April/May 2021 MED Magazine

Protecting Your Practice in the Age of Telehealth Spring & Summer Events

APRIL MAY

Coping with Compassion Fatigue

VOL. 12 NO. 3

2021

A UNITED FRONT

South Dakota Health Systems Join Forces to Get the State Vaccinated THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

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VO LU M E 12 , N O. 3 ■ A P R I L / M AY 2021

Inside This Issue

CONTENTS

FROM US TO YOU

page 6 | [Sponsored]

S

Three Tips for Healthcare Workers Struggling with COVID-19, Compassion Fatigue, and Addiction ■ By Face It TOGETHER

ON THE COVER

A UNITED FRONT South Dakota Health Systems Join Forces to Get the State Vaccinated

Unprecedented cooperation, communication, and coordination between South Dakota healthcare organizations put the state ahead of the pack in the effort to vaccinate against COVID-19.

PAGE

10

ince the release of the COVID-19 vaccines, South Dakota has consistently

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had one of the highest per capita rates

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sparsely populated geographical area

PAGE 14 | News & Notes Your comprehensive roundup of medical community news including new hires, moves, certifications, awards, and more.

month’s cover feature, we look at how

PAGE 20 | Protecting Your Practice

in the Age of Telehealth ■ By Copic’s Patient Safety and Risk

Management Team 2020 was the Year of Telehealth. Here’s what you need to know to safely and legally embrace this fast-growing trend in your practice.

of vaccination. Providing vaccines across such a large and sometimes has required an unprecedented level of coordination and cooperation from the state’s largest—and most competitive—healthcare systems. In this they did it.

Also in this issue... expert advice from Face It TOGETHER on coping with the stress of continuing to provide high quality and compassionate healthcare in the era of COVID. Plus, exciting vaccine research in Omaha, all the latest area news, and a roundup of upcoming virtual and in person events. (See the inside back cover.)

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Institute to lead COVID-19 Vaccine Trials in Pregnant Women & Children Physician scientists in Omaha are on the leading edge of research to ensure a safe, effective COVID-19 vaccine for pregnant women and children.

MidwestMedicalEdition.com to stay up-to-date between issues!

Wishing you a beautiful springtime, Steff and Alex

On the Cover A nurse at Avera McKennan Hospital prepares doses of the Pfizer vaccine for the first vaccination clinic for frontline essential healthcare workers at the Avera Prairie Center on Dec 17th.

CONTACT INFORMATION

Publisher / MED MAGAZINE, LLC Sioux Falls, South Dakota Vice President Sales & Marketing STEFFANIE LISTON-HOLTROP Editor in Chief / ALEX STRAUSS Graphic Design / CORBO DESIGN Web Design / LOCABLE Digital Media Director / ALYSSA MCGINNIS

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THREE TIPS FOR HEALTHCARE WORKERS STRUGGLING WITH COVID-19, COMPASSION FATIGUE AND ADDICTION

BY FACE IT TOGETHER While her husband was in the hospital with COVID-19 for two months, she didn’t miss a day of work.

“To live with it and deal with it at work —I was immersed,” she said.

Vicki is a big believer in letting go of the things outside of her control; it’s a skill she learned at Face It TOGETHER. She first reached out after discovering how serious her loved one’s addiction was.

“I can’t control how people act, but I help them as best as I can, protect myself and my boundaries and move on,” she said. “I have a nice work/home separation because of coaching.”

“

There’s nothing wrong with attending to others, but not taking time for yourself can cause resentment and put you in a worse position to help.

”

I

T G O E S WITH O UT SAY I N G that this last year

2. PUT YOUR NEEDS FIRST

has been a difficult time for healthcare workers,

Too often, caregivers put the needs

patients and the loved ones of both.

of others before their own. We see

Unfortunately, as we’ve seen at Face It TOGETHER,

this often in our loved one members;

it gets even more complicated when there’s someone in the

they take on the role of caregiver

family struggling with addiction. An addiction wellness non-

at work and at home, which leaves

profit, Face It TOGETHER has grant funding available for those

them exhausted. There’s nothing

impacted by COVID-19, particularly healthcare workers.

wrong with attending to others, but

Below are just a few recommendations for healthcare

not taking time for yourself can

workers who are struggling with compassion fatigue and

cause resentment and put you in a

moving on from COVID-19, regardless if addiction is affect-

worse position to help.

ing their life or not. We’re also sharing the stories of Vicki*

Early on in coaching, Vicki

and Paul*, two healthcare employees who received

stressed about nearly everything

grant-sponsored loved one coaching.

going on in her loved one’s life.

