MED-Midwest Medical Edition- July/August 2016

JULY AUGUST

2016

Vol. 7 No. 5

Virtually Ideal

Avera’s Expanding eCare Empire Do You Really NEED “Document Management”?

Heart & Stroke Care

Awards

A Talk with

SDSMA’s Recent Past President

THE SOUTH DAKOTA REGION’S PRE M IER PUBLICATION FOR HEALTHCARE PROFESSIONALS

0 9

AR C F O S R YEA

VOC AC Y & I M PAC D A , T I NG

Annual Convention

September 21-23, 2016 – Sioux Falls Convention Center Watch for more details about provocative speakers, networking opportunities and a special gala celebration to be held the evening of September 22!

www.sdaho.org

MIDWEST MEDICAL EDITION

Contents

Virtually

IDEAL

VOLUME 7, NO. 5 ■ J U LY / AUGUS T 2016

REGULAR FEATURES 4 | From Us to You 5 | MED on the Web Cardiac MRI, Invitation to post your events, archived issues

10 | N ews & Notes

New Daisies, Stroke Certification for area RN

35 | Learning Opportunities Summer events and a look ahead to Fall conferences and symposiums

IN THIS ISSUE 6 | How the Healthcare Industry Can End its Cyberwarfare ■ By Marie Ruettgers

18 | Local Company Will Showcase

18 | Solving the Mystery of the Limping Child 20 | First Twin Register Launches in South Dakota 23 | OSHA’s Renewed Emphasis on Healthcare Why Midwest providers may be seeing more of OSHA in the coming months ■ By Vince Weber

26 | Managing Aging Staff Members ■ By Kelly Marshall

28 | Five Reasons to Work with a Financial Professional ■ By Mark Schlueter

On the cover: Brian Erickson, Clinical Operations Director; and Amy Thompson, CNP, in the Sioux Falls hub of Avera eCare.

Photo courtesy Avera.

Vol. 7 No. 5

8 Why Do You Need "Document Management" ■ By Ritch Noble Three reasons why Microsoft Word may not be the best tool for your important documents

its Tech at Innovation Event SD’s Inanovate plans to display its cancer diagnostic technology at BIO 2016

By Peter Carrels 2016

29 | The Nurses Station

ON THE COVER

JULY AUGUST

New providers, awards, accreditations and more

Avera’s Expanding eCare Empire

Virtually Ideal

Avera’s Expanding eCare

Do You Really NEE D “Docume Management”nt ?

Heart & Stroke Care

Awards

Empire A Talk

with SDSMA’s Rece nt Past President

THE SOUT H DAKO TA REGI ON’S PRE M IER FOR HEA LTHC ARE PROF ESSIO PUBL ICAT ION NAL S

22

Area Providers Recognized for Heart and Stroke Care

24 A Talk with Dr. Tim Ridgway, Immediate Past President of the SDSMA The med school’s Dean of Faculty Affairs reflects on his year in office and the future of the medical association

By Alex Strauss

Ten percent of the nation’s critical access hospitals — from Kansas to New Hampshire — count on Avera Health’s growing suite of telemedicine services to save money, support good care, and prevent provider burnout.

We bring you a behind-the-scenes look at the state-of-the-art eCare system.

page

13

From Us to You Staying in Touch with MED

I

t can be easy for healthcare providers on the Great Plains to imagine that they are relatively isolated from the rest of the medical world. But this month’s cover story proves, on a number of levels, that that is increasingly no longer true.

Today, more than ten percent of the nation’s critical access hospitals — including institutions as far away as Vermont and New Hampshire — are relying on Avera providers in Sioux Falls to help them in a myriad of critical care situations. In our cover story this month, see how Avera has risen to the challenge with a growing suite of eCare services that consistently puts them among the country’s most technologically progressive institutions.

Also in this issue, MED talks with the outgoing president of the South Dakota State Medical Association about the organization’s accomplishments during his tenure and about what he sees as its future in light of changing physician demographics.

Finally, if you have ever imagined yourself on the cover of your own magazine, the wait is over. MED is now offering custom publishing services. We can help you envision, create, and distribute your own practice publication to educate, motivate and inspire your patients and colleagues.

Contact us at info@MidwestMedicalEdition.com to learn more.

In the meantime, enjoy this issue of MED, packed with current community news and practical advice from local experts, and be sure to check out the event calendar in the back as you plan for fall.

Until then, best wishes for a healthy, happy, and productive summer!

PUBLISHER MED Magazine, LLC Sioux Falls, South Dakota

VICE PRESIDENT SALES & MARKETING Steffanie

Liston-Holtrop

Steffanie Liston-Holtrop

EDITOR IN CHIEF Alex Strauss

GRAPHIC DESIGN Corbo Design

PHOTOGRAPHER studiofotografie

WEB DESIGN Locable

DIGITAL MEDIA DIRECTOR Jillian Lemons

CONTRIBUTORS: Kelly Marshall

Ritch Noble Alex Strauss

Marie Ruettgers

Mark Schlueter

Lynn Welch

STAFF WRITERS Liz Boyd

Caroline Chenault John Knies

NEWS & NOTES EDITOR Réne Anderson

ADMINISTRATIVE ASSISTANT Erika Tufton

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

—Alex and Steff

©2011 Midwest Medical Edition, LLC

PS - We hope to see you in Chamberlain at the fall MGMA conference August 24–26th!

MED QUOTES

“ 4

If you haven’t any charity in your heart, you have the worst kind of heart trouble.

—Bob Hope

”

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.

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 605-231-0432 MAILING ADDRESS PO Box 90646 Sioux Falls, SD 57109 WEBSITE MidwestMedicalEdition.com

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2016 Advertising EDITORIAL DEADLINES Jan/Feb Issue December 1 March Issue February 1 April/May Issue March 1 June Issue May 1 July/August Issue June 1 Sep/Oct Issue August 1 November Issue October 1 December Issue November 1

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On the Website this month Cardiac MRI at Avera Heart A North Central Heart physician is bringing cardiac MRI closer to home for South Dakota residents. Read more about the capabilities of this versatile, non-invasive diagnostic test.

Post Fall Events for Free It’s always free and takes just a minute to post your upcoming events on MED’s interactive online calendar and be seen by thousands of site visitors. You can even include a link to your website!

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How the Healthcare Industry Can

End its Cyberwarfare

By Marie Ruettgers

W

ITH NEARLY ALL SOF T WARE, APPLIC ATIONS, SYSTEMS, and

devices connected to the Internet, the transition from paper records to EMR has left the healthcare industry exposed, laid bare for cybercriminals. In fact, the Ponemon Institute reported that some 94 percent of medical institutions have now been victims of a cyber attack.

