JUNE
Regulatory Issues with Telemedicine SD Named Best State for Doctors A Nurse Leader Discusses Trust
VOL. 13 NO. 4
2022
PEDIATRIC NEUROSURGERY AT SANFORD
Dr. Eric Trumble & Dr. Shawn Vuong THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS
One number is all you need to connect with the very best pediatric transport team. 1.855.850.KIDS (5437) is your 24-hour link to pediatric specialists for physician-to-physician consults, referrals, admissions and transport.
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24 YEARS OF PROGRESS
Oct. 20, 2022
A day-long symposium offering
7:30 a.m. – 5 p.m.
advances in cardiovascular care
The Monument | Rapid City Snacks and lunch provided
a practical approach to the and technology, new preventative strategies and latest wellness information. CME/CE Credits available
In-Person and Virtual Options Available
To register and for more information, visit monument.health/cardiovascularsymposium
VO LU M E 13 , N O. 4 ■ J U N E 2022
Inside THIS ISSUE
CONTENTS PAGE 6 | Key Legal and Regulatory Issues with Telehealth ■ By John Domeika Providing healthcare services through telemedicine is regulated by a myriad of evolving federal and state laws. Here's how to make sense of them. PAGE 8 | This Month Online Articles you'll find only on the website, upcoming events, and why South Dakota is the best state for doctors
On the Cover
Pediatric Neurosurgery & the Resilience of Children Dr. Eric Trumble & Dr. Shawn Vuong, Sanford Children’s ■
By Alex Strauss
South Dakota's only two pediatric neurosurgeons discuss the joys and challenges of brain surgery in children. PAGE
10
PAGE 12 | NEWS & NOTES New awards, certifications, providers, and advances from across the region PAGE 20 | [Sponsored] FDA Leader Talks Cellular Therapy with Sanford Health Understanding orthobiologics and regenerative medicine with Peter Marks, MD, PhD, director of the Center for Biologics, Evaluation and Research at the FDA and Dr. David Pearce of Sanford Research. PAGE 22 | [Interview] Nicole Kerkenbush, Chief Nursing and Performance Officer, Monument Health A new poll shows nurses are still the country's most trusted professionals. What does it mean for the profession in the post-pandemic era?
FROM US TO YOU elcome to the June issue of MED, your premier source for medical community news and information in the South Dakota region. In this issue, we feature South Dakota's only pediatric neurosurgeons, Dr. Eric Trumble and Dr. Shawn Vuong of Sanford Children's. Although both doctors also treat adult patients, we'll explore why they were both drawn to seek additional fellowship training in pediatrics and why they are excited about the future of the program at Sanford. Telemedicine is nothing new but it did take on a new relevance during the pandemic. As federal and state regulations catch up with the new reality, the experts at COPIC tell you what you need to know to be compliant as you care for your remote patients. Plus, we have 8 jam-packed pages of news and notes, events, exclusive articles you'll only find on the website, and an interview on why nurses are still the most trusted professionals.
W
See you in July! —Steff & Alex
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Benefits of Focused Benefits of Focused Shockwave Therapy Shockwave Therapy Short treatment time Short treatment time Deep tissues can be reached Deep tissues can be reached Non-invasive and no known Non-invasive and noeffects known significant adverse significant adverse effects Precise & targeted application Precise & targeted application Results in few treatments Results in few treatments Alternative to medication Alternative to medication
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Key Legal and Regulatory Issues with Telehealth BY JOHN DOMEIKA
P
ROVIDING HEALTHCARE services through
process still requires a practitioner to obtain licensure
telemedicine is regulated by a myriad of
from each state’s medical board in which the practitioner
evolving federal and state laws. The complexity
seeks to provide telemedicine services and to pay the
of governmental requirements begins with
applicable licensing fee.
what is considered telemedicine—an evolving
concept that will differ among licensing jurisdictions. A practitioner’s telemedicine services will generally
to disciplinary action. Additionally, any negative complaint
require compliance with federal and state laws as if the
against a practitioner is required to be reported to each
practitioner provides the services in an in-person setting,
state participating in the IMLC.
but may include additional requirements that apply in the telehealth setting. This article focuses on three areas: licensure, privacy and security, and prescribing authority.
LICENSURE
PRIVACY AND SECURITY Practitioners must also comply with all privacy and security laws (state and federal, such as HIPAA) in a telemedicine setting to generally the same extent that apply when examining or treating a patient in person.
State licensure laws will apply as there is no nation-
The telemedicine technology platform and all patient
wide license for telemedicine. With limited exceptions,
records and information must be stored, preserved, and
states require practitioners who treat patients through
secured in compliance with all applicable requirements as
telemedicine to be licensed in the state of the physical
in any other setting. Covered healthcare providers who
location of the patient at the time of service. A physician
seek additional privacy protections for telehealth while
practicing in a state through telehealth is subject to the
using video communication products should provide such
state’s medical practice act and all medical board regula-
services through technology vendors that are HIPAA-
tions and policies.
compliant and will enter into HIPAA business associate
Becoming licensed in several states to perform telemedicine is an arduous application process that is
6
If a practitioner provides healthcare services in a state without that state’s license, the practitioner can be subject
agreements in connection with the provision of their video communication products.
somewhat mitigated by the Interstate Medical Licensure
Additionally, patient records originating from a
Compact (IMLC), a group of 34 states, Washington, D.C.
telemedicine setting must adhere to ONC’s Cures Act Final
and Guam, that seek to streamline the application process
Rule requirements that a patient must have immediate
(www.imlcc.org). However, please note that the IMLC
access to his or her medical records.
