MED-Midwest Medical Edition-March 2016

2016

MARCH

Vol. 7 No. 2

Midwest Medical Edition

Clinical Trials The Lifesaving Power of Increased Treatment Options

The ‘New” Dakota Lions Sight & Health A Local Solution

for TELEMEDICINE Avera Advances Rural Cancer Care

The South Dakota Region’s Premier Publication for Healthcare Professionals

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MIDWEST MEDICAL EDITION

Contents VOLUME 7, NO. 2 ■ M A RCH 2016

REGULAR FEATURES 4 | From Us to You 5 | MED on the Web USD Enhances Care in Rural Communities, Regional’s standout employees, Mercy tackles rural obesity, and other content available exclusively on our website

10 | News & Notes Recognitions, new providers, accreditations, and more 35 | Learning Opportunities Spring conferences, symposiums, and other CME Events

■ By Mandy Witt Expert advice for avoiding injury in the medical workplace

Sponsored Feature

8 | Safety Sensitive Positions: Are You at Risk?

■ By Amanda McKnelly and Maria Eining

23 | Area Providers Join Federal Initiative 25 | Prairie Lakes Introduces a Cutting Edge Procedure

26 | Technology Enhances Family Bonding with Babies in Neonatal Intensive Care Unit

26 | Merger Will Expand Reach of Local Medical Supply Company

28 | Business Profile: Beckenhauer Construction ■ By Alex Strauss

30 | The Building and Flow of Medical Credentialing ■ By Lavonne McKee

31 | Physician Sunshine Act: Opening the Windows on Physician Financial Involvement with Medical Product Manufacturers ■ By Scott Leuning

32 | Effective Solutions for Weight Loss and Heart Health

■ By Holly Swee

34|

“It Gives You a Bigger Voice” Pharmacist explains what prompted him to go back to school for his MBA

19 Why South Dakota Lions Eye and Tissue Bank is Now Dakota Lions Sight and Health

20 Sponsored Feature

Local Company On the Forefront of Telehealth Services Qvidity offers affordable telemedicine solutions for rural hospitals, clinics, and patients

24 Expanded Cancer Care in Mitchell and Aberdeen

2016

6 | Safe Patient Handling

ON THE COVER

THE LIFESAVING POWER OF INCREASED TREATMENT OPTIONS

MARCH

IN THIS ISSUE

Clinical Trials Vol. 7 No. 2

Midwest Medical Edition

Clinical Trials The Lifesaving Power of Increased Treatment Options

A Local Solution

for TELEMEDICINE Avera Advances Rural Cancer Care

The ‘New” Dakota Lions Sight & Health

The South Dakota Region’s Premier Publication for Healthcare Professionals

By Alex Strauss Growth in South Dakota’s medical market is paying off in more than just new facilities, providers, and procedures. It also means new opportunities to be a part of — and even instigate — cutting edge clinical trials. In this month’s cover feature, we talk with top researchers at Sanford about some of their latest studies and what the growing number and variety of clinical trials means for patients and providers in our region.

page

14

Cover photo: David Pearce, PhD, President of Research, Sanford Health Photo Courtesy Sanford

From Us to You Staying in Touch with MED

D

ON’T YOU LOVE IT when the world turns the corner toward spring? The air across the Plains states is still plenty cold, but the sun is warmer and milder days begin to finally seem possible

again.

In the spirit of the season, this issue’s cover feature is also about possibility and hope. We’re focusing on the new treatment options and new understanding made possible by the increasing availability of clinical trials in our region.

Our thanks to the researchers at Sanford Health for sharing their insight on this timely topic which impacts not only providers but also patients across the region.

The cold temperatures haven’t slowed down the tide of medical news coming across our desks this month. From the rebranding of the South Dakota Lions Eye and Tissue Bank, to the opening of Mitchell’s brand new medical campus, to an advanced new procedure available in Watertown, to new family-bonding technology in Regional’s NICU, this issue of MED is brimming with news you need to know. (Be sure to check out this month’s News & Notes section, too, for many news doctors.)

In this month’s expert columns . . . Midwest Health Management tackles the difficult topic of physician impairment, RAS has crucial advice on patient handling to avoid worker injury, and Credentialing USA simplifies the complex with a handy infographic.

Finally, we are excited to introduce you to Qvidity, a local telemedicine company raising the bar and lowering the costs of telemedicine for rural providers. You’ll find more about the company in their Sponsored Feature.

It is thanks to companies like Qvidity and the advertisers you see throughout MED that we continue to be able to bring you this quality publication, year after year, free of charge. When you see them, thank them!

As always, your comments and contributions are always welcome. Reach us any time at Info@Midwest MedicalEdition.com.

Warmly, —Steff and Alex

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 CONTRIBUTING WRITERS Maria Eining

Scott Leuning

Alex Strauss

Lavonne McKee Amanda McKnelly Holly Swee Mandy Witt STAFF WRITERS Liz Boyd Caroline Chenault John Knies

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

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

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

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

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On the Website this month Enhancing Care in Rural Communities USD is using telemedicine to link health education facilities in Vermillion, Pierre, Rapid City and Sioux Falls with 28 rural hospitals throughout South Dakota. A win for students and patients.

RE-POWER Rural Weight Management Study Akron Mercy Medical Clinic will take part in an innovative study of obesity in rural communities.

Regional Health’s Latest “I Am Regional Health” Nominees Shining a spotlight on Regional Health’s top employees

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LIST YOUR SPRING EVENT - FOR FREE! - Let MED help you fill your upcoming conference, open house, seminar or other event. Thousands of area healthcare professional’s read MED’s

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Steffanie Liston-Holtrop, VP Sales & Marketing 605-366-1479 Steff@MidwestMedicalEdition.com

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5

Safe Patient Handling In the Next Issue . . .

A New Perspective When Sioux Falls audiologist Bob Froke developed ringing in his ears after a bout of the flu last year, he assumed it would clear up. When it didn’t, and hearing loss also set in, he was suddenly thrust into an experience through which he’d so often counseled patients.

“I had to put a lot of extra energy into concentration and focus just to make sure that I was getting everything,” recalls Froke.

“There were always little gaps.

A couple of times, I gave some pretty off-the-wall answers and someone would says ‘That’s not what we’re talking about’.”

But, whereas a ‘typical’ patient goes through a an average grieving and denial process of about 7 years before finally addressing hearing loss, Froke knew he didn’t have that kind of time.

“I had to come to grips with it pretty quickly because I thought ‘You’re in the profession. Better get real about it, fast.’ So I had to hurry up my grieving process,” says Froke.

That’s not to say he didn’t grieve. And deny. And justify.

And all of the other things his hearing loss patients do. In the upcoming April/May issue of MED, we’ll explore Froke’s story and how this kind of “shoe on the other foot” experience can impact the way healthcare professionals relate to and care for their patients.

6

H

By Mandy Witt

AVE YOU EVER stopped to think about exactly how much patient care providers actually lift in an average shift? It has been estimated that in an eight hour shift, the cumulative weight that a patient care provider lifts is 1.8 tons. Can you see yourself lifting an elephant or six grand pianos every day? Of course not! But patient care providers lift that much in smaller increments all day long, which adds up and puts them at risk for injury.

Nationwide statistics show that patient care providers are ranked at the top of occupations with high work related injuries (Bureau of Labor Statistics, 2006).