How, then, can the industry protect itself? While it is no easy task, the following five steps will tighten networks before you can say “malware.”

Educate Employees Staff training is imperative to patching the vulnerabilities of EMR. No, it is not just the IT department’s concern. It only takes one untrained system user to expose thousands of patients’ documents to ransomware. All employees should be properly trained to not only understand their system, but also understand the world and risks of cyber attacks.

The Department of Homeland Security recently urged healthcare employees to not use computer disks or flash drives unless they are from a trusted source. Additionally, extra caution should be taken with email.

Ransomware attacks are occurring with hackers sending seemingly routine emails loaded with documents prepared to steal patient data and unload malicious software.

Cyberattacks can, and do, happen anywhere.

Employees must be trained to act with caution.

Backup Your Data Yes, it is a no-brainer. However, many healthcare organizations such as the Hollywood Presbyterian Medical Center found themselves paying expensive ransoms to hackers after failing to back-up their system.

Ransomware, as its name indicates, achieves successful ransoms due to healthcare organizations’ failures. Many companies, such as GoodSync, specialize in backing up data.

Every healthcare organization should consider hiring a company for data backup

6

Cyberwarfare

assistance, as well as follow industry and manufacturer/vendor best practices for securing all their devices such as printers, personal medical devices, etc.

Construct an Emergency Plan

Change Up Your Passwords

When mistakes happen and systems are breached, an emergency plan is vital. The plan should include an analysis of the financial and legal implications of a cyber attack.

Is there a system that your organization cannot function without? If so, perhaps it is time to rework your system. In 2015, Anthem failed to have an emergency plan, resulting in compromised names, birthdates, member IDs, social security numbers, emails, and addresses of 80 million people.

Bottom line: have a plan to shut down attacks immediately after they happen.

Password protection is key in preventing cyber attacks. When creating passwords, always use passphrases or longer sequences of text for added security. Every password should have a measure of entropy and be changed on a regular basis. Dictionary attacks by cyber attackers have often exploited parts of systems that still use default passwords. Default passwords are well-known. Every item requiring a password, whether printer, Internet, or computer, should have its default password changed.

With the shift to EMR and an increasing number of open exchanges of healthcare information between patients, insurers, doctors and pharmacists, cyber security has become a dire part of the healthcare industry. If your healthcare organization has experienced a security breach, talk to a lawyer specializing in cyber security.

Healthcare organizations must familiarize themselves with the dangers of cyber attacks and follow best practices for configuring systems and monitoring them for abuse.

The time to act is yesterday. ■

Perform Regular Audits Who has access to your system? Is the system running the expected version of the operating system and software? What are the peak loads, data dropout rates, and number of APs? These are all questions that should be asked routinely. By performing audits in regular intervals, you’ll ensure that your system is configured and running properly.

The best way to prevent an attack is to catch your own mistake. When auditing, do not forget about infrastructure such as wireless or wired links, and also remember to check that all stored data is encrypted.

Marie Ruettgers is Managing Attorney at Goosmann Law Firm

Midwest Medical Edition

Why Do You Need “Document Management”?

A

By Ritch Noble DOCUMENT management

system (DMS) is a computer system used to store, manage, track and secure electronic documents and electronic images of physical media that hold documents, captured through the use of a scanner or a digital camera.

Key features of a document management system include, but are not limited to: ■ check-out and check-in of

documents with document locking ■ version control ■ g ranular user access and

document security ■ audit trail ■ annotation and stamps ■ document page level manipulation ■ data redundancy

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More advanced systems, like FileDirector include integration with other content management systems (CMS) or database systems, both for capture and for retrieval, and integrated workflow that follows or controls the implemented company’s Business Process (BPM).

Many have said, “We already scan documents into Windows folders and the Windows file system, and we use the Windows Search to find what we need.”

This may be all you are looking for.

However, in light of government regulations and business policies, that system is not sufficient to make your business documents as secure and trustworthy as you might like (or need) them to be.

Tracking Your Documents One area where a true DMS can be an asset to your business is in allowing you to know at all times where your documents are, who has them, and what has been done with them.

Hence, the need for tight granular security and a detailed audit trail that records every action taken on each document and by whom.

Another feature is the ability to guarantee the integrity of the documents in the system by knowing that nothing in each document has been modified since it was originally captured into the system. By “sealing” the document, there will be no question that this electronic representation of the docu-

ment is as legally-binding as the original and it will hold up in a court of law.

Improving Efficiency A DMS is optimized to efficiently handle the workload of document data going into and out of the system by many users who are manipulating documents, adding and removing pages, moving documents from one department to another, and indexing the documents for instantaneous retrieval.

This will directly correlate to an ROI in your business which can often times result in 2%-4% net profit on your bottom line through efficiencies alone.

A document management system has a very powerful and consistent index and search mechanism that allows documents to be found by many different methods, and carefully organized for easy recall by whoever needs and has security access to the documents, whether users are the ones who originally filed the documents or not.

Handling the Backup Finally, a document management system handles the backup of document data and the redundancy required to fulfill continuity-of-business requirements in case of a catastrophic event, allowing you to get access to all of your documents in very short order, so that your business can continue without interruption. ■ Ritch Noble is the CEO and Partner of Active Data Systems in Sioux Falls. Noble focuses on services impacting document life cycle, document workflow, and managed document services.

Midwest Medical Edition

Beckenhauer Construction has been providing high quality construction service to its clients for 138 years and counting. Beckenhauer Construction is a family owned general contracting firm specializing in healthcare construction and is now being directed by the fifth generation of family ownership.

Safety of the staff, the patients, visitors, and crews is always at the top of our list to control. We do so by continual training, monitoring, providing the best of equipment to assist us, and constant communication with the client so they are aware of our every move. We go above and beyond the industry standard requirements when it comes to protecting employees, client staff, patients, and visitors. If you are not already one of Beckenhauer Construction’s clients we urge you to visit with any of our past or current clients to see what they have to say about doing business “The Beckenhauer Way”.

Happenings around the region

South Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska

News & Notes AVERA

North Central Heart, a Division of Avera Heart Hospital in Sioux Falls, has announced the area’s first fellowship-trained cardiologist for cardiac MRI.

Elden Rand, MD, received his fellowship training at Duke University and has seen early success in detecting abnormalities through cardiac MRI. Until now, the closest healthcare system with cardiac MRI capabilities was in Omaha.

Avera McKennan Laboratory has been recognized with membership into the Compass Group. Avera is just one of

29 health system members representing more than 600 hospitals to join the Compass Group. The Compass Group is an organization of not-for-profit IDN System Laboratory leaders who have established collaborative relationships to identify and share best practices and strategies to help ensure the survival of the not-for-profit laboratory industry.