MidwestMedicalEdition.com
PRESCRIBING The authority to prescribe controlled substances originates from the practitioner’s state of licensure regardless of the patient setting. Before COVID-19, prescriptions for a controlled substance issued by means of telemedicine were generally predicated on an in-person medical evaluation (21 U.S.C. 829(e)). However, during the designated public health emergency, DEA-registered practitioners may issue prescriptions for all schedule II-V controlled substances to patients for whom they have not conducted an in-person medical evaluation, provided all of the following conditions are met:
♦ The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of his/her professional practice;
♦ The telemedicine visit with the patient is conducted using an audio-visual, real-time, two-way interactive communication system
♦ The practitioner is acting in accordance with applicable federal and state laws. Practitioners must be registered with the DEA in at least one state and have permission under state law to practice using controlled substances in the state where the dispensing occurs. Regardless of whether a public health emergency exists, if the prescribing practitioner previously conducted an in-person medical evaluation of the patient, the practitioner may issue a prescription for a controlled substance after having communicated with the patient via telemedicine, or any other means, so long as the prescription is issued for a legitimate medical purpose and the practitioner is acting in the usual course of his or her professional practice. ❖
John Domeika is General Counsel at COPIC.
Midwest Medical Edition
JUNE
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THIS MONTH ONLINE Highlighting content and opportunities available exclusively at MidwestMedicalEdition.com
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South Dakota Named
EVENTS
BEST STATE FOR DOCTORS Personal finance website WalletHub has named South Dakota as 2022’s Best State for Doctors. WalletHub compared the 50 states and the District of Columbia across 19 key metrics. The data set ranges from the average annual wage of physicians to hospitals per capita to the quality of the public hospital system.
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Practicing in South Dakota (1=Best, 25=Avg.) ♦ 1st – Avg. Annual Wage of Physicians
Location: Grand View Lodge Spa & Golf Resort, Nisswa, MN
(Adjusted for Cost of Living)
♦ 1st – Avg. Monthly Starting Salary of Physicians
July 26 9:00 am – 4:00 pm
(Adjusted for Cost of Living)
♦ 6th – Hospitals per Capita
Avera Infection Prevention Day of Sharing Location: Avera Education Center, Sioux Falls
♦ 10th – Projected % of Population Aged 65 & Older by 2030 ♦ 15th – Punitiveness of State Medical Board ♦ 6th – Annual Malpractice Liability Insurance Rate Other states in the MED region also ranked high. Minnesota came in 2nd on the list, Iowa was 6th, Nebraska 7th, and North Dakota was 9th. A link to the full report can be found on our website.
Spring Daisies!
8
Avera McKennan Diabetes Conference 2022 Location: Hilton Garden Inn Downtown, Sioux Falls
July 9 - 10 7:30 am – 5:00 pm, 7:30 am – 1:00 pm
Here’s how South Dakota stacks up:
Megan Potter, RN, Spearfish Hospital Labor and Delivery
June 10 8:30 am - 4:15 pm
The following nurses from across our region have recently been recognized with DAISY awards for extraordinary nursing:
Erin Bommersbach, BSN, RN, CCRN – Intensive Care Unit, Avera McKennan Hospital
September 23 8:00 am – 4:00 pm CNOS Orthopaedic Symposium Location: Holiday Inn Express, Dakota Dunes
Save the date October 26, 8:00 am – 4:00 pm 28th Annual Avera McKennan Trauma Symposium Registration opens in September
Sara Spartz, BSN, RN, CCRN – Intensive Care Unit, Avera McKennan Hospital
Mindee Olson, BSN, RN, PCCN – Cardio/Pulmonary Unit, Avera McKennan Hospital
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PEDIATRIC NEUROSURGERY & Dr. Eric Trumble & Dr. Shawn Vuong, Sanford Children’s
Sanford's pediatric neurosurgical team (l to r): Gabrielle Price, Sanford DNP, Shawn Vuong, MD, Eric Trumble, MD, and Nikki Thies, Sanford PA-C.
N
O PARENT WANTS to find themselves in Dr. Eric Trumble’s office at Sanford Children’s. And Trumble can certainly
WHY PEDIATRICS? Shawn Vuong, MD, is a native
empathize. In addition to being one of only two pediatric
of Hartford, South Dakota and a
neurosurgeons in South Dakota, he is also a father of seven.
graduate of the USD Sanford School
“I do think being a father makes me more empathetic,” says Dr. Trumble.
of Medicine. He did his neurosurgery
“No one wants to think about their baby needing neurosurgery. But sometimes
training at the University of Cincin-
that is what is required and I am just glad to be able to provide care in South
nati and completed his pediatric
Dakota that was not available at this level in the past.”
neurosurgery fellowship at Cincinnati
A graduate of the University of Virginia School of Medicine, Dr. Trumble
Children’s Hospital Medical Center,
completed his neurosurgery residency at the Medical College of Virginia in
one of the country’s top children’s
Richmond and went on to do a pediatric neurosurgery fellowship at UT South-
hospitals.
western Medical Center in Dallas. Along with pediatric neurosurgeon Shawn Vuong, MD, Trumble treats problems ranging from hydrocephalus, to epilepsy, cerebral palsy, spina bifida, complex brain tumors, and a host of other brain and spinal diseases and congenital abnormalities. Both doctors also treat adult patients.