■ 52% of nurses complain of chronic low

back pain 38% suffered occupationalrelated back pain severe enough to require time away from work ■ 20% are transferred to a different unit,

position, or change employment

■ 12% leave the profession due to back pain

With a growing obesity rate, higher levels of patient acuity, shorter hospital stays, and the continued increase in nursing workloads, today’s hospitalized patients are more dependent on patient care providers for assistance with mobility; putting them at greater risk for injury. Consequences to employers include high workers’ compensation costs, days away from work for injured workers, as well as the need to hire replacement workers. Protecting the health and safety of patient care providers is vital not only to the workers and their employers, but also to the overall health of the nation.

The causes of caregiver injuries are primarily related to the manual lifting and

moving of patients. The primary risk factors for moving patients include forceful exertions, repetition, and awkward postures. Some examples of high risk patient handling activities include: ■ Boosting a patient in bed ■ Turning/repositioning ■ Lateral transfers ■ Vertical transfers to/from bed/

wheelchair/stretcher/toilet/vehicle

■ Assisting a patient from sit to

stand/stand to sit

■ Ambulating/walking patients

The goal of safe patient handling is to reduce the physical stresses and injury risk to patient care providers related to manual lifting and transferring of patients, while striving to improve the safety, comfort, and quality of patient transfers. Safe patient handling aims to reduce lifting demands associated with moving patients to 35 pounds or less, as set forth by the National Institute for Occupational Safety and Health (NIOSH).

Thirty-five years of research has shown us there is no “safe” way to manually lift a patient, and using proper body mechanics alone will not prevent caregiver injury. Use of safe patient handling equipment combined with effective training on safe work practices is the only proven way to reduce caregiver injuries associated with moving and transferring patients. Use of safe patient handling equipment has been shown to reduce exposure of manual lifting injuries by up to 95%.

A comprehensive safe patient handling program is necessary to effectively reduce the risk of caregiver injury. ■ Mandy Witt, OTR/L, is an Ergonomics and Loss Control Specialist with RAS.

Find the key elements of a safe patient handling program–as well as the long-term benefits of such a program–in the full version of this article on our website.

Midwest Medical Edition

March 2016

MidwestMedicalEdition.com

7

SAFETY SENSITIVE POSITIONS

ARE YOU AT RISK?

By Amanda McKnelly and Maria Eining

T

HERE ARE OCCUPATIONS in our communities that

are considered “safety sensitive” because they are responsible for the welfare and safety of others. Safety sensitive positions include pilots, police officers, firefighters, attorneys and healthcare professionals. Because these individuals have a responsibility to the public, these positions require personal accountability and public oversight and are often regulated by a licensing board or similar authority.

Like all professionals, workers in safety sensitive positions are susceptible to illnesses that can lead to impairment. Such illnesses are common in society; both depression and alcoholism each reportedly affect 1 in 10 Americans. If a safety sensitive worker is impaired, errors may occur which could cause significant harm to themselves or others.

Fortunately, there is an organization in South Dakota that provides confidential assessments, resources and ongoing monitoring of individuals at-risk for impairment. Midwest Health Management Services is a confidential, clinical resource for people in safety sensitive positions, including healthcare professionals.

MWHMS was founded to assist professionals and organizations, to be a resource in addressing any of the following: ■ E ducation regarding health and

wellbeing for professionals in safety sensitive positions ■ Education and assistance and evaluation

if substance use or mental health concerns are identified ■ Referral to appropriate treatment

services and ongoing monitoring of continued recovery status.

To date, MWHMS has provided assistance to more than 420 professionals and students across South Dakota. Monitored recovery services offered by MWHMS follow and replicate strategies used

by State Physician Health Programs (PHP) and the Federal Aviation Medicine Advisory Service.

Studies of PHP programs, including the Domino Study and the

Dupont Study revealed that, nationally, PHP participants demonstrate a 78% success in recovery without relapse at an average of over 7 years of monitoring. Long-term success rates of pilot monitoring programs reported by the aviation industry note abstinence rates exceeding 85%. These rates are in stark contrast to recovery rates for the general public, as generally, only about 40% remain in remission at 1-year follow-up.

When an ill professional engages in appropriate treatment and monitored recovery services, a highly valuable resource is preserved and is a benefit to the public. In addition, given the morbidity and mortality related to untreated and undertreated substance use and mental health disorders, professional monitoring programs offer great advantages in recovery outcomes.

A vibrant monitored recovery program for professionals in safety sensitive positions can actually enhance public safety by encouraging early intervention, reducing risk associated with potentially impairing health conditions. Assisting professionals in safety sensitive positions to obtain the appropriate treatment and continued care is key. Professional monitoring programs acknowledge a primary concern for public safety, while taking into account that appropriate intervention and monitoring can save a career, a reputation, or even a life.

MWHMS welcomes questions or referrals from any source including, peers, self, physicians, colleagues, attorneys, treatment centers, family or friends. ■ Amanda McKnelly and Maria Eining are co-owners of Sioux Falls-based Midwest Health Management Services.

Domino, K.B., Hornbein, T.F., Pollissar, N.L., Renner, G., Johnson, J., Alberti, S & Hankes, L. (2005) Risk factors for relapse in healthcare professionals with substance use disorders. Journal of the American Medical Association, 293, 1453-1460.

DuPont, R., McLellan, A.T., Carr, G., Gendel, M., & Skipper, G.E. (2009) How are addicted physicians treated? A national survey of physician health programs. Journal of Substance Abuse Treatment. 37(1), 1-7.

Aviation Medicine Advisory Service, FAA-Sanctioned pilot alcohol abuse programs in business aviation. Accessed online on 7/4/2011.at http://aviationmedicine.com/ articles/index.cfm?fuseaction=printVersion&articleID=18

Sponsored Feature

8

March 2016

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9

Happenings around the region

South Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska

News & Notes AVERA

Avera has announced an agreement to lease operations of the Rock Rapids community hospital and clinics beginning in May 2019. The community

hospital is owned by Merrill Pioneer Community Hospital Association, which in the past has leased hospital operations to Sanford Health. Partnering with Avera, the Hospital Association plans to build a new hospital and clinic in Rock Rapids.

Avera Marketing won the top national Judge’s Choice Award for its “Butt Seriously” colorectal cancer awareness campaign in the 2015 Cancer

Awareness Advertising Awards.

Other Avera awards earned in the competition included two Gold Awards for the 4-D Breast Care radio ad series and Pink Ribbon Campaign and a Silver Award for the Avera Cancer Institute Magazine.

Avera McKennan Hospital & University Health Center in Sioux Falls was named in Becker’s 2015 edition of “100 hospitals with great women’s health programs” for the second year in a row. Avera

Queen of Peace Hospital in Mitchell was named to the list of 52 hospitals with the lowest all-cause unplanned readmission rates. Avera Queen of Peace is the only South Dakota hospital named to this list.

BLACK HILLS

Avera Urgent Care in Mitchell has become AveraNow Walk-in Clinic. In addition, the clinic

Avera Medical Group Liver Disease Sioux Falls has added new FDA-approved technology that provides non-invasive, painless and immediate assessment of liver fibrosis (scarring). FibroScan, also

HIMSS Analytics has awarded Avera McKennan Hospital & University Health Center with a Stage 7 Award. HIMSS

Analytics developed the EMR Adoption Model in 2005 to evaluate the progress and impact of EMR in hospitals in the HIMSS Analytics Database.

The final stage, Stage 7, represents an advanced patient record environment. During the second quarter of 2015, only 3.7 percent of the more than 5,400 U.S. hospitals in the HIMSS Analytics Database received the Stage 7 Award.