BLACK HILLS

Regional Health has finalized the sale of Fairmont Grand Regional Senior Care in Rapid City and Golden Ridge Regional Senior Care in Lead for an undisclosed sum. The buyer is

RCLAL, LLC, and the managing party is Northstar Senior Living, based in Redding, California.

Fairmont Grand Regional Senior Care offers assisted living with accommodations for up to 48 residents. Golden Ridge Regional Senior Care is comprised of 16 assisted living units and 10 independent living apartments.

Cardiologist Oscar Bailon, MD, FACC, and cardiothoracic surgeon Zahir Rashid, MD, have joined Regional Heart Doctors in Rapid City. Dr. Bailon earned

his MD at Cayetano Heredia University in Lima, Peru, and completed his residency at Johns Hopkins and completed his fellowship in cardiology at the University of Texas Health Science Center at San Antonio.

He is board certified in cardiovascular diseases, echocardiography, nuclear cardiology and internal medicine.

It’s time that technology became less painful.

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10

Midwest Medical Edition

Dr. Rashid specializes in performing complex surgery on the heart, lungs and great vessels.

SIOUXLAND

Mercy’s Child Advocacy Center is one of five recipients to be awarded a $25,000 grant from the Jimmie Johnson Foundation Blue Bunny Helmet of Hope.

He earned his MD at R.G. Kar Medical College Hospital in Calcutta, India and completed residencies in surgery and surgical critical care at New York Medical College. He completed his residency in cardiothoracic surgery at the Medical College of Wisconsin.

Briar Cliff President, Bev Wharton (l) is shown with Angie Shilling (r) receiving the Honors Award

SANFORD

Angie Shilling, CEO at Baum Harmon Mercy Hospital in Primghar, was the recipient

Sanford Fargo has partnered with Sioux Falls-based Dakota Lions Sight & Health to serve the

people of Fargo and the Greater Dakota Region by providing a local option for both eye and tissue donation and transplantation.

Dakota Lions Sight & Health has regional offices in Rapid City, Bismarck, and now in Fargo in the Professional Building.

Sanford POWER will launch its first summer strength and conditioning program in Aberdeen on July 11 at Aberdeen Central High School.

The Sanford POWER program offers ground-based training techniques to improve overall athletic enhancement. The program is led by training staff from CHS and Sanford Aberdeen.

Aberdeen area high school and middle school students interested in improving their strength and conditioning are invited to participate.

MED QUOTES

July / August 2016

“

of the Distinguished Management Graduate Student Award at the Briar Cliff University Convocation in May in Sioux City. The distinguished Graduate Student Award is awarded to a graduate student for demonstrating high scholarship, creativity, collegiality, leadership and potential for significant impact on society. Shilling will receive her MA in Management, Specializing in Healthcare Administration when she completes her final course this fall.

Micah Bonderson is the new manager of Mercy Home Medical Equipment. In Sioux City.

Bonderson obtained his Bachelor of Science in Health care Management from Bellevue University in Nebraska. He previously was a branch manager for Avera Home Medical Equipment in LeMars, Iowa. He also has experience as a Respiratory Therapist.

The first wealth is health.

”

The Blue Bunny Helmet of Hope is a program that allows fans and consumers across the country to nominate not-for-profit (501c3) organizations that support K-12 public education. The final five finalists were selected via public vote. In addition to the grant, the Child Advocacy Center will receive a Blue Bunny ice cream party and special recognition on Johnson’s race helmet during the NASCAR Sprint Cup Series race on August 7, 2016 at Watkins Glen (NY) International Speedway.

OTHER Midwest Family Care, a division of Sioux Falls Specialty Hospital in Sioux Falls, is pleased to welcome Chelsea Van Dyke, PA-C. to its care team.

Van Dyke completed her MS in physician assistant medicine at Pacific University in Forest Grove, Oregon. She also earned a degree in athletic training from the University of Mary in Bismarck.

Gina Ditta-Donahue, CNP has joined Dr. Mark Milone at Midwest Digestive Health, a division of Sioux Falls Specialty Hospital. Ditta-Donahue earned

her masters in nursing at Clarkson College of Omaha. Ditta-Donahue has an interest in the diagnosis, treatment and prevention of diseases of the digestive system that has been cultivated in previous positions at Rush Presbyterian St. Luke’s Medical Center in Chicago and University of California Medical Center in Los Angeles.

—Ralph Waldo Emerson

MidwestMedicalEdition.com

Dean Tim Ridgway and Dr. Johnson.

Melissa Johnson, MD, general surgeon for the Sioux Falls VA Health Care System, is the

recipient of the 2016 USD-Alpha Omega Alpha (AOA) Volunteer Faculty Award. This award is determined by students.

Under a new strategic agreement, two South Dakota based information technology companies will join forces.

EarthBend announced in June that it will acquire SDN Communications’ phone/data equipment division and cloud contact center platform.

MED

is hiring!

MED magazine is looking for a freelance staff writer.

The ideal candidate will have at least five years’ experience with long-form article writing for newspapers, magazines or websites and a working knowledge of medical/ scientific terminology, concepts, and issues.

Familiarity with the South Dakota area medical community a plus.

Contact us at info@ MidwestMedicalEdition. com to learn more.

11

Keither Holt, eICU Nurse Educator

Virtually Id Avera’s Expanding eCare Empire

A

42 YEAR OLD PARKSTON,

South Dakota area man is having dinner with friends when he suddenly develops the classic signs of a stroke. He becomes weak, half of his face droops, and he loses the ability to talk. His wife rushes him to the nearest hospital, Avera St. Benedict Health Center in Parkston, where his friend, family physician Jason Wickersham, MD, is waiting.

Dr. Wickersham, who has worked in Parkston for 12 years, is not unfamiliar with

12

stroke and has had experience using clot-busting drugs in the treatment of elderly heart attack patients, but this is a different scenario. In a larger health center, he and his patient would likely be surrounded by colleagues who could weigh in on the situation. Here, he is on his own.

Until, he presses a button on the wall of one of the two ER rooms.

Within seconds, the high-definition screen on the wall fills with the image of an ER physician at Avera’s eCare hub in Sioux Falls and he and Dr. Wickersham are collaborating on the case, working in tandem

as physicians are trained to do. Within a short time, the two are joined by a neurologist, who helps walk Dr. Wickersham through a series of tests with the patient to confirm the diagnosis they all suspect: acute ischemic stroke.

“I knew about clot-busting drugs but I also knew that very few patients meet the criteria for using them, and we don’t give them very often,” says Dr. Wickersham.