Vuong says he was drawn to pediatric neurosurgery not so much for its specificity as for its diversity. “When I was looking at specialties, it seemed as though every adult spe-
“About fifty percent of all pediatric neurosurgery is done by adult neuro-
cialty was trying to force you to do a
surgeons with an interest in pediatrics,” says Dr. Trumble, who became the
smaller and smaller sliver of it,” he
state’s first board certified pediatric neurosurgeon when he joined Sanford in
says. “But in pediatric neurosurgery,
2018. “Dr. Vuong and I have done an additional fellowship beyond our adult
we can treat traumas, vascular issues,
residency so we have more than an interest in pediatrics.”
10
MidwestMedicalEdition.com
THE RESILIENCE OF CHILDREN BY ALEX STRAUSS
spinal problems, tumors, peripheral
80 percent of them with surgery,”
So whether I’m operating on a 3-year-
nerves, and more. I felt like a pediatric
says Dr. Trumble. That’s largely
old or an 83-year-old, I’m working
fellowship was going to allow me to
because slow-growing Grade 1 JPA
with the same team.”
expand as a neurosurgeon.”
(juvenile pilocytic astrocytoma) is the
“I knew from the beginning that
As a parent himself to three young
most common childhood brain tumor.
I wanted to treat both adults and
boys, Dr. Vuong says he also appreci-
In contrast, the most common adult
children,” says Dr. Vuong, who joined
ates the positivity and resilience of
brain tumors are aggressive and
Sanford in 2019. “I ultimately chose
children.
hard-to-treat glioblastomas.
Sanford because I felt like the admin-
“I see adults sometimes get frus-
“Many kids with brain tumors
trated when they aren’t feeling better
can be cured with chemotherapy or
Since then, Dr. Vuong has encoun-
as quickly as they think they should,”
radiation,” says Trumble. “Then we
tered a number of rare and challenging
says Dr. Vuong. “But, with kids, when
follow them with MRIs for years.”
pediatric cases, including a toddler
they start feeling even a little bit better, you open the door to the exam
WHY SANFORD?
istration had my back on that.”
with a brain stem lesion triggered by an infection and a young teen who
room and they are ready to run out.
Prior to joining Sanford in 2018,
slipped into a coma after the family
Particularly with the nervous system,
Dr. Trumble spent 21 years in Orlando,
stopped following up on the shunt he
kids really bounce back. They have
Florida. Although he says it was hard
received as an infant. Both kids are
tremendous neuroplasticity.”
to leave patients he had watched grow
now doing well and Drs. Vuong and
As an example, he points to func-
up, with his own kids out of high
Trumble say they are upbeat about
tional hemispherotomy, a delicate
school, the timing seemed right for
the future of Sanford’s program, its
procedure to disconnect the brain’s
the Minnesota native to come back to
patients, and the neurosurgery
two hemispheres. It is sometimes
the Northern Plains. Trumble says
profession.
necessary when a brain growth prob-
Sanford’s commitment to pediatric
lem or a small stroke at or right after
excellence was a big draw.
birth causes a child to have constant
“I’ve always been interested in the great frontier,” says Dr. Trumble, who
“At Sanford, we have a broad spec-
once hoped to be an astronaut. “To
trum of pediatric subspecialists so
me, the brain is still a big black box.
“In an adult, functional hemi-
there is always someone available to
We use our entire brain, but we only
spherotomy would lead to paralysis
me to talk about a clinic [i.e., the spina
understand about ten percent of what
on one side,” says Dr. Vuong. But
bifida clinic],” says Dr. Trumble. “At
it does. The most plastic time of our
children who undergo functional
the same time, from a surgeon’s
brain is while it’s still being formed.
hemispherotomy before age two
standpoint, the ORs are connected.
In neurosurgery, we still have so
seizures.
experience no paralysis and tend to
much to learn.” ❖
recover well. Likewise, Vuong says children can also bounce back from serious traumas such as a large brain bleed, whereas adults rarely do. But resilience is not the only thing Vuong and Trumble love about pediatric patients. “One of the reasons I got into pediatric neurosurgery is because brain tumors are the most common solid tumor in kids and we can cure about Go online for a list of the conditions Dr. Trumble and Dr. Vuong can treat.
Midwest Medical Edition
JUNE
11
Happenings around the region
News & Notes
South Dakota | Southwest Minnesota | Northwest Iowa | Northeast Nebraska
AVERA Avera celebrated all employees who work in its facilities, including clinics, hospitals, senior living centers and more during National Hospital Week (May 8-14), National Nurses Week (May 6-12), and National Skilled Nursing Care Week (May 8-14). Avera has 20,000 employees in 315 locations in 100 communities across five states in the Upper Midwest.