MED QUOTES

10

Black Hills Surgical Hospital has been ranked Number 6 in the nation out of more than 3,000 hospitals for high quality patient care by

will move to the new Grassland Health Campus in March.

called transient elastography, is a technique used to measure liver stiffness and provides assessment of liver fibrosis including liver cirrhosis. Liver disease often advances without specific symptoms. FibroScan provides specialists with a tool to catch liver disease in its earliest stages.

“

The following new providers have also joined Regional Health: Andrea Baier, MD, Palliative

Care, Rapid City Regional Hospital.

Modern Healthcare, a weekly healthcare magazine. The rankings are based on high quality clinical processes, high levels of patient experience and satisfaction, and high efficiency in providing healthcare in a cost effective manner. Black Hills Surgical Hospital is the only South Dakota hospital listed in the rankings.

Andrew Brevik, DO, Hospital

Medicine, Rapid City Regional Hospital.

Jessica Brosz, CNP, Cardiology,

Regional Heart Doctors, Rapid City.

Board-certified orthopedic surgeon Paul Miller, MD, has joined Regional

Michelle Gourley, CNP, Cardiology,

Regional Heart Doctors, Rapid City.

Health. Dr. Miller has 28 years’ experience and joins the system from MPG Orthopaedic Specialists in Oklahoma. His practice is located on the first floor of Regional Medical Clinic – Western Hills Professional Building in Rapid City.

Holli MoellerMontiel, CNP,

Occupational Medicine, Regional Urgent Care, Rapid City.

Patricia Schroeder, CNP, Cardiology,

Regional Heart Doctors, Rapid City.

Ashley Tupper, FNP, Family

Medicine, Regional Medical Clinic, Newcastle, Wyo.

The life so short, the craft so long to learn.

”

— Hippocrates

Midwest Medical Edition

SANFORD Two new vice presidents have joined the Sanford Health Network. Dale Gillogly brings

more than 25 years of experience in healthcare administration.

He most recently served as a regional administrator for Avera McKennan Hospital. Terry Mahar joins Sanford from Home Health and Hospice in Minnesota where he worked as the regional director. He was also a senior management healthcare consultant at Eide Bailly for more than 15 years.

Two new members have joined Sanford Health’s Board of Trustees: James E. Cain and

Melissa C. Hinton. Cain is the co-founder and chairman of Cain Brothers in New York, and he is actively engaged with the firm’s clients and the nation’s leading healthcare providers. Hinton is a partner with Evans, Haigh & Hinton, LLP. The majority of her practice is focused on the area of healthcare law.

Daniel Lister, MD, is now offering orthopedic outreach services at Sanford Webster Medical Center. Lister

graduated from the University of California-Irvine College of Medicine and completed his residency and internship at the Letterman Army Medical Center in San Francisco. He is certified by the American Board of Orthopedic Surgery. Dr. Lister, who also practices in Aberdeen, will offer appointments one day per month in Webster.

March 2016

SIOUXLAND Hematologist/ oncologist Susan Roeder, DO, has joined the June E. Nylen Cancer Center. Roeder

comes to Sioux City after 13 years at the Roy J. and Lucille A. College of Medicine, University of Iowa where she served as Clinical Outreach Director and clinical associate professor for the Division of Hematology, Oncology and Blood & Marrow Transplantation.

Roeder earner her DO from the University of Osteopathic Medicine and Health Sciences in Des Moines and did a fellowship in hematology/ oncology at the University of Colorado, Denver.

Mercy Medical Center— Sioux City will host more than 1,700 Siouxland women at its fifteenth annual Women’s Night Out on Thursday, April 7th at the Sioux City Convention Center. Proceeds will benefit

Mercy’s Child Advocacy Center, which was recently re-accredited by National Children’s Alliance. Since 1989, Mercy’s Child Advocacy Center has served more than 15,000 abused children and their families.

See Learning Opportunities on the inside back cover for more information on the fundraiser.

Mercy Medical Center honored local physicians at the Medical Staff Appreciation Dinner meeting at the Marina Inn on January 21st. The Golden

Heart award was presented to Dr. Matthew Timm, Pender Mercy Medical Clinics, Dr. Jeffrey Krohn, Kingsley Mercy Medical Clinic and Dr. Mary Schneider, Siouxland Women’s Health Care, PC. for exceptional customer service, great bedside manner, timely response, and compassion.

Sara Karpuk, PA-C, has joined the staff at Mercy Internal Medicine and Pediatric Clinic. Karpuk earned an MS

in Physician Assistant Studies from the University of Iowa Carver College of Medicine.

Most recently, she has worked as a physician assistant at Siouxland Community Health Center in Urgent Care.

Seek

HELP

Find

HOPE Helping Professionals Stay on Track

Midwest Health Management Services SD Health Professionals Assistance Program

ph | 605-275-4711 fax | 605-275-4715

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www.mwhms.com

11

Happenings around the region

South Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska

News & Notes Board Certified Family Nurse Practitioner Staci Schweder, ARNP, has joined the staff at Mercy Singing Hills Family Medicine. Schweder holds an

MS from Briar Cliff University.

Most recently, she was an ARNP at Family Medicine Clinic in LeMars, Curaquick Urgent Care and Tri-State Physicians.

Schweder has also taught nursing as an Adjunct Faculty member at Briar Cliff University.

Sandra Gutierrez has joined the Mercy Medical Center board of directors.

Ms. Gutierrez is the co-owner/manager of Mundo Latino Spanish newspaper and an insurance agent for MetLife Auto and Home–both in South Sioux City, Nebraska.

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

Log on!

12

Mercy Home Care is among the top ten home health agencies in the nation according to a ranking published by LexisNexis Risk Solutions. LexisNexis

performed rankings of home health and hospice services based on annual claims and patient volumes. The rankings help home health and hospice service companies better understand their market positions, dynamics and environment.

OTHER Dr. Tim Ridgway of Brandon has been named Executive Dean of the University of South Dakota Sanford School of Medicine. Dr. Ridgway

currently serves as Dean of Faculty Affairs at the medical school and is a practicing gastroenterologist. As Executive Dean, Dr. Ridgway will represent the school’s dean, Dr. Mary Nettleman, if she is unavailable, and he will also serve as a senior advisor to the medical school.

Midwest Medical Edition

GO PAPERLESS AND

Greg Carlson, PhD, is the new CEO of CNOS, PC, in Dakota Dunes.

Omaha, Nebraska native, Dr. Mayhan received his BS from Creighton University, and his PhD from the University of Nebraska. Dr. Mayhan comes to the medical school from Louisiana State University (LSU) Health Sciences Center, Shreveport, where he was head of the Department of Cellular Biology and Anatomy.

Dr. Carlson previously served 11 years as the CEO of a 500-bed community hospital in Owensboro, Kentucky and 5 years as COO of Marian Health Center (now Mercy Medical Center) from 1990-1994. He holds a PhD in Health Services and Policy from the University of South Carolina, and a Bachelors in Business and Political Science from Southwest Minnesota State University.

Dr. Russell Wilke has been named the new chair of the University of South Dakota Sanford School of Medicine’s Department of Internal Medicine. Wilke is

Dr. Keith M. Baumgarten, an orthopedic surgeon with Orthopedic Institute who has worked with professional sports teams at several levels, is quoted in an in-depth article by ESPN Senior Writer Bonnie D. Ford on Human Growth Hormone. It is titled, “A study

might change the way sports thinks about human growth hormone”.

This designation is the only Emergency Care award that identifies healthcare institutions based on female patient satisfaction and preferences.