“I knew that this was serious and it made me a little nervous. It was great to have both the ER physician and the neurologist agree with me.”

Midwest Medical Edition

Cherie Wright, RN, and Dr. David Kovaleski, MD, in the eICU

By Alex Strauss

As a team, the three agreed that Dr. Wickersham should administer the clot-buster. It was the right call. By the time the helicopter arrived to transport the patient to Sioux Falls (a process that was also sped up by the eEmergency system), he had begun to move and was able to speak.

“Today, you wouldn’t know that anything had happened to him,” says Dr. Wickersham.

“That was my first really great experience with eCare.”

Since then, Wickersham and his colleagues in Parkston have had many great experiences with Avera’s suite of telemedicine services, which also include ePharmacy, for comprehensive oversight of drug administration when a pharmacist may not be on site, eICU, to monitor critical care patients

July / August 2016

Chad Panning, Pharmacist and Keith Carlson, Pharmacist

in real time, eConsult for specialty visits, and four other services (see sidebar).

ANSWERING THE CALL Through eCare, even the most geographically remote or understaffed facilities can connect with an ER physician 24/7, for everything from a quick second opinion to assistance with a complex procedure. At 120 sites and counting, eEmergency is second only to eConsult as the most popular eCare service.

“It is truly amazing,” says Sioux Falls emergency medicine specialist Brian Skow, MD, medical director of both eEmergency and eCare. Skow has logged more than 8,000 hours in front of a camera and a 50-inch high definition monitor, working alongside rural doctors like Wickersham from a distance.

“We have had some amazing cases in trauma where we were able to help bedside providers places chest tubes or needle decompression of a tension pneumothorax,” says Dr. Skow. “We recently helped with a cricothyroidotomy by putting a handheld camera right above the neck and had a great outcome.

The patient was flown to a trauma center and was discharged a few days later without complication.”

While the physicians consult, an eEmergency nurse can be documenting critical patient data, freeing up the nurse on the ground–who may be the only nurse there–to attend to direct patient care. eEmergency providers even have data on the storage location of every tool in the room, saving bedside providers from having to search for

13

Photos courtesy Avera

eal

SERVICE

No. of Sites

eCONSULT 157 eEICU 30 ePHARMACY 70 eEMERGENCY 120 eLONGTERMCARE 34 e CORRECTIONAL HEALTH 4 e SCHOOLHEALTH 9 Dr. Kelly Rhone, eEmergency Associate Medical Director

something when time is critical. When transfer is needed, they can facilitate that, too.

MULTIPLE SERVICE LINES

Dr. Brian Skow

Avera eCare comprises eight different service lines designed to support rural patients and providers as well as providers in other situations–such as schools, prisons, and long term care facilities–where current staffing levels may be insufficient. The idea is to improve access and outcomes while simultaneously lowering costs and enhancing the stability of the local workforce.

“Our real skill here in telemedicine is that we have gotten very adept at integrating specialty trained physicians–both in the consult world where you have one patient and one doctor in a scheduled visit, and in the critical care or emergency arena–with local providers,” says Deanna Larson, President and CEO of eCare.

“We like to say ‘We come to them, we don’t make them come to us.’”

In fact, through eCare, more than 100 types of Avera specialists in areas such as critical care, infectious disease, pulmonology, cardiology, neurology and others now provide care in ten percent of the nation’s critical access hospitals across ten states in the Midwest and the Northeast.

eCARE EVOLUTION

Deanna Larson

14

What began in the early 1990s as an outreach service heavily funded by the Helmsley Charitable Trust has evolved into a self-sustaining business with new sites coming on board every few months. More than two-thirds of these sites are non-Avera facilities.

“Ten or twelve years ago, we were faced with the questions of how do we maintain access to healthcare in those communities where physicians are leaving, places where it is hard to recruit and hard to retain,” says Larson.

“We began to see that the answer was to work in collegiality with

AVERA NOW 3,000 enrolled

partners. Otherwise, in some communities, you may have two providers who are on call 24 hours a day, every other day. Pretty soon, a physician in that situation just can’t provide the highest level of healthcare.”

In the same building where an eEmergency doctor and nurse are standing by 24/7, a pharmacist is also on hand to provide ePharmacy services, reducing the risk of medication errors and keeping prescribers up to date on current medication practices.

An estimated 28,000 adverse drug events have been prevented by the service.

Critical care nurses and an intensivist, either in Sioux Falls or at another facility with whom Avera contracts, continuously monitor 100 ICU beds in 30 sites. This service has been found to reduce length of stay, decrease transfers, reduce complication and mortality rates, and decrease provider burnout.

Through eConsult, Avera specialists have provided more than 10,300 virtual visits saving 2.7 million driving miles and an estimated $1.12 million dollars.

VIRTUAL RELATIONSHIPS As Avera’s eCare services have expanded, so has its need for doctors, nurses, and pharmacists willing to step up and put themselves out there in a whole new way.

Dr. Skow, who says he is beginning to

Midwest Medical Edition

Photos courtesy Avera

AVERA eCare

recognize the regional accents of distant providers with whom he works, says the virtual environment offers some unique advantages over the “real” ER. “One of the joys of working over the camera is that you are getting providers who are reaching out to you for help or consult, and patients who want your help,” says Skow.

“You don’t always get that in the main ER. You’ll get drug seekers, abusive patients, etc. You really don’t get that over the camera.”

But not everyone is up to the challenge of providing healthcare in a virtual environment. No one is forced to work in eCare and not everyone who wants to is a good fit.

As Dr. Skow puts it, “This isn’t Burger King. You can’t have it your way. Some people are used to that, but that doesn’t work here.”

“We are very aware that they can hang up on us on their end,” says Larson. “So we look for people who not only have good camera presence but who can establish and maintain relationships. When that happens, you see people beginning to work together seamlessly. The fact that they are on video becomes nothing more than a glass between them in the same room. It’s just magic.”

And the magic is likely to continue to grow. Avera has plans to expand its eSchool Nurse services into more schools and eventually offer eHospitalist services to support those caring for non-critical hospitalized patients. ■

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July / August 2016

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15

When Drama Becomes Trauma

By Lynn Welch

Unsettling events can affect anyone, so be sure your support systems are ready

A

CRITIC ALLY ILL CHILD, accompanied by her parents, was being trans-

ported from the ICU to the operating room on another floor, under emotionally wrenching circumstances. A plant engineer was summoned to operate the elevator to ensure the family a non-stop transition between floors. Later that day, a nursing house manager who had been trained to reach out to staff involved in unsettling events realized he hadn’t checked in with the plant engineer. He sought him out in his basement workspace and discovered him alone there, sobbing. The quiet conversation that ensued provided an opening for the plant engineer to share his distress at witnessing the parents’ extreme pain, and his grief at the acute realization that he could lose his own daughter, the same age as the couple’s child. Before they parted, the engineer expressed deep gratitude to the manager for reaching out, and he confided that he hadn’t planned to return to work the next day.