DAVID FLICEK David Flicek has been named Chief Operating Officer for Avera Health. Flicek is currently President and CEO of Avera McKennan Hospital & University Health Center and Chief Administrative Officer for Avera Medical Group. He is a native of Sioux Falls and a graduate of the University of South Dakota and has been with Avera for 27 years. Beginning in October, Flicek will lead all of Avera’s integrated operations of clinics, hospitals and long-term care centers as well as Avera@Home. He will continue his duties as CAO for Avera Medical Group.
12
Avera has opened a new four-story wing as part of its Avera Behavioral Health Hospital in Sioux Falls. This wing adds several new services including 24/7 Behavioral Health Urgent Care, observation care, youth addiction care services and partial hospitalization for youth. The wing is also home to Avera’s senior behavioral health unit, previously located on the Avera Prince of Peace campus. An anonymous donation of $11 million dollars will fund a number of capital improvements at Avera. These will include updates and new projects at: • Avera McKennan Hospital & University Health Center campus in Sioux Falls • Avera St. Luke’s Hospital in Aberdeen • Avera Marshall Regional Medical Center, Marshall, MN • Avera Queen of Peace Hospital, Mitchell • Avera Sacred Heart Hospital, Yankton • Avera St. Mary’s Hospital, Pierre Construction on these projects will begin later this year.
Avera will develop 12 pickleball courts on its Avera on Louise Health Campus. Upon completion, this complex will be the largest dedicated pickleball facility in South Dakota. Construction and development of the 12 courts, along with lighting and restroom facilities, will begin in mid-May on land east of the Avera Human Performance Center next to 77th Street. When the $1.5 million project is complete in early August, courts will be open and free to use by the public. Avera Research Institute is among more than 30 research teams across the country participating in the Research COVID to Enhance Recovery (RECOVER) Initiative
through the National Institutes of Health. Research efforts will focus on the long-term effects of COVID in children and young adults. Avera Health has partnered with Theralink Technologies, a precision medicine company with a novel phosphoprotein-based assay for breast cancer, to advance comprehensive molecular profiling. Theralink will provide key patient-specific information about which drug targets are activated in each patient’s tumor. Coupled with the genomics findings, the information will provide a molecular profile for Avera oncology patients. In exchange, Avera will help Theralink validate new clinical assays for other tumor types.
MidwestMedicalEdition.com
MONUMENT The American Cancer Society has awarded $30,000 in grants to the Monument Health Cancer Care Institute in Rapid City to help patients pay for transportation and lodging related to their care. The Monument Health grants are part of more than $5.7 million in grant funding awarded to over 400 health systems to alleviate the financial burden of transportation for cancer patients. Cancer patients and their caregivers can use the money to cover expenses such as gas, bus fare, hotel rooms, and temporary lodging during their treatment.
Mavis Jewitt, the Registered Nurse who has been involved in Hospice of the Northern Hills since it began 25 years ago, was named the first-ever recipient of the Monument Health Foundation’s Dignity Award. She was presented the surprise honor during the 25th annual Northern Hills Hospice Ball in Spearfish. The event raised more than $62,000 for Hospice of the Northern Hills, well above the $55,000 fundraising goal. Monument Health Foundation Director Hans Nelson presents the Dignity Award to longtime Hospice of the Northern Hills Director Mavis Jewitt.
May 6 was the first day that Monument Health had no COVID-19-positive patients in any of its five Black Hills Hospitals. Monument Health’s first COVID-19 hospitalized patient was admitted on March 26, 2020 and the system has been caring for COVID-19 patients ever since. For a time in late August of 2021, Monument Health hospitals were caring for 110 COVID-19- positive patients, most at Rapid City Hospital.
JAE H. KIM Interventional Neurologist Jae H. Kim, MD, has joined the Monument Health Neurology and Rehabilitation Clinic in Rapid City. Dr. Kim completed his Neurology residency at Temple University Hospital in Philadelphia and completed fellowships in Vascular Neurology and Endovascular Surgical Neuroradiology at the University of Minnesota. He is board-certified in Vascular Neurology and Neurology and is part of Monument Health’s new stroke team.
JUNE
Barb Hespen has been selected as the new President of Monument Health Custer Hospital and Market. She will lead Monument Health’s healthcare operations in the southern Black Hills. Prior to joining Monument Health, Hespen served as the Chief Nursing and Quality Officer at Sheridan Memorial Hospital in Sheridan, Wyoming. She also worked for Monument (Regional) Health from 1997-2013 as Director of Risk Management and Accreditation, Director of Patient Services, and Supervisor of the Home Care Department. Hespen will replace Mark Schmidt, who recently accepted the role of President of the Sturgis Hospital and Market.
SIOUXLAND Monument Health recognized seven Black Hills physicians at the inaugural Physicians and Providers Awards Banquet on Thursday, March 24. The 2022 winners are: John Palmer, DO, the Julie Raymond, MD, Distinguished Clinician Award Bruce Eaton, MD, FACP and Jason Knudson, MD, the Distinguished Educator Award Daniel Petereit, MD, the Distinguished Researcher Award Heather Brewer, MD, the Mark Harlow Distinguished Community Leader Award Forest Brady, MD, and Harold Edward Fromm, MD, the Robinson-Howe Legacy Award
Midwest Medical Edition
BARB HESPEN
MercyOne Air Med partnered with LifeServe Blood Center, Iowa’s largest nonprofit community-based blood center, to host blood drives in three regions across the state. The donation event, called “Answering the Call to Save Lives” was held on May 13th in Des Moines, Mason City and Sioux City. MercyOne Air Med serves more than two-thirds of Iowa and is available 24/7 for on-scene emergency and hospital-to hospital transport.