SAY GOODBYE TO YOUR PAPER MESS AND

HELLO TO INCREASED EFFICIENCY

WITH DOCUMENT SCANNING FROM ACTIVE DATA SYSTEMS

“

Active Data Systems was able to scan all the paper charts, which made it very seamless and easy for us to import these records into our EMR software, saving our busy practice countless hours.

}}

a practicing general internist and also holds the position of enterprise director of pharmacogenetics at Sanford Imagenetics. He received both his MD and his PhD in pharmacology and toxicology from the Medical College of Wisconsin. Wilke replaces Dr. LuAnn Eidsness who is retiring.

Prairie Lakes Healthcare System has been named a recipient of the Women’s Choice Award as one of America’s Best Hospitals for Emergency Care for a third consecutive year.

GET ORGANIZED

“

William G. Mayhan, PhD, has been named dean of the division of Basic Biomedical Sciences at the University of South Dakota Sanford School of Medicine. An

Ophthalmologist Dr. Vance Thompson of Sioux Falls was a principal investigator for the FDA-monitored clinical trial for the FDA-approved AcuFocus KAMRA corneal inlay and he testified before the FDA on the inlay’s efficacy. The

Dr. Rizan Hajal Pulmonary & Sleep Consultants

KAMRA corneal inlay was approved by the FDA in April of 2015. The corneal inlay is an implantable device designed to correct near vision in patients with presbyopia.

your business technology leaders 2504 West 46th Street, Sioux Falls, SD 605-335-5906 // www.activedatasystems.com

March 2016

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13

Clinical Trials THE LIFESAVING POWER OF INCREASED TREATMENT OPTIONS

14

By Alex Strauss

B

IOMEDICAL RESEARCH stud-

ies conducted on human participants are universally known in the profession as “clinical trials”. But for the President of Research at Sanford Health, the term is just too limited.

“I prefer the phrase ‘increased treatment options’, because that’s what clinical trials really are,” says David Pearce, PhD, Senior Scientist with Sanford Children’s Health Research Center and director of the Pearce Lab. “Biomedical science and medicine are always advancing. When you are treating a patient, you have the standard of care. But [through clinical trials] you also have the ability to offer them the most up-to-date technology or intervention for their malady that may eventually become the standard of care.”

While bench research can take place almost anywhere innovative thinkers and a wellequipped laboratory exist, clinical trials require a sufficient number of eligible human participants and, often, significantly more funding.

Less than a decade ago, there were few of these “increased treatment options” available in the South Dakota region. But as the area’s population has grown and the number of qualified physician scientists and researchers has increased, institutions like Sanford have committed more resources to clinical trials and have been rewarded for their efforts.

“Sanford has expanded Sanford Research because there was a feeling that our research needs to impact patients,” says Dr. Pearce whose own research has focused on the molecular basis of inherited pediatric neurodegenerative diseases. “We have basic and translational research, but we have also invested in advancing our clinical research.”

The effort got a major boost when Sanford was admitted into an elite group of 34 healthcare institutions that are part of the National Cancer Institute’s Community Oncology Research Program. NCORP sites participate in NCI cancer prevention, control, screening and post-treatment surveillance clinical trials.

Sanford Health’s large footprint means that

March 2016

MidwestMedicalEdition.com

many of the region’s cancer patients are able to take part in large-scale national trials they might never have been able to access just a few years ago .

Clinical trials lead to more clinical trials in a sort of snowball effect. An institution’s involvement in NCORP-style community based clinical trials can, as it has in Sanford’s case, open the door to what Dr. Pearce calls commercial trials.

A growing number of pharmaceutical companies and device manufacturers now look to South Dakota as a good place to run an FDA trial.

“Reputation is everything in research,” says Dr. Pearce.

The third category of trials happening with increasing frequency are those initiated by local clinicians or researchers. “Every year, we have had more applications to the FDA generated by us, our own intellectual ideas,” says Pearce.

“In these cases, one of our own investigators has developed an approach or a compound.”

Beyond the obvious advantages of increased treatment options for area patients and their physicians, the availability of more clinical trials has had another positive effect. “It allows us to attract some fantastic physicians in oncology, radiation oncology, breast surgery, and a number of other areas. These doctors want to be able to offer the very latest treatment options to their patients. So it really has a knock-on effect,” says Dr. Pearce.

Although Sanford makes an effort to keep providers up-to-date on the various open clinical trials, like other area institutions, it also lists all available trials on its website for easy reference by any physician looking for an alternative or, in some cases, an add-on to the standard of care for patients who have few options.

“It is important to remember than a clinical trial is not an experiment and that a treatment has already been extensively tested in the laboratory before it is even approved to be tried in people,” says Dr. Pearce. “My message to clinicians is that you should always consider these additional treatment options and clinical trials as possibilities for your patients who qualify.”

15

New and Notable Sanford Research Trials

Gerard David, MD

Steven Powell, MD

A VACCINE FOR EBOLA

THE ROLE OF GENETICS IN CANCER

With ebola continuing to resurface in the wake of last year’s outbreak in Africa, research being conducted by infectious disease physician and researcher Gerard David, MD, is especially timely. David and his colleagues are conducting a Phase 3 randomized placebo controlled multicenter safety study on the immunogenicity of an ebola vaccine.

“The vaccine uses a recombinant vesicular stomatitis virus in which the protein of this virus is replaced with ebola protein,” explains Dr. David. “Our goal is to determine whether this is immunogenic and whether it is safe.”

The study, sponsored by Merck Pharmaceuticals, had met its 1125 patient enrollment goal (including 17 participants from Sanford) just a month after it opened in August 2015. Most participants are healthcare workers. They will have three follow-up visits to report side effects and be tested for antibody titers over the course of the six month study.

“There is currently no vaccine for Ebola,” says Dr. David. “This trial has very good potential, although it is too early to say how effective the vaccine will be.”

The role that a patient’s genes play in the development, progression or treatment response of their disease is another major focus for area researchers. The recently-concluded GEMMA (Genetic Exploration of the Molecular Basis of Malignancy in Adults) trial utilized nextgeneration gene sequencing technology to analyze tumor samples and provide real-time clinical information to the care teams of 120 adults with rare or recurrent cancer.

“One thing we learned from the GEMMA trial is that patients really want access to these kinds of treatments but that insurance doesn’t always want to pay for it and physicians don’t always know how to interpret it,” says Sioux Falls oncologist and clinical researcher Steven Powell, MD. For this reason, the next generation of GEMMA–COMPASS (Community Oncology use of Molecular Profiling to Personalize the Approach to Specialized Cancer Treatment at Sanford) will offer genetic testing to any children or adults with incurable cancer, with the goal of helping to direct them toward the most effective treatment.

Immunotherapy is another area of interest for Dr. Powell, who is leading a trial of the PD-1 inhibitor pembrolizumab as a way to enhance the effects of standard chemotherapy for head and neck cancer. “This allows us to use a lower dose of chemotherapy. So we are hoping for higher cure rates with less toxicity,” says Powell.

“ My message to clinicians is that you should always consider these additional treatment options and clinical trials as possibilities for your patients who qualify.” —David Pearce, PhD

16

Midwest Medical Edition

Open Clinical Trials in South Dakota

A NEW STENT GRAFT FOR TAAA Sanford physician inventor Patrick Kelly, MD, recently operated on the first patient treated as part of the clinical study of a new kind of stent graft for thoracoabdominal aortic aneurysm. Dr. Kelly says the Medtronic Valiant TAAA Stent Graft System, which he developed, allows for minimally invasive repair of a type of aneurysm for which the openprocedure mortality rate is 25 percent.