She learned to take a step back,

6

1. ROUND OUT YOUR TOOLKIT

they’re incredibly beneficial.

remind herself what she can con-

Make sure you have several

trol and meet her needs first and

Coping skills look different

to rely on when you’re faced

foremost.

for everyone, but they’re

with a challenge.

“You can’t help others if you don’t

critical when it comes to

As an acute care health-

take care of yourself,” she said. “My

handling stress and difficult

care worker for more than

nutrition, exercise and sleep—I’m

emotions. Many are simple

20 years, Vicki has been pro-

protective of those things. I need

—like deep breathing or a

fessionally and personally

them in order to help and listen to

daily gratitude practice— but

challenged by the pandemic.

others, including my loved one.”

MidwestMedicalEdition.com

3. SEEK HELP Whatever you’re facing, you don’t need to do it alone. Find a professional or organization that meets your needs and makes you feel safe and supported. You’ll get help developing those essential coping strategies and ease the fatigue that comes with caring for others. Whether it’s therapy, a support group or medication, get the support you need to move forward.

Paul and his wife reached out to Face It TOGETHER for help with their daughter’s alcohol addiction late last year.

“We didn’t know how to interact with our daughter; we were always walking on eggshells. We didn’t know how to live our daily lives with addiction always in the background,” he said. “We just really needed somebody to talk to.”

Paul is in a facilities leadership role in a senior living facility. Though he doesn’t regularly interact with patients, the pandemic has had a major impact on revenue and his department’s staffing capability. Learning more about addiction and how to cope with it has made other areas of Paul’s life easier.

“I don’t worry about what’s happening outside of work anymore,” he said.

“Instead of wondering what’s going on and what we should do, I have some new tools now that I never had before.”

By your side, and moving

FORWARD.

Face It TOGETHER peer coaching is evidence-based, confidential and available to anyone impacted by addiction. Free support is available for healthcare workers and others impacted by COVID-19. Learn more at wefaceittogether.org. ❖ * Pseudonym

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

April / May 2021

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

Exclusive Articles Online The University of Minnesota recently unveiled NXT GEN MED, a partnership between the University and Google Cloud that will combine technology, research and immersive learning approaches for students pursuing a Bachelor of Science in Health Sciences degree in Rochester. The program will leverage technology and learning tools from Google Cloud that engage students virtually and will match students with mentors at the Mayo Clinic.

Tax time can be stressful and complicated for people with highly diversified financial portfolios.

The greater the variety of financial interests such as a medical practice, family business, vacation home, rental property, farmland, stocks, art, gold, etc., the more complex things can be. But there are ways to make it easier.

Choosing the right air filters for your facility affects more than air quality–It can also impact your bottom line. HVAC Elements explains how to make sure you’re doing it right.

Join the VIP list.

MED VIPs get exclusive free access to the digital issue of this magazine plus bi-monthly news summaries via email. Sign up at MidwestMedicalEdition.com.

MED Prepares to Expand News Distribution Territory Midwest Medical Edition is living up to its name as the company prepares to expand its medical community news distribution territory even further across the upper Midwest. Nebraska healthcare professionals are about to become the newest group to have the opportunity to receive news from their region from MED. MED already sends comprehensive bi-monthly compilations of the latest news headlines in both North and South Dakota. Subscribers to the news distribution services receive direct links to articles and events in their own areas.

“We know that it is hard enough for people in healthcare just to stay on top of the rapidly-evolving news on COVID-19, let alone keep up with all the other news and events in their region,” says MED Editor Alex Strauss. “We are thrilled to now have the opportunity to streamline the process for healthcare providers and administrators in Nebraska.”

Digital distribution of the MED newsletter to the various regions is made possible by MED’s team of Digital Partners (see sidebar). There is no cost to subscribers.

“Nebraska is a rapidly growing and expanding healthcare market with a lot going on,” says Steffanie Liston Holtrop, MED’s VP for Sales & Marketing. “MED gives organizations in each area a simple, low-cost way to share their information with a highly-targeted regional audience. We expect this service to be very popular in Nebraska.”

Interested in sponsoring one (or more) of MED’s digital newsletters?

Get in touch with us at Info@MidwestMedicalEdition.com. We can customize a package to suit your company’s marketing goals.

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Feeling

STRESSED About Your Role in Life?

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E A UN NITED FRONT R

BY ALEX STRAUSS

Unprecedented cooperation, communication, and coordination between South Dakota healthcare organizations put the state ahead of the pack in the effort to vaccinate against COVID-19

Photo courtesy Avera Health

TAKING ON THE PUBLIC HEALTH ROLE “One of the biggest challenges early on in the pandemic was that we were thrust suddenly into a public health role instead of the typical day-to-day episodic care that we are used to,” says internist Shankar Kurra, MD, Vice President of Medical Affairs at Monument Health Rapid City Hospital. “Unlike other diseases such as hypertension or diabetes, a pandemic, by definition, does not spare anyone.”