13
• Happenings around the region
News & Notes
Happenings around the region
HIJINIO CARREON MercyOne Chief Medical Executive Hijinio Carreon, DO, is one of 88 chief medical officers of hospitals and health systems to know in 2022, as selected by Becker’s Hospital Review. Dr. Carreon is the only Iowa-based health leader to be recognized. As chief medical executive, Dr. Carreon serves as a resource for regional chief medical officers to provide leadership to quality and safety, health informatics, patient logistics, virtual integrated care, and service line development.
UnityPoint Clinic–Marketplace opened in early May, providing family medicine and urgent care services to patients and residents of the city’s north side. The new clinic includes 7,742 square feet and will be home to UnityPoint Clinic providers Stephen Pallone, MD, and Jeanne Rasmussen, ARNP, with room for four additional providers. Construction of UnityPoint Clinic–Marketplace began in November 2021. A ribbon cutting and community open house was held on May 23rd. UnityPoint Health is one of the top places to work in healthcare in the US according to a national healthcare trade publication. Becker’s Hospital Review included UnityPoint Health on their 2022 list of “150 Top Places to Work in Healthcare.” The list highlights hospitals, health systems and healthcare companies that promote diversity within the workforce, employee engagement and professional growth.
14
KECHI KWIZERA UnityPoint Health has partnered with Bank of America which provides the health system with a loaned executive to help advance diversity, equity and inclusion efforts in hiring and career advancement. As part of her role, Kechi Kwizera, a Senior Vice President & Director at Bank of America, is helping to launch the UnityPoint Health Pathways Program. This initiative will help team members from underrepresented communities advance their careers.
ASHLESHA KAUSHIK Dr. Ashlesha Kaushik, Pediatric Infectious Disease physician for UnityPoint Clinic has been selected as the Iowa Ambassador for the CDC’s Project Firstline/American Academy of Pediatrics Infection Prevention and Control. As an Infection Prevention and Control Ambassador, Dr. Kaushik is among 17 national ambassadors selected from across the nation and is the only representative for the state of Iowa. The appointment took effect in January.
D’ANDRE CARPENTER Dr. D’Andre Carpenter has been selected as Chief Nursing Officer at UnityPoint Health. Carpenter most recently served as the Senior Vice President and Associate Chief Nurse Executive at Jefferson Health/Thomas Jefferson University in Philadelphia. As Chief Nursing Officer, Dr. Carpenter will lead enterprise-wide initiatives to ensure safety, quality, and exceptional patient experience in alignment with the strategic direction of UnityPoint Health.
St. Luke’s College – UnityPoint Health held a commencement ceremony on Friday, May 6th for graduates of the Spring Class of 2022. Forty-three students graduated from the college’s professional healthcare programs. Associate degrees were awarded in Registered Nursing, Radiologic Technology, and Respiratory Care. In addition, Bachelor’s degrees in Nursing and Health Sciences were awarded to four students.
SANFORD ERICA DEBOER Sanford Health’s chief nursing officer, Erica DeBoer, RN, MA, CCRN-K, CNL, has been appointed to join a select group of nursing executives from across the country on the Vizient System Nurse Executive Committee. Vizient is the nation’s largest healthcare performance improvement company, serving more than half of the nation’s acute care providers, including ninety-seven percent of the nation’s academic medical centers and a fifth of all ambulatory care providers.
MidwestMedicalEdition.com
15
JUNE
• Happenings around the region News & Notes
Happenings around the region
2022
ORTHOPAEDIC SYMPOSIUM
Investing in Learning. IMPROVING HEALTH.
Join us for a one-day symposium and discover the latest orthopaedic practices to best serve the health and recovery of our patients. CNOS Orthopaedic Symposium September 23, 2022 • 8am – 4pm Holiday Inn Express & Suites Dakota Dunes Event Center
EARLY BIRD PRICE
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16
Sanford Health celebrated the groundbreaking of a new 26,500 square foot clinic in northeast Sioux Falls in early May. The Sanford Madison & Veterans Parkway Clinic will be located on the northwest corner of Madison Street and Veterans Parkway, just minutes from Interstate 90. It will feature 34 clinical exam rooms, housing family medicine, pediatrics, outpatient physical therapy, and women’s services. There will also be a lab, radiology, and ultrasound services inside the clinic and an attached Lewis Drug retail store and pharmacy. Completion is expected in 2024.
PAUL BERGER III Sanford Health pulmonologist Paul Berger III, DO, FACOI, FCCP, is the co-author of a peer-reviewed, published paper that looks at the process of how critically ill patients are treated, specifically how to identify effective pharmacotherapies in a reasonable amount of time. The clinical trial streamlined the process in the beginning of the pandemic to find effective therapies to combat the virus for patients with severe COVID-19. “Clinical trial design during and beyond the pandemic: The I-SPY COVID trial” has been published in Nature Medicine.