“As an artery becomes diseased, it becomes deformed. To develop a graft that is going to match everyone’s anatomy is virtually impossible,” says Dr. Kelly who designed his alternative stent when faced with a particularly challenging case of aortic disease. “Our design makes no attempt to try to match people’s anatomy so we are not limited by their anatomy.”

Kelly credits his ability to “think outside the box” and design a creative solution to his background as a structural engineer. Based on the positive responses of the first 29 patients treated with the new stent, Sanford entered into a license agreement with Medtronic to produce the final design which is now the subject of the multi-center clinical trial.

“This procedure marked an important first step in the process to obtain FDA approval,” says Dr. Kelly.

Kelly was also recently involved in a collaboration with USD to create drug coated balloons for the treatment of peripheral artery disease.

Although clinical trials are often associated with cancer treatment, hundreds of trials in a variety of disciplines are underway in the state of South Dakota alone and many more in the surrounding states. Below is a partial list of disease processes being studied by researchers in our region. A full list of open clinical trials and their eligibility criteria are available on each institution’s website.

• Acute Myeloid Leukemia • Alzheimer’s Disease • Aneurysm • Atherosclerosis • Brain Cancer • Breast Cancer

• Multiple Myeloma • Musculoskeletal Disease

• Coronary Artery Disease

• Non-Hodgkin’s Lymphoma

• Crohn’s Disease

• Ovarian Cancer

• Cystic Fibrosis

• Phenylketonuria

• Type 1 Diabetes

• Pancreatic Cancer

• Type 2 Diabetes

• Prostate Cancer

• Gastric Cancer

• Pulmonary Arterial Hypertension

• Heart Disease • Heart Failure • Hypertension • Infectious Disease • Inflammatory Bowel Disease

MidwestMedicalEdition.com

• Lymphoma

• COPD

• Cataracts

• Head and Neck Cancer

March 2016

• Lung Cancer

• Neurological Disorders (Huntington’s, MS, Neuropathy)

• Genitourinary dysfunction

Patrick Kelly, MD

• Leukemia

• Interstitial Cystitis

• Rheumatoid Arthritis • Sexual Dysfunction • Squamous Cell Carcinoma • Stroke • Various pediatric cancers • Vascular Diseases • Vitamin D Deficiency

17

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We develop scholars, practitioners and leaders in health and human services to serve South Dakota and beyond.

18

w w w. u s d. e d u / h e a l t h

Midwest Medical Edition

Why The “South Dakota Lions Eye and Tissue Bank” is now

“Dakota Lions Sight and Health”

By Alex Strauss

I

F YOU HAVE been in the area for more than a handful of years, you probably remember that the South Dakota Lions Eye and Tissue bank adopted this name in 2012 to better reflect its growing involvement in tissue (not just corneal) recovery and distribution.

After all, the former Lions Eye Bank also recovers bone and skin, tendons, heart valves, and veins for transplantation. Experts there also prepare corneas for advanced surgical procedures, work closely with local and national research partners, provide public education about organ and tissue donation, and even offer EMS training. Calling themselves an “eye bank” just did not cover it.

Now, the organization is rebranding itself once again to reflect an expansion of its service area and of its mission to restore the gifts of both sight and better health.

“We had an increased need for corneal tissue and at the same time the eye bank in

North Dakota was struggling because of regulatory changes,” says Dakota Sight and Health CEO Marcy Dimond. “Partnering with an agency that had a local presence and a similar mission not only helped us meet our demand but also helped to grow their program.”

Since implementing the partnership with North Dakota in 2015, the organization has consolidated staff to a single headquarters in Sioux Falls with satellite offices in Rapid City, Bismarck and Fargo. More importantly, it has doubled the number of corneas coming from North Dakota and increased distribution by 48 percent in 18 months.

“Part of reframing the name was to better identify the region that we serve and to really raise up our mission by keeping it front and center,” says Dimond.

Meanwhile, Dakota Lions Sight and Health continues to expand the scope of

its services and its tissue recovery efforts. The organization works closely with law enforcement, coroners, and with hospice to identify tissue donation opporMarcy Dimond t u n it ie s t h at might otherwise be missed when an individual dies in a setting other than the hospital.

Anxious to stay on the leading edge of up-and-coming fields such as cancer research and genomics, DLSH is also committed to keeping as much tissue as possible in the Dakotas.

“This is an exciting time for us as we continue to grow and renew our focus on our communities,” says Dimond. ■ Photo courtesy DLSH.

Dakota Lions Sight and Health headquarters in Sioux Falls. Photo courtesy DLSH

March 2016

MidwestMedicalEdition.com

19

Local Company On

the Forefront of Telehealth

Services

20

If you, your practice,

high that they are a loss leader. Our business

or healthcare system

model is different. We want our clients to profit

are considering adding

from using telemedicine in their practices.”

telehealth to your

Dr. Storm states that 2015 saw the approval

current offerings, have

of over 200 bills related to telehealth. Studies

begun evaluating soft-

show that not only are patients and providers

ware solutions, or are

ready to adopt telemedicine, but that

utilizing telemedicine

telemedicine will save the U.S. economy billions

but looking at new or better solutions, then

of dollars annually. CMS, Medicare, the VA, and

you need not look further than your own

private insurers are rapidly loosening regulations

practices, Dr. Storm states adoption is expected

backyard for the industry’s up and coming

and improving reimbursement. “Up until now,

to double year over year throughout the

telehealth company – Qvidity.

telehealth was too costly, poorly reimbursed,

industry and into all segments. “ACO’s and large

Dr. Jeremy Storm

Qvidity, formed in 2014 by Dr. Jeremy

and had serious technology limitations. The tide

healthcare systems were early adopters, but we

Storm (a local infectious disease physician and

has now turned, with improved reimbursement,

are seeing a growing demand among small to

telemedicine specialist) and Brian Brua (owner,

ready technology, and patient demand.”

medium sized hospitals and medical practices.”

Fused Interactive) is a telemedicine software and consulting company based in Sioux Falls, SD. Qvidity licenses its proprietary telehealth platform, Qvidity Direct, to doctors, medical practices, hospitals, and other healthcare organizations to use with their providers and for their patients.

“We believed in 2014 that telemedicine would not only be rapidly adopted, but would go mobile. As it turns out, we were right.”

Features of Qvidity include HIPAA compliant video, secure messaging, secure photo, scheduling, and payment processing. Qvidity is browser neutral, device neutral, practice neutral, and

Qvidity

Telemedicine utilization is expected to

Dr. Storm says that the use of Qvidity’s technol-

increase dramatically over the next 5-10 years,

ogy could even expand into non-healthcare

with most doctor visits occurring remotely via

related businesses, such as banking, law,

connected devices. “You will no longer have to

and other types of sales and consulting. “If a

offers affordable solutions for rural hospitals, clinics, and patients EMR neutral. “We built a truly universal solution,

sit and wait at the doctor’s office. You will see

company has a need for secure messaging,

that any healthcare provider can use for any

your doctor from the convenience of work or

secure video, scheduling, and payment process-

conceivable visit type.” Qvidity can be utilized

home.” Telemedicine is also seen as having the

ing, we can service them,” Dr. Storm says.

not only on mobile devices, such as tablets and

potential to revolutionize healthcare in remote

In addition, Qvidity provides professional

smartphones, but also fixed equipment including

and underserved areas, including developing

consulting related to telehealth. “We assist our

Polycom cameras and other hard-wired devices.

countries. “We provide telehealth functionality

clients with understanding state and national

“Because of its versatility, we get calls from

not only to regional and national clients, but are

law, scope of practice, and how to grow a robust

potential clients and industry leaders nearly every

expanding into the international market as well.”

and profitable telemedicine service line.” Qvidity

day,” Dr. Storm says.