Like healthcare providers around the state, Monument had to quickly adjust to its role as the public health leader in the region. And that required a whole new structure for streamlined communication within its own system, with the state health department, and

T

An Avera volunteer provides a vaccine at the 59th Street Vaccination Clinic in Sioux Falls in January.

HE FDA APPROVED THE FIRST COVID-19 VACCINE on December 18 and by December 21, the first South Dakota patients were being vaccinated. As the rollout continued, South Dakota quickly pulled far ahead of other states in the percentage of the popu-

lation getting vaccinated.

As of this writing, South Dakota has fully vaccinated nearly 16 percent

of its population, compared to a national average of just 11 percent. Only Alaska and New Mexico are doing better and only by a couple of percentage points. South Dakota’s health systems have distributed nearly 400,000 vaccine doses.

How did a state with such a vast geographical area, a large number of rural residents, and a highly competitive healthcare environment manage to pull this off? To find out, we spoke to some of the people involved in that effort at the state’s three largest health systems.

10

with other healthcare entities. Those wide open communication channels, including frequent conference calls with the state and the other systems, served them well as the release of the COVID-19 vaccine loomed closer.

“We were very fortunate that the health department has been an excellent partner in making sure that we were all kept informed,” says Kurra.

“Already in November, they were letting us know that the vaccines were getting close to their trial dates and we were beginning to coordinate across the state on how we would do this. That allowed us to get prepared.”

MidwestMedicalEdition.com

COMMUNICATION IS KEY “I think the key to our success as a state has been clear messaging and consistent communication,” says David Erickson, MD, Chief Medical & Innovation Officer for Avera Health.

“We are a small state and we already knew each other well. There are a lot of things, such as the Sturgis Motorcycle Rally, on which we have to work together that most people never realize. We get on calls together. When it came to the vaccine, everyone’s goal was just to get shots in arms. We all know that vaccination is the

Dr. David Erickson

Dr. Jeremy Cauwels

only way forward out of this pandemic,” he says.

Erickson says the fact that public mes-

“Each side has a vaccine coordinator

saging regarding the COVID-19 vaccines

and they make their requests,” says

comes from the state health department,

Dr. Erickson. “Avera has 24 sites around

and that all of the health systems are

Eastern South Dakota where we administer

invited to provide input, helped to lay the

these vaccines. We have an internal currier

groundwork for a strong and streamlined

and distribution system from Sioux Falls.

vaccination effort. “If we were all pushing

Our goal is to have shots in arms within

out different communication pieces, it

a week of receipt of the vaccines.”

would be disastrous,” he says.

“There are trades back and forth depending on where we’re going that

DIVIDING TO CONQUER

week,” says Dr. Cauwels. “Every day is sort

The first step to vaccinating South Dakota

of a work in progress to make sure that

was to divide the workload. The state’s

Sanford, Avera, and Monument are doing

health systems conferred to decide who

the things they need to do to make sure

would take which counties.

that people get taken care of. This vaccine

THE STATE “ DECIDED NOT TO GET BOGGED DOWN IN THE DETAILS AND TO LET THOSE WHO ALREADY KNOW HOW TO DO THIS DO WHAT THEY ARE GOOD AT.

”

doesn’t do any good in our freezers.”

“Some of those decisions were easy because one health system had a major Physician Jeremy Cauwels, MD. “Other communities were mixed. And others didn’t really have a presence from any of the three.”

The 66 counties were divided among the state’s three major health systems, Mobridge Hospital, and the Northern Plains Health Network, including Huron Regional Medical Center, Prairie Lakes Healthcare in Watertown, Madison Regional Health

Photo courtesy Monument Health

presence there,” says Sanford Health Chief

System, and Brookings Health System.

Avera and Sanford agree to share responsibilities in the state’s most populous East River counties, Minnehaha and Brown.

Each system receives a weekly supply of vaccines from the state’s allocation, depending on their needs. (The VA, the IHS, and federal retail pharmacies receive their own supplies from federal allocations.)

Monument Health Pharmacist Scott Peterson, left, and Dr. Shankar Kurra, Vice President of Medical Operations.

April / May 2021

11

Photo courtesy Monument Health

Dakota’s health systems the authority to take the vaccination ball and run with it.

“We are giving vaccinations to everyone anyway,” says Cauwels. “It made sense to work with the infrastructure that already exists.

The state decided not to get bogged down in the details and to let those who already know how to do this do what they are good at.”

SHARING THE BURDEN The COVID-19 effort has not only required a high level of communication between the state’s major health systems, but also significant cooperation to keep the state on track.