BRENT TEIKEN Sanford Health Board of Trustees member Brent Teiken is among 14 leaders nationwide recognized by Modern Healthcare with an Excellence in Governance award. The Excellence in Governance program recognizes influential individuals who serve on a board of directors for a healthcare organization and foster advancement in culture, mission and performance. Teiken, who served as chair of the Sanford Health Board of Trustees in 2020-2021, has been a Trustee since 2011. Sanford Research will lead a multi-state effort across the upper rural Midwest to study the long-term effects of COVID-19 as part of the National Institutes of Health (NIH) RECOVER initiative. Dr. Susan Hoover, infectious disease physician at Sanford Health, and Lora Black, RN, MPH, executive director of clinical research at Sanford Health, are leading the Sanford Research Post-SARSCoV-2 Cohort at sites across the Sanford Health footprint.
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USD School of Health Sciences
Success Spotlight Three Sanford Health leaders were panelists at the Becker’s 12th Annual Meeting in April in Chicago, joining executives from the nation’s top health systems. Jeremy Cauwels, MD, Sanford Health chief physician, Erica DeBoer, RN, MA, CCRN-K, CN, Sanford Health chief nursing officer, and Luis Garcia, MD, Sanford Health president of clinic, took part in panel discussions covering some of the most pressing issues facing hospitals and health systems today.
Steve Young Degree: MS in Physical Therapy Current Position: President of Sanford Sports For nearly as long as he can remember, Steve Young wanted to be a physical therapist. An aptitude test in 8th grade confirmed it, and he headed to the University of South Dakota. His hope was that an undergraduate
Sanford Health opened a new pharmacogenomics (PGx) clinic inside the Sanford Imagenetics building in Sioux Falls in April. The focus of the new clinic is to help understand how some commonly used over-the counter and prescription medications interact with a patient’s genetics. Approximately 90 percent of people have at least one gene change that may affect medication response.
DAVID A. PEARCE David A. Pearce, PhD, president of research at Sanford Health, was recently named Chair of the International Rare Disease Research Consortium (IRDiRC). One in 10 people in the world are living with a rare disease. During the COVID-19 pandemic, some rare disease patients experienced challenges in obtaining a diagnosis and treatment options to manage their condition. As Chair of the IRDiRC, Dr. Pearce, along with a group of 59 other organizations from across the world, have a primary focus to re-engage rare disease research.
To improve access for patients and allow more room for providers, the Sanford Psychiatry & Psychology Clinic will now have two locations in Sioux Falls. The clinic at the Oxbow Business Center along 49th Street will remain in business. The new clinic located at 7511 South Louise Avenue now houses thirteen providers from the 49th Street location, which includes psychologists and therapists. Most of their positions will be backfilled with additional physicians, Advanced Practice Providers, psychologists, and therapy providers.
degree from USD would improve his chances of being accepted into what was then a two-year master’s program in physical therapy at the USD School of Health Sciences. “I am a South Dakota guy from Custer,” says Young. “I was grateful to find an in-state PT program at USD and I knew that was where I wanted to further my education.” The plan worked. Now Young, who has worked in both private practice and in Sanford’s large integrated health system, says his USD education prepared him for so much more than just physical therapy practice. “USD trained us in physical therapy to become kind of a jack-of-all trades in rural South Dakota where our patients may or may not have access to other professional help,” says Young. “We were very well-versed in all aspects of healthcare and the broad nature of the program gave everyone the opportunity to choose exactly where they wanted to take their PT careers.” As a result, Young says every one of his colleagues in the master’s program at USD chose a different path within the physical therapy profession. “USD prepared me to work as part of an integrated healthcare team,” says Young, who says he is passionate about leading teams. “We learned that our work as physical therapists is not only an opportunity but also a privilege and a responsibility. And that is a gift to my patients.” Young has been a clinical instructor in the PT department at USD and sits on the board of the Alumni Association.
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Midwest Medical Edition
JUNE
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• Happenings around the region
News & Notes
Happenings around the region
INDEPENDENTS
Dr. Ivaldo Lunardi and Dr. Evelio Garcia, Interventional Cardiologists, with the first PLHS Cath Lab team in 2007.
In May, Prairie Lakes Healthcare System Cardiac Catheterization Lab celebrated the 15 year anniversary of its first patient. Opened in 2007, the Cath Lab was the start of offering specialty services and advanced procedures at Prairie Lakes. The Cath Lab now includes a staff of seven people, including four nurses and three cardiovascular technicians.
MARK KELLER
Prairie Lakes Healthcare System now offers intravascular lithotripsy for problematic calcium buildup in the arteries of the heart. The new device uses sonic pressure waves to disrupt calcified plaque by creating a series of micro-fractures allowing the artery to be expanded at low pressure and a stent safely implanted to restore blood flow. Interventional Cardiologist, Richard Howard MD, FACC, FSCAI, treated the first Prairie Lakes patient with Shockwave IVL technology in April.
Mark Keller is the new General Manager of nutritional and environmental services and PLHS. Keller grew up in a small community in central Montana. He attended Dickinson State University in North Dakota and started his management career working in Montana and Washington for 19 years. Keller was most recently with Sodexo at Altru Health System in Grand Forks, North Dakota, the past eight years as the Operations Manager and Safety Team Leader.