“It’s important for hospitals and clinics to recognize that everyone suffers, and we need to be proactive in developing and ensuring that systems and services are in place to support care providers and staff

and patients when there are unsettling events,” says MMIC’s chief medical officer, Laurie Drill-Mellum, MD, MPH. She prefers the phrase “unsettling events” to the more familiar “adverse events” because

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“it more accurately reflects the scope of situations where support may be needed.”

“An unsettling event could be an adverse outcome,” she says. “But it could just as easily be a terrible event that we are witness to: a SIDS death, a horrible car accident, a patient suicide.”

As the importance of clinician and family support becomes more acknowledged, and its impact on everything from clinician wellbeing to patient satisfaction to malpractice litigation risk is better understood, more organizations are implementing programs to help care providers deal more effectively with the challenges they face.

Schwartz Center Rounds In hundreds of healthcare settings across the country, clinical caregivers participate in a unique, multidisciplinary forum called the Schwartz Center Rounds where they are able to discuss, in a supportive and nonjudgmental setting, the difficult emotional and social issues that arise in patient care. According to one facilitator, participants gain “a much greater understanding of the issues their colleagues are dealing with” — an understanding that fosters a greater sense of compassion and empathy for patients.

MITSS Another organization dedicated to supporting clinicians and patients is Medically Induced Trauma Support Services (MITSS).

MITSS was launched in 2002 by Linda Kenney, who, as she describes it, “found myself at the sharp end of an adverse medical event that nearly took my life.” Her experience made her aware of the lack of emotional support, not only for patients and their families, but also for care providers following traumatic incidents.

Midwest Medical Edition

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Listening to almost any patient’s recounting of an adverse medical event, one is struck by how often the physician withdraws in those situations, and how devastating that distancing can be for the patient.

Dr. Drill-Mellum understands the strong urge care providers can feel to turn inward rather than toward their patient in difficult circumstances. “Many physicians are introverts to start with,” she says. “They often don’t have strong social networks. In fact, they may have given up building their networks while their peers were building theirs, because of the demands of the profession.”

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It can be different Sometimes, the courage to resist turning away requires the encouragement of someone able to help you see the bigger picture. Scott recalls one physician in this situation.“She’d had a bad experience and had really shied away from the family,” says Sue Scott, PhD, manager of patient safety and risk management at University of Missouri Health Care and a leader in the field of patient safety and clinician support research. “A colleague urged her to go to the bedside and talk to the family.”

Reluctantly, the physician agreed. As Scott recounts, “She sat down on the side of the bed and said, ‘I’m terribly sorry this happened to you.’ The patient started to cry. The physician cried.

They hugged. Six years later, she’s still treating that patient.”

That’s the difference the right support at the right time can make. ■

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Find a link to a compelling example of Schwartz Center Rounds in action, MITSS’ Clinician Support Toolkit, and other resources in an extended version of this article on our website.

July / August 2016

MidwestMedicalEdition.com

17

Local Company Will Showcase its Tech at Innovation Event INANOVATE, INC , A SOUTH DAKOTA

biotechnology company developing diagnostic tests for cancer, has been awarded a booth at BIO 2016 by the National Institutes of Health. The booth will help showcase Inanovate’s new blood test for detecting breast cancer recurrence in its earliest stages, when it may be more effectively treated.

Inanovate is also using this opportunity to showcase partnerships with local institutions. Inanovate works closely with Sanford Health and the South Dakota Governor’s Office of Economic Development, and will be using its exposure at BIO 2016 to highlight the strengths and value of these organizations to the national and international Life Science community.

“Clinical trials for our breast cancer diagnostic and monitoring test are progressing very positively,” says David

Ure, President and CEO of Inanovate.

“Exposure at a conference like BIO, especially with the backing of the NIH, is a nice boost for our company as well as our commercial and investment partners.“ Inanovate will be finalizing a private

placement this summer, open primarily to SD based investors. The offering will provide additional resource in support of the next phase of clinical trials for Inanovate’s breast cancer test, as the company prepares for commercial launch. ■

Solving the Mystery of the Limping Child FROM INJURY TO INFECTION,

there are a myriad of reasons why a child can present with an acute limp. Overuse is the most common cause; septic hip, septic knee and tumors are among the most concerning. The potential ramifications of a delayed or improper diagnosis underscore the importance of thorough investigation.

“If it’s something that could potentially cause harm like a septic joint or osteomyelitis, the sooner we can intervene, the more we decrease our chances of a bad outcome,” says Maegen Wallace, MD, ATC, with Children’s Hospital & Medical Center in Omaha. “In cases of

18

septic hip, for example, negative outcomes can range from cartilage destruction to avascular necrosis,” A limp is defined as a deviation in the walking pattern away from the expected normal pattern for the child’s age. The most prevalent causes of limping in children are wide-ranging, and include overuse, fracture, tarsal coalition and infection.

The journey toward an accurate diagnosis–and the most effective treatment–begins by obtaining a thorough patient history. Dr. Wallace also recommends incorporating a number of key components into the comprehensive physical exam,

including observation, taking of temperature and vital signs, a gait exam, a table top exam to determine the affected joint, and a standing/floor exam.

Dr. Wallace says imaging– starting with two views of the affected joint–is warranted any time an acute limp is involved.

X-rays are normally used to evaluate for septic joint, osteomyelitis or tumors. An MRI or bone scan can be helpful if the child is sick. In those cases, lab tests, including CBC, ESR and CRP, are also needed to evaluate for infectious processes. If the child is febrile, blood cultures at the time of fever are recommended as well.

Dr. Wallace recommends urgent referral for patients who have acute limps with fever and suspected septic joint or osteomyelitis. The pre-adolescent or adolescent with a slipped capital femoral epiphysis also needs to be made non-weight bearing and transferred urgently. Other types of limps can be referred on a less urgent basis.

The most effective treatment for the limping child is driven by the cause of the limp. For optimal outcomes, Dr. Wallace says limping children should be seen by an orthopaedic surgeon who specializes in pediatric patients. ■

Midwest Medical Edition

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First Twin Register Launches in South Dakota AVERA AND THE AVERA INSTITUTE

for Human Genetics have established the first and only twin register in South Dakota. The new register will enable the AIHG to collect and analyze DNA from twins throughout the Midwest to provide insight into traits and diseases that are specific to the region.