When, having overcome some logistical challenges, Monument Health finished vaccinating one of the priority groups before the East River health systems had reached that point, Monument agreed to share some of their allocation so the other systems could catch up.

Monument Health vaccinator Mary Seifert administers a COVID-19 vaccine in the former Herberger’s department store space at the Rushmore Mall.

DOING WHAT THEY DO BEST NO POINT “ ATDURING OUR DISCUSSIONS DID ANY OF THE HEALTH SYSTEMS LOOK AT THIS IN ANY OTHER WAY THAN ‘HOW CAN WE COLLABORATE TO MEET THIS CHALLENGE?

”

“This allowed us to all be in the same place, so that we could all move on to the next phase together,” says Dr. Kurra. “At no point during our discussions did any of the health systems

Vaccinating people against a pandemic is new

look at this in any other way than ‘how can

territory, but South Dakota’s health systems

we collaborate to meet this challenge?’ It was

are no strangers to providing vaccinations–

remarkable and heartening to see. The best

even in remote, rural areas.

part is that we prevented long-term conse-

“It’s important to remember that we gave a quarter million flu shots before the COVID-19

quences for South Dakotans so we have a healthier state.”

vaccine was even available,” says Dr. Cauwels.

“The Ebola scare a few years ago required

“This is something we know how to do and we

the same type of tabletop discussions, but it

do it very well. In South Dakota, we are willing

never required this level of implementation

to cover miles, put things in vans, transport

because it never came to fruition,” says Dr.

things. We just have to make sure there are

Cauwels. “I don’t think there has ever been

people ready to use those vaccines when we

anything that has encompassed as many

get them there.”

people as have been involved in this effort.”

In some cases, this has meant joining

“This experience has allowed us to build

forces not only with other healthcare providers

additional relationships at multiple levels at

but also with community resources like the

all of the organizations,” says Dr. Erickson.

Salem Armory in Salem, where National Guard

“Ultimately that is going to benefit every orga-

members are helping with the vaccination

nization in the state as well as the people of

effort. All three doctors we talked to praised

South Dakota. From that standpoint, I think it

the state health department for giving South

is a very positive thing.” ❖

T D NITED A UN 12

2021

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Hilton Garden Inn - Downtown May 25-26 • Sioux Falls, SD

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April / May 2021

Conserving Energy, Saving Money and Enhancing Patient Experience Inviting all Healthcare CEOs, CFOs, Facility Engineers, Directors & Managers, Architects, Mechancal Engineers & Contractors

13

Happenings around the region

News & Notes South Dakota | Southwest Minnesota | Northwest Iowa | Northeast Nebraska

AVERA Avera Health marked March 11, the one year anniversary of the WHO’s declaration of a global pandemic, with a look back at some notable milestones. Avera’s long history of telemedicine expertise allowed the organization to quickly pivot from in-person to virtual visits. Those virtual visits quickly climbed to 1,000 per day. Avera providers have provided more than 110,000 virtual visits since March 2020. “Avera has drawn upon our strengths as a system and past innovations,” said David Erickson, MD, Avera Chief Medical and Innovation Officer.

“This includes Avera’s 24-hour medical call center, telemedicine, and a robust home care program that were already in place.” Other notable statistics from Avera as of March 11: ■

5,000 hospitalizations

■

5,000 people monitored and treated at home through Avera@Home’s Care Transitions program

■

132,000 contacts via the Avera COVID-19 hotline

■

307,000 COVID-19 tests

■

49,000 people vaccinated (with at least one dose)

After a delay due to COVID-19, Avera and Avera Gregory Hospital are moving forward with plans to build a new hospital, clinic and long-term care center on 20 acres of land east of Gregory on US Highway 18. This $35.7 million project will integrate a 17-bed hospital, 30-bed long-term care center and a clinic that will accommodate up to 10 local providers and visiting outreach specialists, inside space totaling 88,000 square feet. Features include a 24-hour emergency room, diagnostic imaging center, larger surgical suite and post-surgical rooms, enhanced dialysis center, helipad, and connection to telemedicine services. The design was updated in the wake of COVID-19 to include negative pressure rooms, security measures and improved workflow for emergency services. The long-term care center is expected to be complete in summer of 2022 and the hospital and clinic in fall of 2023.

SANFORD Sanford Health provided on-site COVID-19 testing of players, coaches and staff for the NBA All-Star 2021 events in Atlanta in early March. Sanford Health lab technicians travelled to Atlanta in one of the mobile testing units used for the PGA Tour COVID-19 testing to process the tests for NBA All-Star 2021. NBA All-Star 2021 features premier players from the NBA competing in the Skills Competition, 3-Point Contest, Slam Dunk Contest and All-Star Game. There were no fan activities, ticketed events or hospitality functions.

