th Annual Perinatal Conference

Location: CJ Callaway’s Restaurant, Sioux Falls Information: mckeducation@avera.org Registration: 605-322-8950, www.Avera.org/conferences

Location: UnityPoint Health – St. Luke’s, Sioux City, IA Information & Registration: 712-279-894 www.unitypoint.org/professional-education

April 11

7:00 pm – 11 pm “ The Big Grape: Next Generation” Fundraising Event

May 9

Location: Prairie Center, Avera McKennan Hospital Information & Tickets: www.AveraFoundation.org

Location: Sioux Falls Convention Center Information & Registration: 605-977-5311 www.Avera.org/conferences

April 16

May 7

8:00 am – 3:45 pm

19th Annual North Central Heart Vascular Symposium

7:30 am – 4:00 pm

22nd Annual Avera Trauma Symposium Location: Sioux Falls Convention Center Information: mckeducation@avera.org Registration: 605-322-8950, www.Avera.org/conferences

June 6

8:00 am - 4:30 pm

Pulmonary Symposium Location: Prairie Center, Avera McKennan Information: mckeducation@avera.org, 605-322-8950 Registration: www.Avera.org/conferences

April 25 – 26 Friday 3:45 pm – Sat 5:00 pm

13th Annual Sanford POWER Strength & Conditioning Clinic

June 13

Location: Sanford Fieldhouse Information: 605-312-7809 Registration: Sanfordhealth.org/forms/PowerStrengthConditioning

Information: mckeducation@avera.org, 605-322-8950 Registration: www.Avera.org/conferences

8:00 am – 4:00 pm

Avera Sports Medicine Symposium

June 18

8:00 am – 4:00 pm

Critical Care Symposium May 2 – 3

7:00 am – 5:15 pm

8th Annual Sanford Sports Medicine Symposium Location: Best Western Ramkota Hotel, Sioux Falls Information: 605-312-7808, tryg.odney@sanfordhealth.org

Location: Prairie Center, Avera McKennan Information: mckeducation@avera.org, 605-322-8950 Registration: www.Avera.org/conferences

Log on to MED’s calendar to see the newest upcoming events or add your own.

MED reaches more than 5000 doctors and other healthcare professionals across our region 8 times a year. If you know of an upcoming class, seminar, webinar, or other educational event in the region in which these clinicians may want to participate, help us share it in MED. Send your submissions for the Learning Opportunities calendar to the editor at Alex@MidwestMedicalEdition.com.

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