“We look at twins because they have nearly identical DNA. Why does one twin get a disease and the other doesn’t? That’s what we are studying. We look at both the genetics and environmental influences on diseases such as type 1 diabetes, behavioral disorders and cardiovascular disease,” says Gareth Davies, PhD, Chief Scientific Officer and Scientific Director at the

Avera Institute for Human Genetics.

The register is the result of Avera’s experience and longstanding association with the Netherlands Twin Register at Vrije Universiteit (VU) in Amsterdam, one of the world’s premier twin studies and databases, for which Avera provides DNA sequencing. The two entities have recently formalized their international partnership to expand their scientific collaboration.

Through its partnership with the Netherlands Twin Register, the AIHG has collected and analyzed more than 80,000 DNA samples. Along with the twin studies, Avera and VU will be working on several scientific collaborative projects, including the exchange of staff between

Avera and VU, a joint PhD program, largescale genotyping of the twins collection, deep sequencing and phenotyping of thousands of twin pairs, and the creation of an Avera/VU bioinformatics team.

The AIHG will continue to serve as the genetics lab for all genotyping for the Netherlands Twin Register and future genetics research in partnership with VU. All identical or fraternal twins, triplets and multiples and their immediate family members are invited to sign up for the Avera Twin Register. Enrollment is free and includes genetic testing to determine if twins are identical or fraternal. More information is available at avera.org/twin-register. ■

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Midwest Medical Edition

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Area Providers Recognized for Heart and Stroke Care THE AMERICAN HEART ASSOCIATION HAS RECOGNIZED

several healthcare institutions and one regional ambulance service with quality achievement awards for heart and stroke care.

Rapid City Regional Hospital, Avera Heart Hospital, Sanford USD Medical Center, UnityPoint Health-St. Luke’s Cardiology and Cardiovascular Associates, PC (CVA), and Paramedics Plus were all recognized with Mission: Lifeline Awards for implementing quality improvement measures for the treatment of patients who experience severe heart attacks.

Rapid City Regional Hospital received the Bronze Plus Award for Receiving Centers; St. Luke’s Cardiology and CVA received the Silver Award for Receiving Centers; Avera Heart Hospital received the Gold Award for Receiving Centers; Sanford USD Medical Center received the Gold Plus Award for Receiving Centers; and Paramedics Plus received the EMS Bronze Award.

Mission: Lifeline seeks to save lives by closing the gaps that separate STEMI patients from timely access to appropriate treatments. The Mission: Lifeline program in South Dakota was made possible by an $8.4 million dollar gift from The Helmsley Charitable Trust to the American Heart Association, which began the process to improve the system of care for heart attack patients.

“Our institutions are helping to create a new standard of rural care for heart attack patients, and it is very exciting that South Dakota has gone from leading the country in heart attack death rates to leading the way in heart attack care,” said Gary Myers, Director of Mission: Lifeline South Dakota and EMS Consultant for Midwest Affiliate of the American Heart Association.

Rapid City Regional Hospital has also received the American Heart Association/American Stroke Association’s Get With The Guideline-Stroke Gold Plus Quality Achievement Award and Sanford USD Medical Center has received the American Heart Association’s Get With the Guidelines-Heart Failure Gold Plus Quality Achievement Award. ■

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Midwest Medical Edition

OSHA’s

Renewed Emphasis on Healthcare

By Vince Weber In April 2015, the Occupational Safety and Health Administration (OSHA) renewed indefinitely its “National Emphasis Program (NEP) on Nursing and Residential Care Facilities.” This renewed focus has not only resulted in the addition of new OSHA offices and staffing here in the Midwest, but is also expected to result in additional activity, including OSHA inspections, for local employers.

The five areas specifically targeted during inspections will be:

1

Ergonomic

and

Musculoskeletal Disorders (MSDs)

OSHA asserts that MSDs related to patient handling account for about 44% of all reportable injuries in the healthcare industry. Compliance Safety and Health Officers (COSHOs) will spend considerable time reviewing the number of ergonomic injuries at a worksite.

2

Slips, Trips, and Falls Slips, trips, and falls are the second

3

Blood-borne Pathogens With the advent of several new high

4

profile disease concerns such as the Zika and Ebola viruses, along with existing diseases such as HIV and Hepatitis, OSHA will increase their focus on blood-borne pathogens and infection control.

Tuberculosis/

COSHOs will conduct reviews of injuries related to workplace violence and determine if appropriate controls and policies are in place to address aggressive or violent persons. ■ Vince Weber is a Loss Control Specialist with RAS.

Contagious Diseases

With some areas of the United States experiencing an increase in active tuberculosis cases, inspectors will evaluate whether a facility has had a suspected or confirmed tuberculosis case among patients within the prior six months.

leading cause of work related injuries.

The NEP will focus on a number of areas within the facility, including kitchens, dining rooms, hallways, laundries, bathing areas and access/ egress points.

5

Workplace Violence

See our website for a more detailed explanation of each area and advice on how to be prepared.

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EarthBend CEO , Rob Beyer, seals the deal with SDN CEO, Mark Shlanta.

23

A TALK WITH . . .

Dr. Tim Ridgway, Immediate Past President of the SD State Medical Association

By Alex Strauss

E

Faculty Affairs at the USD Sanford School of Medicine nine years ago that he was encouraged to take a more active role in the SDSMA. “The dean at the time, Dr. Rodney Parry (also a past president), pointed out that there is a rich tradition of association between the medical school and the medical association,” recalls Dr. Ridgway. “This is not true in a lot of other states and we are often envied for that. Dr. Parry suggested that I think about getting involved with the organization.”

After a few meetings, during which he says he often heard doctors discuss policy in terms of its impact on patients, Ridgway says he was “hooked”. For nine years, he worked his way up through the leadership ranks, a process he says is critical for turning a physician into a leader in policy and advocacy.

“The year I started with the group, I thought I could never do this. There is just too much to know and too much to learn,” says Ridgway.

But, as a member of the Medical Association executive committee, Dr. Ridgway began paying more attention to what went on in Pierre and its potential impact on South Dakota healthcare. He attended national AMA meetings and says he was inspired to see physicians giving up their time to participate in the process.

Today, looking back on his year in office, he is particularly proud of the the time he spent meeting with doctors in each of

the state’s 132 districts, the passage of the meningococcal vaccine requirement in Pierre, and the formation of a new physician Leadership Institute, set to kick off with an initial cohort this fall.

“The goal of the leadership institute is to offer high quality leadership training here at home for doctors in South Dakota and possibly surrounding states. This will be open to all physicians but will be especially valuable for those who need to take leadership roles in their clinics,” says Dr. Ridgway.