Sanford Health estimated it would run between 500-750 tests for the event.

❱ Intrigued by something you’ve read here? Want to go deeper? Read the full versions of these and other recent news items on our website.

14

MidwestMedicalEdition.com

Sanford Health has also extended its partnership with the PGA Tour to provide COVID-19 testing at on-site at Tour events through June. The collaboration began last June when tournament play resumed at the Charles Schwab Challenge in Fort Worth, Texas, after a nine-week pause due to the pandemic. Sanford Health lab technicians travel to tournaments in one of three mobile testing units deployed across the country.

Each unit, staffed by a driver and three to four technicians, will arrive the Saturday prior to the tournament to begin processing RT PCR tests. Sanford Health is also title sponsor of Sanford International, a PGA Tour Champions event in Sioux Falls scheduled for September 13-19, 2021.

The L3 Foundation recently donated $250,000 to the Sanford Health Foundation to fund childhood cancer treatments, allowing Sanford to launch a larger program of pilot trials through its oncology research program. Researchers and teams can apply for grants to advance treatment or research cures. Program organizers hope to work through two or three trials annually, with at least one of those trials focused on pediatric soft tissue cancer. Grant recipients do not need to be employed by Sanford, but will collaborate with Sanford physicians and researchers.

The Texas-based L3 Foundation is named for Landon Ahrendt who died of cancer in 2014 at age 10. It raises funds to advance cancer research and programs.

U n i q u e a n d S p r i n g

f u n

April reminds us that spring is just around the corner!

The seasons of the year often impact our choice of wine.

Warmer weather will tend to make our palate crave a bottle of Rose or a crisp Sauvignon Blanc.

Perhaps some classic wine cocktails are what you desire?

For something light with a little spritz, try Lillet with equal parts of tonic water (or ginger ale) and a Luxardo Cherry.

White Port also makes an amazing spring cocktail.

Mix

with equal parts of club soda and garnish with an orange slice.

Cheers!

JESSICA BAUMAN Sanford nurse Jessica Bauman, RN, of the Canby Clinic was recently honored with a DAISY Award for extraordinary nursing. The patient who nominated her said Bauman recognized a potentially dangerous airway issue and sent her for further testing, even though the patient had only come for a COVID-19 test.

winetimeonmain.com

330

S.

Sioux

April / May 2021

Main

Ave

Falls,

SD

15

• Happenings around the region

News & Notes

Happenings around the region

MONUMENT JACOB WEASEL

The Sanford Pentagon has partnered with Hudl to access video capture and analysis services that will allow fans to watch live events and help athletes improve their skills and visibility. The Sanford Pentagon is the first multi-sport club facility in the country to utilize Hudl Focus cameras and offer Hudl services to its basketball and volleyball teams. It’s part of a club-wide subscription that includes Hudl’s coaching tools, Hudl Assist’s stat breakdowns and Focus smart cameras, which will allow parents and fans to livestream games and practices. Sanford will be a testing and development partner for Lincoln, Nebraska-based Hudl.

16

Dr. Jacob Weasel has been named Assistant Dean for Diversity and Inclusion at the University of South Dakota Sanford School of Medicine. Dr. Weasel, a general surgeon with Monument Health, has worked with USD as a clinical instructor, as well as helping facilitate medical students in their transition from classroom to clinical experience.

Dr. Weasel earned his MD from the University of Nebraska Medical Center and completed a General Surgery residency at the Iowa Methodist Medical Center in Des Moines. He is an enrolled member of the Cheyenne River Sioux Tribe and joined Monument Health in 2018.

MidwestMedicalEdition.com

SIOUXLAND ASHTON PRUETT Ashton Pruett, ARNP, has joined UnityPoint Clinic Urgent Care– Sunnybrook. Pruett received a Bachelor of Science in Nursing degree from Kaplan University and a Master of Science in Nursing degree from Briar Cliff University. Prior to joining UnityPoint Clinic Urgent Care, Pruett worked at Family Medicine Clinic in Onawa, Iowa; Biolife Plasma Services in Coralville, Iowa; Pleasant View Care Center in Whiting, Iowa; and Oaknoll Health Center in Iowa City, Iowa. She has also completed several clinical rotations in family medicine, emergency services, and surgery and is certified by the American Academy of Nurse Practitioners.

JANE ARNOLD and KEVIN HANDKE Jane Arnold, Senior Vice President of Operations, UnityPoint Health–Sioux City and Kevin Handke, Emergency Preparedness Specialist and STEMI Coordinator, are the first in the region to receive the Unity Pin. Newly-appointed UnityPoint Health CEO, Clay Holderman implemented the Unity Pin to recognize team members who go above and beyond to demonstrate the institution’s brand promise, “know how much you matter to this world.” Arnold and Handke received their pins during Mr. Holderman’s first visit to Sioux City in March as part of his meet and greet tour of the system.