Qvidity does this thru the use of language

is also partnering with regional and national

translation technology, which is a standard offer-

sales groups, consulting companies, medical

ing of its “Executive” subscription platform.

associations, and the pharmaceutical industry.

Prices range from $30-$70/month per using provider. Qvidity’s branded (white label) subscription platform starts at $50/month. For new

Qvidity’s clients include providers from

“Our timing couldn’t be better, and we are

clients, Qvidity charges either a one-time brand-

multiple specialties including internal medicine,

excited to be a part of the growing healthcare

ing/launch fee or a free launch option with a

family medicine, urgent care, infectious disease,

revolution.”

per visit fee. “Our prices are what we believe a

general surgery, dermatology, plastic surgery,

If you or your healthcare organization

physician would reasonably want to pay to

pediatrics, gastroenterology, ob-gyn, and psy-

is interested in telehealth, telemedicine, and

have a telemedicine solution.” Dr. Storm states

chiatry to name a few. While hospitals and

mobile health, then consider Qvidity –the

that with even minimal use, providers can profit

healthcare systems have adopted telemedicine

premier telemedicine software and consulting

from Qvidity. “Other solutions are priced so

at a faster rate than small to medium sized

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MidwestMedicalEdition.com

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21

New Leader at Sanford Health’s Imagenetics Research Program CORNELIUS BOERKOEL, MD, PHD, has joined Sanford Health as the executive director of the Sanford Imagenetics Research Center on Genomic and Molecular Medicine.

Boerkoel will use his more than 30 years of research and clinical expertise to investigate new ways of expanding Sanford Imagenetics through development of genetic and genomic medicine tools for primary care medical practice at Sanford Health. Sanford Imagenetics is an initiative that brings personalized medicine and pharmacogenetic testing into primary care for adult patients.

“Boerkoel’s experience as a physician scientist makes him a perfect fit for this role and a natural addition to Sanford Imagenetics,” says Gene Hoyme, MD, chief of genetics and genomic medicine at Sanford Health.

Boerkoel most recently served as a staff clinician and directed the translational laboratory at the National Institutes of Health Undiagnosed Diseases Program. He is also a co-founder of the Rare Disease Foundation.

“Sanford’s vision for genomic medicine is thoughtful, logical and attentive to the interaction between genetic and ecological factors,” says Boerkoel. “We have a great opportunity to revolutionize the integration of genetics within internal medicine.”

Boerkoel received his MD and PhD degrees from Case Western Reserve University School of Medicine in Cleveland and completed his residency at the University of Washington in Seattle. He also completed a fellowship in clinical genetics at The Hospital for Sick Children of Toronto. Boerkoel joined Sanford Health in February. ■

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22

Then and Now

For Drs. Richa

Plastic Surgrd and Tom Howard, ery is a Fa mily Affair

Father and son in the

By Alex Strau

S

“T-Ball” days

ss

IOUX FALL S PLASTIC Dr. Tom surgeon Richard Howa How ard and But things rd, MD, says Dr. Rich changed for T-Ball that it was ard How his father, Dr. Tom Howa when he originally ard realized how prompted rd him to establ and the oppor the cardio landscape ish his practi Sioux Falls tunity to get vascular had chang ce in in 1992. to know patien over time, ed in recen Specifically “Inte rvent such as over t years.

Tommy’s ts , his son ional cardi the course T-Ball. reconstruct of a breast become so ologi sts ion. As much “We were proficient have as stand living in that the surge he knows s to learn from to get the Kansas City time and we he ons tend very sickes his dad, he’s at the had one son. to be able t patients. also hopin more challe to It was T-Bal That teach and, if I wante g means some, too. nges, longe l season d to catch “I am hopin r recovery, problems,” a game, it 45 minute g that he will more says the young was a drive there of the old show me some who comp er Dr. Howa and then tried-and-tr minutes back leted his another 45 rd, ue things work and I’ll Plastic & to the office that alway tive Surge Reconstru to finish up,” be Dr. Howa able s ry to show him residency crd. “An hour says that are on at the Unive some things Oklahoma and a half the forefr one game rsity of in June. “With to watch ont of the . Living in says Tom, plastics, every specialty,” seemed really the big city who will be and cons one had pros studying for happy and but, at that exam in the excited to work. Their his board point, the fall. outweighing go to patients tend cons were the pros by For his part, to be happi It all seeme a long shot.”

Dr. Richa er, too.

Leaning on d much more rd Howard, Sioux Falls advice from attractive.” whose After discus Cente “a man who his father sions with that fails his famil structive Surge r for Plastic and Recon his dad and ation of the Dr. Howa y fails his ry has been evalulocal medic rd moved life”, practice, primarily al landscape, his family of coming is glad to a solo pract ice to the idea home to Sioux and surgic be gaini ng Sioux Falls, partner he al Falls not Katie only a with likes enjoy (also T-Ball as his wife and trusts ed as much a Sioux Falls he could, , but also relationship native) and and never son seeme a closer with his threelooked back. young Twenty-thr d more attrac old grand and-a-half ee years later, tive, too. son, Benja “My dad year on family that emph min. and I get appears to asis “He’s my along great Tom. “He’s be paying Not only only ,” off in spade says a wonderful grandson did Thom going to get s. and now teacher, a as Howard, surgeon, and I am to go to his to follow his talented MD, decid great with T-Ball game father into Dr. Howa e people. I missi ng a s,” says rd. ■ medicine, recently decid would be great oppor but he has ed – after tunity if I where else.” some consi went anydebate – to derable follow him NOT E: Dr. into his Sioux “I’m confid Tom will practice. ent knowing join Dr. Falls practice Richard ity, his Tom’s perso at the Sioux in high stand “Tom told nalFalls Cente and Recon me years ago ards, and r for Plastic approaches structive that he was lutely not how Surge takin he going to go ry in Augus g care of absowill do very people, that t. into plasti recalls Dr. c surgery,” well here,” he Howa rd with says Dr. Richa who is hopin a laugh. “He into medic g to cut back rd, al school got his own workl by 25 to 30 at USD and most of his percent. “I oad arranged rotations think it will of fun. And outside of He decided be a lot Sioux Falls. the timin that he wante g for me could n’t be d to do cardio right cular surge better.” now ry.” vasLike his father , Dr. Tom enjoys the Howard says personal natur he e of plasti c surgery Contact

informati

on: 6301

S. Minnesota

Ave. Suite

300 Sioux Falls,

SD 57108

605-3341930

Midwest Medical Edition

New Area Providers Join Federal Initiative SIOUX FALLS SPECIALTY HOSPITAL, Brown Clinic in Watertown, and the Yankton Medical Clinic are now part of a Medicare Accountable Care Organization (ACO), a national initiative of CMS designed to manage healthcare costs and quality. They are among 121 new participating oragnizations across the country announced in January.

Dakota Healthcare Partners, DBA AccoCare, in Sioux Falls was selected as one of 100 new Medicare Shared Savings Program Accountable Care Organizations (ACOs), bringing the total to 434 Shared Savings Program ACOs serving over 7.7 million beneficiaries nationwide.

Doctors, hospitals and healthcare providers establish ACOs in order to work together to provide quality coordinated care to their patients, while helping to slow healthcare cost growth. Beneficiaries seeing healthcare providers in ACOs can choose whether to see a doctor inside or outside of the ACO. ACOs receive a portion of the Medicare savings generated from lowering the growth in healthcare costs as long as they also meet quality standards for care.