But the year wasn’t all rosy. Like every leader, Dr. Ridgway says he was reminded of the difficult lesson this year that you can’t please everyone.

“Independent docs would say to me ‘Your organization represents the systems, not independents’. But system docs will say to me, ‘You represent the independents’,” says Ridgway. “But the truth is that we are here for all physicians, regardless of whether they are independent or employed.”

“My hope is that the SDSMA will be able to evolve with the changing physician demographics in the state and get more doctors on board. I have seen what organized medicine can do. Our mission is to support doctors and thereby provide better care to patients. If we work together, we can accomplish that.”

Dr. Ridgway is succeeded in office by Dr Tom Hermann, Jr., a family doctor with Massa Berry Regional Medical Clinic in Sturgis. ■

“The year I

VEN BEFORE SIOUX FALLS

gastroenterologist Tim Ridgway took the position of president of the State Medical Association in June of 2015, he already felt the weight of the organization’s long history and its elite leadership. We spoke to him the week after his tenure ended in June for some perspective on his year in office.

“When you look at the list of past presidents, it’s a regular ‘Who’s Who” of South Dakota doctors,” says Dr. Ridgway. “These weren’t people who were doing it because they needed the title on their CV. They were people who really cared and I was very aware from the start that I was in elite company. You really feel that during the year.

You don’t want to let the group down.”

Ridgway, a gastroenterologist at Sanford, did not originally aspire to a leadership role among South Dakota physicians. It was not until he took a position as the Dean of

started with the group, I thought I could never do this. There is just too much to know and too much to learn,”

Check out our website for the SDSMA’s legislative agenda and 2016 legislative accomplishments

24

Midwest Medical Edition

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Managing Aging Staff Members

By Kelly Marshall

• F lexibility in use – The system allows

ACCORDING TO THE BUREAU OF LABOR, it is predicted that by 2020, one in every four

for choice in the methods of use to

American workers will be over the age of 55.

accommodate for individual

The impact of an aging Baby Boomer

preferences and abilities.

population, combined with the Great Recession,

• T olerance for error – The system

has left a higher percentage of older workers

continues working, even when

with no choice but to continue to work well into

errors are made.

their retirement years. It is vital that employers consider the impact of this aging workforce when

5. I ntegrate wellness and health

managing their workplaces, as well as developing

promotion for all workers (diet,

and enhancing their injury prevention and man-

exercise, tobacco cessation, etc.)

agement programs.

6. P rovide ongoing training.

What Should You Know?

1. O lder workers contribute a wealth

to their needs

of knowledge and experience to the workplace.

2. Overall, older workers are actually less likely to be injured at work. However, roadway crashes are the leading cause of occupational fatalities for older workers and the incidence rate of slips, trips, and falls for older workers is nearly double the rate of that for younger workers.

3. O lder workers are likely to have more severe injuries and take longer than

3. A ssess your jobs in order to best determine what accommodations may be made available to ALL employees,

4. A s people age, a natural decline tends to occur in hearing, vision, balance, and respiration.

What Should You Do? 1. Assess the age demographic of your workplace. Do you have a lot of employees approaching retirement?

How will you make up for the loss of this skill and expertise?

2. Embrace older workers for their knowledge, skills, and expertise.

needing assistance and the likelihood

•

Renew and reinforce critical

•

Offer new challenges

career flexibility. Ideas include:

•

of age-related disability litigation.

• Assess lighting conditions and provide additional lighting, contrast, or

(for example, older workers

may provide training for new employees).

courses; consider driver safety policies

Design, which allows for accessibility to people of all ages and abilities.

• Simple and intuitive use – The system allows for understanding for a wide range of reading and writing skills and abilities.

remote work, consulting,

• Shift into different positions

Provide driver training and refresher

4. E mbrace the concepts of Universal

Reduced hours, job sharing, projects, or temporary work

high-visibility tape where needed.

•

skills for the job

7. C onsider additional workplace or

in order to reduce any stigma of

their younger counterparts to recover and return to work.

• Tailor products and techniques

•

Phased or delayed retirement, in order to avoid mass exodus of experienced employees

Kelly Marshall is an occupational therapist and a member of the South Dakota Occupational Therapy Association and the American Occupational Therapy Association. She is a Job Analysis and Ergonomics Specialist with RAS.

References Safety and Health Magazine: 2016 State of Safety: Changing demographics by Kyle Morrison, December 19, 2015 Center for Disease Control, NIOSH: Productive Aging and work: September 11, 2015

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Midwest Medical Edition

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27

5 Reasons to Work with a Financial Professional

A

By Mark Schlueter RE YOU SUDDENLY ON your

own or forced to assume greater responsibility for your financial future? Unsure about whether you’re on the right track with your savings and investments? Finding yourself with new responsibilities, such as the care of a child or an aging parent? Or maybe you simply feel your assets could be invested or protected better than they are now.

These are only some of the many circumstances that prompt people to contact someone who can help them address their financial questions and issues. This may be especially true for women, who live longer than men on average and therefore may face an even greater challenge in making their assets last over that longer life span. In fact, one study found that women often value advice from a professional in their financial decision-making even more than men do.

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2. I f you don’t feel confident about your knowledge of investing or specific financial products and services, having someone who monitors the financial markets every day can be helpful.

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Find tips for making the most of your financial professional’s expertise in the extended version of this article on our website.

3. E ven if you have the knowledge and ability to manage your own finances, the financial world grows more intricate every day as new products and services are introduced. Also, legislative changes can have a substantial impact on your investment and tax planning strategy. A professional can monitor such developments on an ongoing basis and assess how they might affect your portfolio.

4. A financial professional may be able to help you see the big picture and make sure the various aspects of your financial life are integrated in a way that makes sense for you. That can be especially important if you own your own business or have complex tax issues.

5. If you already have a financial plan, a financial professional can act as a sounding board, giving you a reality check to make sure your assumptions and expectations are realistic. For example, if you’ve been investing far more conservatively than is appropriate for your goals and circumstances, either out of fear of making a mistake or from not being aware of how risks can be managed, a financial professional can help you assess whether and how your portfolio might need adjusting to improve your chances of reaching those goals.

If you feel that consulting an expert might be helpful, don’t postpone making that call. The sooner you get your questions answered, the sooner you’ll be able to pay more attention to the things—family, friends, career, hobbies—that an organized financial life could help you enjoy. ■ Mark Schlueter CFP, FIC, CLTC, is a Financial Consultant with Thrivent Financial.