April / May 2021

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• Happenings around the region

News & Notes

Happenings around the region

PROUD TO BE RECOGNIZED AS A

RFG CIRCLE OF EXCELLENCE

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2021

INDEPENDENTS KELCEY GEDITZ Board-certified family nurse practitioner Kelcey Geditz has joined Modern Day Health Care in Aberdeen. Geditz received her BS in nursing from Presentation College and earned her Master of Science in Nursing as a Family Nurse Practitioner from Walden University.

She will provide the Aberdeen and Ipswich areas with online, in-home, and in-clinic appointments.

Modern Day Health Care (MDHC) is an advanced practice nurse owned and operated healthcare clinic, focusing on closing a gap in the rural healthcare landscape by using modern technology to offer primary care services.

TROY HOWARD and ROB SCHLEIFFARTH Rapid City Medical Center’s Ear, Nose, and Throat Department has expanded through a merger with West River Ear, Nose, and Throat.

Troy Howard, MD, has moved his ENT practice across 5th street to a newly-completed building on Minnesota Street in Rapid City.

Dr. Howard and Kristi Larson, C-NP, will now be joined by Rob Schleiffarth, MD, and his team. Dr. Schleiffarth’s team includes ENT specialist Mark Guy, MD, JaNell Rubelt, C-NP, Audiologist Ashley Huerta, and Certified Speech Therapist John Burke. The merger allows Rapid City Medical Center to offer speech pathology services for the first time.

CONTACT US:

1-800-477-2425 ABBUSINESS.COM

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The South Dakota Board of Nursing has approved Yankton Medical Clinic to offer a clinical enrichment program (CEP) for up to three qualifying nursing students starting in 2021. The CEP intern will assist nursing staff with nursing functions including assessing medical needs of patients and implementing care, performing selected nursing procedures/ treatments, patient education, proper use of documentation, participation in nursing/staff meetings to improve understanding of professional nursing, shadowing experiences, and presentation of a clinical case study. Students will spend 320 hours over a 10–12-week period learning and working alongside nurses, medical providers and clinic staff.

MidwestMedicalEdition.com

TYLER PTACEK Rapid City Medical Center’s Tyler Ptacek, MD, recently performed a groundbreaking new treatment for chronic pain in Western South Dakota. The Senza SCS system delivers HF10 spinal cord stimulation therapy for chronic back and leg pain. HF10 was developed by California-based Nevro and has been clinically shown to offer substantial pain relief without the tingling or buzzing used to mask pain in traditional spinal cord stimulation. It is also the only SCS system approved for use without patient restrictions on driving while receiving therapy. The CDC has recently determined that the use of chronic opioids is not an effective therapy for long-term treatment of persistent pain. In a clinical study, HF10 patients demonstrated an average reduction in use of opioid medications of nearly 70%.

The South Dakota Department of Health’s Cancer Programs have announced the release of the Implementation Grant Request for Applications (RFA). The programs are seeking applications that support the South Dakota Cancer Plan, focus on evidence-based intervention implementation, and promote equitable and accessible cancer prevention, early detection, and cancer survivorship efforts in South Dakota. Eligible applicants include organizations that have the capacity to implement the required interventions. Eligibility includes, but is not limited to, federally qualified healthcare centers, health plans, healthcare clinics, healthcare systems, cancer treatment centers, healthcare professional organizations, Indian Health Service, non-profits, quality improvement organizations, school-based healthcare clinics, tribal health centers, universities, coalitions, and worksites. (See MED’s website for more information.)

ERIC FJELDHEIM Eric Fjeldheim, Physical Therapist with Prairie Lakes Rehabilitation Services, is one of only 20 fellows in the US to complete the Fellowship in Pain Sciences through Evidence in Motion. The 350 hour fellowship program provides advanced assessment and treatment for people suffering from pain. Fellows gain exceptional understanding of pain in order to assist with decision making when caring for patients.

Fjeldheim completed his Therapeutic Pain Specialist certification in 2018 to broaden the scope of practice available to people receiving rehabilitation services at Prairie Lakes Healthcare System.

Congenital Cytomegalovirus (CMV) is one of the leading causes of childhood hearing loss.

1 in 3 pregnant women infected with CMV will pass the virus to their child in utero.

CMV is the most common condition present at birth, but it’s one of the least well-known conditions among those in the United States.

Cannon et al., 2012; Muldoon, 2020; Centers for Disease Control & Prevention

Want to learn more?