JACKLYN KARLI Jacklyn Karli, Nurse Practitioner with Prairie Lakes Cardiology, recently completed her Doctorate of Nursing Practice. It is the highest degree of educational training in the nursing profession. Karli received her Associates Degree in Nursing from the University of South Dakota, Bachelors of Science in Nursing from South Dakota State University, Masters of Science in Nursing from South University, and her Doctorate from Capella University. She has been at PLHS for 16 years.
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NANCY SCHULTE Nancy Schulte, RN, has been awarded the 2022 Award for Nursing Excellence at Yankton Medical Clinic, PC. Nominations are submitted by the nursing staff and reviewed by a randomly selected award committee. Schulte has worked at YMC for 19 years. The CNOS clinic in Dakota Dunes recently scored in the top quartile of midsized employers who participated in Gallagher’s 2021 Benefits Strategy & Benchmarking Survey. CNOS was recognized as an organization that provides innovative solutions for creating organizational structures, workplace policies and total rewards, which inclusively engages and motivates its employees.
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Jason Pettigrew has joined HRMC as director of human resources. Pettigrew has more than 20 years of human resources experience in various industries in his home state of South Dakota, as well as in Texas. Pettigrew holds a master’s degree from Amberton University in Garland, Texas and a Doctorate in Higher Learning Education Leadership from Northcentral University in Arizona. For the last 10+ years, he has served as HR director at Presentation College in Aberdeen, where he has also been an adjunct faculty member.
STEVEN MEYER Dr. Steven Meyer, founder of Siouxland Tanzania Educational and Medical Ministries (STEMM) in Sioux City, Iowa, was inducted into the Iowa Volunteer Hall of Fame in a ceremony at the Iowa State Capitol building in April. Meyer, a board-certified orthopaedic surgeon with CNOS, co-founded STEMM 25 years ago to develop a relational bridge between Siouxland and Tanzania by addressing the priorities of spiritual growth, medical care, and educational opportunities. LifeScape has achieved Person-Centered Excellence Accreditation from The Council on Quality and Leadership. Person-Centered Excellence Accreditation is a four-year accreditation term for human service providers that transform person-centered philosophies into everyday practices and utilize data to assess the effectiveness of the support that people receive. This designation validates that LifeScape is committed to personcentered practices that promote the attainment of individually defined outcomes by people with disabilities.
SAREN KAHRE Huron Area Center for Independence awarded Saren Kahre, physical therapist assistant at HRMC, with the 2022 Distinguished Health Professional Award for her work with developmentally disabled patients. Kahre has worked in the rehabilitation services department at HRMC for nearly 19 years.
Brown Clinic has hired four new Advanced Practice Providers. Certified Physician Assistants Maggie Donovan, PA-C, Sarah Olson, PA-C, and Rachel C. Goetz, PA-C, graduated last year from the Master of Science in Physician Assistant Studies program at the University of South Dakota. Jamie L. Tracy, PA-C, earned her MS in Physician Assistant Studies last year from the University of Dubuque. All four are Board Certified by the NCCPA.
SHAUNA RICH JACOBSON The University of South Dakota School of Health Sciences has named Shauna Rich Jacobson the inaugural director for its new Doctor of Nurse Anesthesia Practice (DNAP), a post-baccalaureate degree to prepare registered nurses to become Certified Registered Nurse Anesthetists. Jacobson has 28 years of experience in nursing, 18 of those in nurse anesthesia. She holds a DNAP from Mount Marty University, as well as a paralegal certificate from the Center for Advanced Legal Studies in Houston, Texas. She began her duties at USD on May 9.
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• Happenings around the region
News & Notes
[ S P O NS O R E D ]
FDA LEADER TALKS CELLULAR THERAPY WITH SANFORD HEALTH doesn’t require investigation, new drug applications or biologics license applications. “Then there are more complicated products. There, one needs to go through the normal investigation process that we expect, which is when an investigator comes to the FDA and files an investigational new drug application,” said Dr. Marks. The approval process is complex and includes several regulatory steps. “If it sounds like a lot of work, it’s because it is a lot of work,” said Dr. Marks. David Pearce, Ph.D., is the president of innovation, research and Sanford World Clinic at Sanford Health, which offers regenerative medicine clinical trials. “It’s a complicated process, and we’re trying to do right by our patients. In the environment we’re in right now, we know many groups are
O
offering cellular therapies that are unapproved.
RTHOBIOLOGICS CAN REFER to
Sanford Health clearly can’t be in that group. We
a variety of treatment options based
obviously want to do the safe thing and we all
on a patient’s specific needs. These
want to do the efficacious thing,” he said.
treatments are relatively new, so
Not everyone who offers cellular therapies goes
oversight is important to make sure patients
through the correct channels. Some stem cell clin-
are getting the best care.
ics are charging patients money for therapies that
Peter Marks, M.D., Ph.D., is the director of the
should go through an investigational new drug
Center for Biologics, Evaluation and Research at
application process but haven’t. The treatments
the Food and Drug Administration in Washington,
these facilities offer are unapproved and unproven.
D.C. He helps manage the regulation of complex
Education is hugely important for patients, as
biologic products, including cell and gene thera-
it can help them identify which facilities and treat-
pies, blood products and vaccines.
ments they can trust.