Midwest Medical Edition

The Nurses’ Station Nursing News from Around the Region

DAISIES Bloom at Area Institutions

REGIONAL HOSPITAL Emily Rowan, RN, who provides care in Rapid City Regional Hospital’s Cardiac Intervention Unit recently received a Daisy award for her compassion in consoling an anxious patient. According to the patient, “When my heart rate went from fast to slow, to fast again, Emily called the doctor and told him what she was seeing.

I feel it is because of Emily that my doctor found my underlying heart problem.”

SANFORD Sanford Ortho/Neuro nurse Sam Croatt, RN, was recently recognized with a Daisy award for exceptional nursing. According to her nomination, “Having the assistance of an individual, who greets you with such cheerfulness and eagerness to help, is somewhat unusual today.

Sam cures more patients with her effervescent smile and personality than most doctors. What a delight! She deserves a round of applause from all of us patients who had the joy to be assisted by her.” mbulatory nurse Cyrene Davis, RN, A works for Sanford Children’s Clinic MB2.

Her nomination was submitted by a coworker who wrote, “For a triage nurse, with no physical patient contact, to consistently build these relationships with our patient’s parents says a lot about her compassionate, giving character. That is just one example of how Cyrene has touched our patients and their parent’s lives as well as her coworkers lives.”

OTHER RECENT SANFORD DAISIES

Laurie Madsen, RN – CRP/ Rescue

Koni DeKam, RN – Birth Place

Robin Hilligas, RN – Surgical/Renal

VA MEDICAL CENTER Robyn Weber, RN, Intensive Care Nurse with the Sioux Falls VA Health Care System, has been recognized with a Daisy Award for commitment to VA’s ICARE principles. The Daisy Award honors nurses who go above and beyond and make positive differences in patients’ and families’ healthcare experiences.

Shea Achieves Stroke Certified RN, Status

Nicole Shea, RN, SCRN, clinical nurse specialist and Stroke Program Manager at Mercy Medical Center, has earned SCRN certification through the American Board of Neuroscience Nursing. Stroke nursing practice includes clinical practice, consultation, research, administration, or education in the neuroscience field. SCRN status is granted for five years and is renewed through validation of continuing education or re-examination. There are currently more than 2,000 nurses who have earned the SCRN designation.

The American Board of Neuroscience Nursing (ABNN) is the independent, not-for-profit corporation established to design, implement, and evaluate a certification program for professional nurses involved in the specialty practice of neuroscience nursing.

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RURAL COMMUNITY

YOUR HEALTH : OUR MISSION

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Each MED Custom Publishing package is tailored to meet your needs and budget. It may even be possible to create your own magazine at a significant savings with support from your top vendors.

Our services include: • Consulation • Content creation and editing • Layout and Design • Photography • Printing • DIstribution • Digital Edition Creation

Ninety-one percent of all adults read print or digital magazines, and the numbers are even higher for adults younger than 35.

In fact, print magazine readership is more consistent across generations than any other media.

Pick and choose the services you need for a truly customized magazine that will engage, inform and impress your patients and clients.

Phone 605-366-1479

Let us show you how fun and effective magazine publishing can be. Call us for a free consultation and save 20% on your first publication.

Information info@MidwestMedicalEdition.com

Source: Magazine Publishing Association, MPA Factbook 2013/2014

South Dakota Medical Group Management Association Fall Conference

surviving in the Changing Healthcare Environment

August 22-24, 2012 Cedar Shore Resort Chamberlain, SD

For the full schedule or to register, visit our website at

www.sdmgma.org

30

Midwest Medical Edition

Learning Opportunities

Summer / Fall 2016 July 20 9:00 am – 4:00 pm

Avera Infection Prevention Day of Sharing Location: Information: Sr. Colman Room, Prairie Center,Sioux Falls

Information: averaeducationevents@avera.org, 605-322-7879

Registration: Avera.org/conferences

July 28 - 29 8:30 am – 4:30 pm and 8:30 – 11:30 am

Power of Presence in End of Life Care Information: averaeducationevents@avera.org, 605-322-7879 Registration: Avera.org/conferences

August 18 - 19 8:00 am – 4:30 pm

Avera Child Sexual Abuse Conference Location: Sioux Falls Convention Center

Information: averaeducationevents@avera.org, 605-322-7879

Registration: Avera.org/conferences

September 8 9:00 am – 4:00 pm

4th Annual Avera & Hazelden Symposium Location: Ramkota Hotel, Sioux Falls

Information: 605-322-7879, AveraEducationEvents@avera.org

Registration: Avera.org/conferences

September 12 7:45 am – 3:00 pm

Mercy Infectious Disease Symposium Location: Sioux City Convention Center Information: mercysiouxcity.com/professional-education

September 12 8:30 am – 2:00 pm

Dialectical Behavior Therapy: A Day with Marsha Linehan Location: Ramkota Hotel, Sioux Falls

Information: 605-322-7879, AveraEducationEvents@avera.org

Registration: Avera.org/conferences

September 21 - 23

SDAHO 90th Annual Convention

Location: Sioux Falls Convention Center

Information: SDAHO.org

September 23 8:00 am – 4:30 pm

Avera Pulmonary & Critical Care Symposium Location: Holiday Inn City Centre, Sioux Falls

Information: 605-322-7879, AveraEducationEvents@avera.org

Registration: Avera.org/conferences

September 29-30

17th Annual Oncology Symposium

Location: Prairie Center, Avera McKennan Hospital

Information: 605-322-7879, AveraEducationEvents@avera.org

Registration: Avera.org/conferences

SAVE THE DATE: OCTOBER 7 16th Annual Community Response to Child Abuse Conference

MED reaches more than 5000 doctors and other healthcare professionals across our region eight 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.

ECMO ExtraCorporeal Membrane Oxygenation| Now at Sanford Children’s In order to bring the latest in care to pediatric patients across the Midwest, Sanford Children’s has added ECMO services. Our specialized, coordinated ECMO team of nurses, specialty doctors and respiratory therapists provides around-the-clock access to highly acute pediatric critical care.

ECMO provides cardiac and respiratory support to patients whose heart and lungs are badly damaged or diseased. This allows the patient to get rest and heal at the bedside, outside of the operating room. ECMO is used to treat conditions such as: • Severe pneumonia • Heart failure • Pulmonary hemorrhage

• Trauma • Respiratory failure • Sepsis and other overwhelming infections

With the largest pediatric critical care team and the only tertiary children’s hospital in the region, Sanford Children’s is here to provide the individualized and advanced care your patients need.

mINUTes maKe a DIFFereNce. reFer Your PaTIenT ImmeDIaTeLY BY caLLING (605) 312-1050.

012000-00423 6/16

childrens.sanfordhealth.org