Get involved today at ehdi136.com or find us on Facebook @SouthDakotaEHDICollaborative

April / May 2021

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• Happenings around the region

News & Notes

PROTECTING YOUR PRACTICE IN THE AGE OF TELEHEALTH

BY COPIC’S PATIENT SAFETY AND RISK MANAGEMENT TEAM

A

MONG OTHER THINGS, 2020 will go down as The Year of Telemedicine. What began as a response to COVID-19 has emerged to become a more permanent shift in healthcare. A recent report 1 by the consulting firm McKinsey and Company estimated that 20% of US healthcare will happen via telecare in 2021. At least 76% of providers across all specialties and

locations currently use telehealth or plan to use some aspect of it.

During the last year, the Centers for Medicare & Medicaid Services relaxed

restrictions and approved more than 80 new services. Commercial payers are following CMS’s lead with mixed enthusiasm. HIPAA and DEA constraints have also been relaxed, and we’ve witnessed state licensing boards starting to modify rules to make interstate telecare easier and more straightforward.

Medical liability carriers like COPIC are taking steps to support providers in this new environment, while trying to foresee implications for patient safety/ standards of care. It is possible that the regulatory and liability context for telemedicine will stabilize around a narrowing set of concerns in a few years.

But as we enter 2021, here are the key points from COPIC’s perspective (we use the terms “telehealth,” “telemedicine,” and “telecare” interchangeably):

1. LICENSURE For regulators, telemedical services within one’s state of primary licensure are considered today more or less “business as usual.” Providers must be sure their telepractice is consistent with their usual scope of practice and privileges. Regulators will scrutinize services outside a provider’s training or credentials.

Some states also impose specific requirements regarding consent and documentation. But, for the most part, services a practitioner offers in the office will be acceptable via telehealth, when this is clinically justifiable.

❱ See the full version of this article on our website for a summary of requirements and waivers and other pertinent telehealth information.

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MidwestMedicalEdition.com

2. O UT-OF-STATE PRACTICE Outside the state where a practitioner is licensed, things are more complicated. Each state has a different tolerance for “extraterritorial” providers rendering care to patients physically located there. Some states explicitly do not allow this. Others accommodate practitioners not

COVID-19 (the DEA has suspended the requirement for an initial inperson visit). However, a controlled substance prescription must be consistent with guidelines, within the scope of the provider’s usual practice, and accompanied by necessary due diligence.

5. DOCUMENTATION There are some unique aspects of telehealth documentation. First of all, it’s important to know when a given encounter was a telehealth visit. A good practice is to note the medium (e.g., teleconference, phone, telemetry data review, etc.). If any technical issue prevented optimal communi-

licensed in the remote state with var-

4. LIABILITY

ious waivers and exceptions. COPIC

The medical liability exposures for

“Exam limited by capabilities of the

advises you to check the licensing

telemedicine are largely the same

patient’s cell phone.”). It’s required by

rules in any state where you provide

as for in-person care. The liability

some states to record the fact that

remote care, even by telephone.

question for any telehealth service

the patient was aware of the limits

is, “Is it reasonable?” In some cases,

of the technology and that there was

the answer is altered by COVID-19.

a backup plan if it failed. Extra steps

Telephoning prescriptions across

Some procedures may not be ideal

need to be taken to document consent

state lines has traditionally not been

choices in a perfect world, but

for recording or photography. You

much of a problem. That doesn’t mean

during current conditions they may

should note any additional parties

every prescription will be accepted;

be acceptable—or even superior—

at either end, such as assistants or

it means you can usually rely on the

options. As telehealth is the ultimate

relatives. If an in-person visit would

pharmacist to know whether they are

PPE during the COVID pandemic,

have been preferable but was not

allowed to cooperate. Obviously,

one should consider adding the

possible or advisable due to circum-

controlled substances invite greater

documentation that the visit was

stances (e.g., weather, COVID, etc.),

scrutiny. But even these are not

per for med v ia telehealth as a

this needs to be documented in the

prohibited under DEA rules during

“COVID countermeasure.”

disclosure and consent. ❖

3. PRESCRIBING

1

cation, that should be noted (e.g.,

w ww.mckinsey.com/industries/healthcare-systems-and-services/ourinsights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality#

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Child Health Research Institute to Lead COVID-19 Vaccine Trials in Pregnant Women & Children

P

HYSICIAN-SCIENTISTS IN OMAHA will be on the leading edge of research to ensure a safe, effective COVID-19 vaccine for pregnant women and children. The Child Health Research Institute (CHRI), a pediatric research partnership between

University of Nebraska Medical Center (UNMC) and Children’s Hospital & Medical Center, will be leading two new COVID-19 vaccine trials in these unique, important populations. Both studies are sponsored by Pfizer.