Since ACOs first began participating in the program in early 2012, thousands of healthcare providers have signed on to participate in the program. The new and renewing ACOs, announced in January, brought approximately 15,000 additional physicians into the ACO program.

ACOs continue to show promising results on cost savings.

In 2014, they had a combined total net program savings of $411 million for 333 Medicare Shared Savings Program (Shared Savings Program) ACOs and 20 Pioneer ACOs. Based on 2014 quality and financial performance results for Shared Savings Program ACOs who started the program in 2012, 2013, and 2014, ACOs that reported in both 2013 and 2014 improved on 27 of the 33 quality measures, including patients’ ratings of clinicians’ communication, beneficiaries’ rating of their doctors, screening for tobacco use and cessation, screening for high blood pressure, and Electronic Health Record use. Shared Savings Program ACOs also outperformed group practices reporting quality on 18 out of 22 measures. ■ Source: AccoCare

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Our extensive selection of intravenous nutritional therapies can be custom tailored to your patient’s needs. We use patient information during intake assessment and specific lab work in conjunction with current conditions and medical history to determine the best protocol to provide integrative care and meet each patient’s needs and goals. By fusing traditional and nutritional medicine together, we can truly offer the best in whole person care for everyone we serve in health and healing.

For more information see www.rebalancesf.com or call 605.275.0001 to speak with one of our health care providers.

Healing Happens Here

Visit our website for more information about the Shared Savings Program and list of new and renewing ACOs.

South of 69th Street at 6301 S. Minnesota Ave.

March 2016

MidwestMedicalEdition.com

23

Photo courtesy Avera.

Expanded Cancer Care in

Mitchell and Aberdeen

The Don and Carmen Meyer Center of Excellence, the new home of Avera Cancer Institute Aberdeen

Photo courtesy Avera.

Avera Cancer Institute Mitchell’s new fully-digital Elekta Infinity linear accelerator.

MED QUOTES

24

“

MITCHELL RESIDENTS HAD their first opportunity to meet the area’s new medical oncologist, Kathleen Naegele, DO, at a January open house celebrating Avera Cancer Institute Mitchell’s 15th Anniversary. The event was also a celebration of the installation of a fully digital Elekta Infinity linear accelerator.

The new machine, which is the same model recently installed in the newly-relocated Avera Cancer Institute Aberdeen, is more precise and features an increased number of leaves and a built-in CT. “Patients can now get the same care here as they could in Sioux Falls, which means they can stay closer to home for treatment,” says Dr. Naegele.

A Chicago native, Dr. Naegele completed her hematology/ oncology fellowship and internal medicine residency at Midwestern University in Chicago and recently moved to Mitchell from Kingman, Arizona. She joins radiation oncologist Stephen Dick, MD, and medical oncologist Anwarul Haq, MD, and says she is excited about the collaborative spirit she has found in Mitchell.

“It is a very well-oiled machine with a high level of respect among the physicians,” says Dr. Naegele. “That is not something that you can really know about a place until you get there. You just hope.”

Another milestone for the Cancer Institute in both Mtichell and Aberdeen is the recent installation of new high-tech chemotherapy chairs. “The new chairs are not only more comfortable but they are equipped with wifi-connected tablets, vibration, and heaters and can be tipped back quickly if a patient has a reaction, which is very important,” says Dr. Naegele.

At the same time, Avera Cancer Institute in Aberdeen doubled its space in January when it moved into the newly constructed Don and Carmen Meyer Center of Excellence.

The new facility houses the practices of medical oncologist Richard Conkin, MD, and radiation oncologist Troy Adolfson, MD. ■

Spring is the time of plans and projects.

”

— Leo Tolstoy

Midwest Medical Edition

PRAIRIE LAKES INTRODUCES A CUTTING EDGE PROCEDURE Photo courtesy Avera.

NEW GRASSLAND HEALTH CAMPUS OPENS IN MITCHELL AVERA OFFICIALLY OPENS

and urology, as well as derma-

“This is the location for

the new Avera Medical Group

tology starting this summer.

the future of healthcare in

Family Health Center on the

Behavioral health services are

Mitchell, and it all starts with

Grassland Health Campus in

integrated with primary care

the opening of this beautiful

Mitchell this month.

at this location.

healthcare facility,” says Tom Clark, Avera Queen of

The 70,000 square foot, three-story Health Center

OTHER SERVICES INCLUDE

Peace Regional President

offers comprehensive medical

■ Urgent

care which will be known as AveraNow

and CEO. “The design focuses

■ O n on-site pharmacy with drive-through

and comprehensive services,

■ D ialysis (relocating from Avera Queen of Peace)

location.”

services provided by 16 physicians, four advanced practice providers, a psychologist, and trained care teams.

Specialties include family medicine, internal medicine,

■ Laboratory

pediatrics, general surgery,

■ Diagnostic imaging

on patient-centered care offered at one convenient

■

PRAIRIE LAKES Healthcare System is one of the first facilities in South Dakota to implant a UroLift System, a less invasive option to relieve symptoms of an enlarged prostate.

Dr. Henri Lanctin, Urologist, implanted the first UroLift System on Monday, February 1st. The UroLift System is a new treatment option for Benign Prostatic Hyperplasia (enlarged prostate) patients who are looking for an alternative to drugs or major surgery.

Typically, patients can go home on the same day of the procedure and see rapid symptom relief.

Over 500 million men suffer from Benign Prostatic Hyperplasia. Having an enlarged prostate is not associated with prostate cancer and is not life threatening, but can affect the urinary tract. Symptoms of an enlarged prostate can impact the quality of life and may result in the loss of sleep. The UroLift System is the first and only treatment that does not remove prostate tissue and does not negatively impact a man’s sexual function. ■

THE SYMPHONY STRIKES BACK

SDSO

SOU TH DAKOTA SYMPHONY ORCHESTRA

The Music of John Williams, Hans Zimmer, and more

SATURDAY, APRIL 9 AT 7:30 PM IN THE MARY W. SOMMERVOLD HALL OF THE WASHINGTON PAVILION

Call for Tickets (605) 367-6000

March 2016

www.sdsymphony.org

MidwestMedicalEdition.com

THIS CONCERT GENEROUSLY SPONSORED BY:

25

Merger Will Expand Reach of Local Medical Supply Company SIOUX FALLS-BASED medical supply distributor Kreisers, Inc. is one of a trio of companies joining forces to form one large distribution company known as Concordance Healthcare Solutions.

When the merger is complete, the combined organization will serve more than 1,300 hospitals, 1,000 extended care/home care providers and 5,000 physician practices and cover about 70 percent of the US population. Kreiser’s CEO Dave Larson will serve on the Senior Advisory Board of the new organization.

Joining with Kreisers to form Concordance The new NICVIEW camera hangs over the bed of baby Tate Lammers as his mother holds her phone to demonstrate how the new live-streaming video system works. Photo courtesy Regional.

New Technology Enhances Family Bonding with Babies in Neonatal Intensive Care Unit A NEW REAL-TIME, live-streaming video system called NICVIEW is up and running in Claire’s Place, the Neonatal Intensive Care Unit (NICU) at Rapid City Regional Hospital. NICVIEW allows families to see their babies in the NICU anytime, anywhere on any device with Internet access.