“For cellular therapies, they go through differ-
“I think we sometimes think it’s the wild west
ent processes depending on whether or not they
out there,” said Dr. Marks. “So, the goal here would
meet certain requirements. Some products don’t
be to try to get the wild west under control by
actually even have to come to the FDA for
helping people know enough about what they’re
approval,” said Dr. Marks.
getting into, so they don’t get involved and pay
Skin grafts fall under tissue rules, meaning if they’re made according to regulations, the FDA
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money for things that aren’t going to be effective.”
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“ Education is hugely important for patients, as it can help them identify which facilities and treatments they can trust.”
For patients getting an investigational therapy, they shouldn’t be paying the retail price. Instead, the provider needs to provide the FDA with an accounting of what it costs to make the product and can only charge the patient or their insurance company that amount. This approach keeps providers from charging to make a profit on products that may not benefit the patient but still incentivizes research, such as through clinical trials. Products in the clinical trial phase are unproven but can still offer great benefits to patients and the research community as a whole.
“For me, I think this area of regenerative med-
“The beauty of participating in a clinical trial
icine is so exciting. And I think to date, it has not
is that even if ultimately the product doesn’t work,
flourished as well as it could because people hav-
you haven’t done something for nothing. You’ve
en’t done what Sanford’s doing, which is
helped advance knowledge because even a nega-
systematically going through and finding out if
tive trial helps us learn something,” said Dr. Marks.
things work or not,” said Dr. Marks.
“And if it’s positive, that’s really great because then
Individuals interested in treatments related to
you’ve probably benefited some, and society has
regenerative medicine should go through a trusted
benefited as well.”
and verified source for a clinical trial.
Sanford Health is offering a clinical trial that
“When you are considering cellular therapy, I
seeks to apply cellular treatments to orthopedic
think you, first of all, want to feel comfortable that
medicine, specifically in treating osteoarthritis in
you’re dealing with a reputable entity. It should be
five different joints.
somebody that you feel like you can find out about them, and you know what they are about. They should be interacting with you on a very transparent level,” said Dr. Marks. Clinical trials require getting informed consent and making sure patients have all the information they need to make a medical decision, such as whether to pursue a treatment. A red flag for a cellular treatment provider is if they’re charging an excessive amount of money for their treatments. That isn’t what clinical trials are for. “To sum up, the most important thing is to be able to feel confident you’re working with a reputable organization,” said Dr. Marks. For more information on Sanford Health’s clinical trials in orthobiologics and regenerative medicine, visit their website. ❖
“ For patients getting an investigational therapy, they shouldn’t be paying the retail price.”
Midwest Medical Edition
JUNE
21
[ INTERVIEW ]
Nicole Kerkenbush CHIEF NURSING AND PERFORMANCE OFFICER, MONUMENT HEALTH
A
to find nurses, 81% percent of those polled said they had very
MED: All around the country, there are more vacant positions for nurses than there are nurses to fill them. Why do you think this is?
high trust in nurses. Medical doctors rank second on the list
NK: Like everyone else, we had
GALLUP POLL RELEASED EARLIER THIS YEAR showed that, for the 20th year in a row, nurses are the most trusted professionals in the US. Even as healthcare systems struggle
at 67% and pharmacists rank fourth.
to deal with the pandemic in our
We spoke with Nicole Kerkenbush, Chief Nursing and Performance
personal lives. But it also created
Officer at Monument Health, for some insight into the poll and what it
a lot of stress in our professional
means for the nursing profession in the post-pandemic era.
lives. Workplace violence has grown the fastest and been the most extreme in healthcare. When people are seeking healthcare, they are not coming to us as their best self anyway. But I think that the pandemic has given some people the idea that it is OK to be uncivil. The other thing is that we had to limit visitors, even though people want to be with their loved ones when they are sick. So that added to the stress.
MED: Why would you say nursing is still a good profession to get into? NK: People are leaving the tra-
MED: Why do you think nurses continue to rank so high in the annual Gallup poll?
ditional workforce and part of
tend to rank very high on the trust
MED: What is different about nurses, as far as the public is concerned, from others who also care for them in the healthcare setting?
scale, nurses are seen as always
NK: I think one thing is that almost
you can not only make a real
being there for their communities.
everyone knows a nurse and that
difference, but you can choose
This applies no matter what kind
is not necessarily true of other
how you want to do it. We have
of nurse they are. If they are in
types of providers. Nurses are in
nurses in finance, in IT, and in law.
home health, they help people stay
our churches, our schools, and our
We have nurses who work full-
in their homes. If they are a pedi-
neighborhoods. Whenever I have
time or part-time, during the day
atric nurse, they help children stay
moved to a new place, it gets
or at night. It is a career that can
healthy. If they are a hospice
around very quickly that there is
adapt to your life. At the same
nurse, they help people at the end
a nurse living nearby. If you call a
time, there is real security. We are
of life. I think nurses are seen as
triage line because you are sick,
always going to have people who
having a service mindset.
it’s a nurse that picks up.
get sick and need care. ❖
NK: Like the military, which also
the reason is that they want to integrate their work and their life more, to find work-life harmony. They also want to feel like they are making a difference. In nursing,
You can find a link to the full Gallup Poll on our website.
22
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