The first trial is a randomized, placebo-controlled study evaluating the safety, tolerability and effectiveness of a vaccine candidate against COVID-19 in pregnant women and their newborns. Kari Simonsen, MD, MBA, chair of the UNMC Department of Pediatrics and pediatrician-in-chief at Children’s, will serve as the site primary investigator; Teresa Berg, MD, associate professor of Obstetrics and Gynecology at UNMC and director of Maternal-Fetal Kari Simonsen

Medicine, will be the lead co-investigator.

Participants will be patients from the Olson Center for Women’s Health who intend to deliver their baby at Nebraska Medicine. The global study aims to recruit 4,000 pregnant women; it is anticipated around 50 women will be enrolled from the Omaha site. The vaccinated mothers and their babies will be followed until the baby is 6 months old. After a child’s birth, maternal participants who received the placebo will be unblinded and able to receive the vaccine.

The second trial is a pediatric study, evaluating a vaccine’s safety and efficacy in healthy children ages 5 to 18. Dr. Simonsen will serve as site primary investigator. CHRI will partner with Children’s Physicians primary care offices to recruit study participants starting in late spring or early summer; however, children not cared for at these locations may also be enrolled. This global study will involve around 6,000 pediatric participants. The Omaha site

Ann Anderson Berry

plans to enroll around 50 children. Vaccine administration will take place at Children’s Specialty Pediatric Center, led by Children’s Pediatric Infectious Disease specialists.

“

THESE IMPORTANT TRIALS PROVIDE NECESSARY SAFETY AND EFFECTIVENESS INFORMATION TO EXPAND IMPLEMENTATION OF COVID-19 VACCINES TO THESE GROUPS.

”

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“COVID-19 vaccine studies for pregnant women and children build on the knowledge gained from the completed adult studies. These important trials provide necessary safety and effectiveness information to expand implementation of COVID-19 vaccines to these groups. We are proud to contribute to these global efforts,” says Dr. Simonsen.

“CHRI is excited to support these two vaccine studies conducted by our highly skilled investigators at our sponsoring institutions, Children’s and UNMC. Bringing world-class research to the children of Omaha and Nebraska is core to our mission, and we are proud to be a part of ensuring that children have safe and effective access to a COVID-19 vaccine in a timely manner,” says Ann Anderson Berry, MD, PhD, executive director of CHRI. ❖

MidwestMedicalEdition.com

Spring / Summer 2021

UPCOMING EVENTS APRIL 12 – 16

Monday, 10:45 am – Friday, 1:15 pm Avera Orthopedic and Sports Medicine Virtual Conference Location: Virtual (WebEx or Zoom) Information & Registration: avera.cloud-cme.com

APRIL 17

8:00 am – 4:30 pm Sanford POWER Strength & Conditioning Virtual Clinic Information: (605) 312-7809 Registration: sanfordhealth.org/classes-and-events

APRIL 28

12:00 pm – 1:00 pm Sanford Frontiers in Genetic Medicine Lecture Series Location: Schroeder Auditorium at Sanford Medical Center (and WebEx) Information & Registration: sanfordhealth.org/classes-and-events

APRIL 28 – 29

9:00 am – 5:00 pm SDAHO Post-Acute Partners in Care Conference Information & Registration: sdaho.org/post-acute-partners-in-care-conference/

MAY 21 – 22

Friday, 12:25 pm – Saturday, 3:10 pm Mayo Clinic Orthopedic Infectious Diseases Livestream Information & Registration: ce.mayo.edu

JUNE 4 – 5

5:00 pm – 11:00 pm daily PorkPalooza (Music & Barbeque - LifeScape benefit) Location: 4800 N. Career Avenue, Sioux Falls Information: lifescapesd.org/events

JUNE 11

CNOS Golf Invitational Location: Two Rivers Golf Course in Dakota Dunes, SD Information & Registration: 605-217-2817

JULY 10

7:00 pm – 11:00 pm Dreamfest Midwest Music Festival (LifeScape benefit) Location: 8th & Railroad Center, Sioux Falls Information: Dreamfestmidwest.com

VISIT THE ONLINE CALENDAR at MidwestMedicalEdition.com to find more information on these and other upcoming events between issues. You can also add your own event to the calendar for free.

WHEN IMAGING SERVICES ADVANCE,

SO DOES YOUR CARE.

Sanford Health is proud to offer a new X-ray system to deliver low dose, full-body imaging. Using state-of-the-art technology, the EOSedge System can enhance your musculoskeletal and orthopedic surgical practice.

The EOSedge provides: • High-resolution X-ray exams for children and adults • A radiation dose that is reduced by up to 80% while optimizing image quality with new Flex Dose™ feature • 3D weight-bearing images for an accurate view of the spine and lower limbs in a natural standing position

Call (800) 325-5741 to refer a patient for an EOSedge scan.

511-911-967 3/21