When newborn babies need specialized, critical care at Rapid City Regional Hospital, they can spend anywhere from days to months in the NICU. This can be a difficult time for families who want to see their child, but cannot spend 24 hours a day in the NICU. NICVIEW is the next best thing to being there, because it can reduce the unease of separation from the baby, supplement actual visits, and enhance family bonding.

The NICVIEW system consists of a simple unobtrusive camera mounted close to a baby’s bed that delivers streamed video

26

images around the clock, so families can watch their newborn anytime. Live streaming is only accessible to specified users, using passwords issued by the NICU staff.

The NICVIEW system, which cost just under $50,000, includes cameras, software and mounting hardware. This technology, enhancing family-centered care for patients, was paid for by funds from both Children’s Miracle Network Hospitals® at Regional Health and the Rapid City Regional Hospital Volunteer Auxiliary.

“We are happy to provide this new technology, in partnership with the Auxiliary, which will benefit the hospital’s smallest patients and their families throughout the region. This is a great example of Regional Health’s efforts to fulfill its purpose of helping patients and communities live well,” said Angie Kliewer, Regional Health Foundation Director. ■

Healthcare Solutions are MMS of Earth City, Missouri and Seneca Medical of TIffin, Ohio.

According to a press release, the new company will focus on distributing medical supplies and equipment, providing healthcare supply chain services, supporting healthcare providers to improve patient experience, supporting population health and reducing the perepisode cost of care.

Concordance will have approximately 1,000 employees, 19 distribution centers and $1.1 billion in annual sales. “We have 19 warehouses, which are close to our customers, with the potential of expansion from there,” says Larson.

“I believe that Kreisers will be perceived as more credible by our larger customers.”

The three companies bring different areas of expertise to the new company. “Kreisers has a strong presence in both acute care and alternate site, and it has a very strong government division, which we’re all excited about,” says MMS Executive Vice President Tom Harris who will serve as one of the co-presidents of the new company.

The transition is expected to be completed

in the first quarter of 2016. ■

Midwest Medical Edition

Multiple Sclerosis No Longer Just an Adult Disease MULTIPLE SCLEROSIS (MS) – once considered an “adults-only” disease – is increasingly being diagnosed in children and adolescents, a fact that puts pediatricians on the front lines when it comes to recognizing its symptoms.

“Up until recently, we had never thought of MS as a childhood disease,” says pediatric neurologist Geetanjali Rathore, MD, with Children’s Hospital & Medical Center in Omaha. According to Dr. Rathore, an estimated 10 percent of all MS cases now present before age 18.

The National Multiple Sclerosis Society says as many as 8 to 10 thousand American children age 18 and under have MS, and another 10 to 15 thousand have experienced at least one symptom suggestive of MS. The disease involves an immune-mediated process in which an abnormal response of the body’s immune system is directed against the central nervous system.

“If a person is diagnosed with MS at age 40, they will accumulate disabilities as the disease progresses,” Dr. Rathore says. “But a person who is diagnosed at age 15 will accumulate significantly more disabilities as

the disease progresses through the course of their life. This emphasizes the need for early diagnosis and treatment.”

Dr. Rathore says that diagnosing MS in children is more challenging than in adults because many other childhood disorders, such as acute demyelinating e n c e p h a l o m yel i t i s , exhibit similar symptoms and characteristics.

“Most pediatricians do not expect to find MS in children so they may not be looking for it,” Dr. Rathore says. “But if a child presents symptoms that indicate the possibility of MS, the pediatrician should refer to a specialist who is experienced in diagnosing and treating MS.” Dr. Rathore says a diagnosis requires evidence of damage in at least two separate areas of the central nervous system – which includes the brain, spinal cord and optic nerves – and evidence that the damage occurred at least one month apart while also eliminating all other possible diagnoses.

“It is a combination of clinical evaluation, a recent episode and MRI evidence of a prior event,” Dr. Rathore says. “With this information, we can diagnose MS at the patient’s first clinical presentation.

With many neurological disorders, early treatment leads to better outcomes.”

Dr. Rathore and her colleagues at the Neurology Clinic at Children’s regularly diagnose and treat disorders of the nervous system and diseases of the brain, spinal cord, nerves and muscles. In addition to her work in pediatric MS, Dr. Rathore has a special interest in other pediatric autoimmune disorders. ■

South Dakota Medical Group Management Association

Spring Conference April 27-29, 2016

Holiday Inn City Centre, Sioux Falls, SD

Featuring:

Jason Kotecki, CSP

Artist, Author & Professional Speaker

Danielle Crough, Ph.D., SPHR, SHRM-SCP

Senior Consultant – Human Capital, Silverstone Group

Jennifer Pollack, JD

MGMA Government Affairs Representative

Holly Arends, CHSP

Program Manager, Great Plains Quality Innovation Network, SD Foundation for Medical Care

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

sdmgma.org

Like us on Facebook at www.facebook.com/sdmgma Follow us on Twitter @SDMGMA

March 2016

MidwestMedicalEdition.com

27

Business Profile

Beckenhauer Construction

By Alex Strauss

Photos courtesy Beckenhauer Construction

W

HEN Norfolk, Nebraska -based Beckenhauer Construction was established in 1878, hospitals and health clinics in the Great Plains were few and far between, even given the area’s small population.

By the early 1950’s, when Beckenhauer was called upon to help build some of the region’s first hospitals, the company’s leaders could see the writing on the wall; healthcare construction in the Plains states had nowhere to go but up.

Today, more than 130 years later, both the population and the healthcare infrastructure that serves it, have exploded.

Beckenhauer CEO Buster Beckenhauer says healthcare projects now make up 75 percent of the company’s business. And that is just the way they like it.

“We have to keep up with what’s changing in the industry because healthcare trends and the needs of our healthcare customers are constantly changing,” says Beckenhauer whose firm is part of a nationwide association of companies that specialize in healthcare construction.

In addition to attending conventions

Kearney County Medical Center in Minden, Nebraska

and seminars on healthcare construction, Beckenhauer says the team often makes site visits to larger medical centers–like the prestigious Texas Children’s Hospital in Houston–in a continual effort to stay on the cutting edge of medical facility design and building.

“We have learned a lot, for instance,

from the Texas Children’s Hospital, including new ideas about how we do infection control and negative air monitoring which we can then share with clients who need help in this area,” says Beckenhauer. “Anytime we can learn how to do things better and faster, it not only helps us as a company, but it helps our healthcare clients.”

In most of their healthcare projects, the company prefers to take on the role of construction manager or design/build contractor, which Beckenhauer says allows them to lend their expertise to a building or renovation project from the very beginning.

“A lot of the success of a project comes down to the planning and sequencing of each subcontractor’s part,” says Beckenhauer.

“This is especially true in healthcare where you often have to maintain and monitor the safety of the environment in the facility while the project is going on.”

Utilizing leading edge LEAN Design principles for streamlined construction scheduling, Beckenhauer says the company has been able to cut the timeline for most projects by 20% or more. saving customers not only time but money. The technique is proving its value in a recent $16 million dollar

Inside the Jennie M. Melham Medical Center in Broken Bow, Nebraska

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Midwest Medical Edition

library renovation project at Wayne State University, where it had to be “business as usual” for students during construction.

“In hospitals, our philosophy is to be invisible and to get done as quickly as possible while maintaining safety for everyone by monitoring and validating what we are doing in terms of infection control and negative air monitoring,” says Beckenhauer.

Although Beckenhauer Construction has many repeat customers across Nebraska, the company’s next Buster Beckenhauer goal is to expand its presence in the South Dakota region with an office in Yankton. They are already making inroads in Burke, South Dakota–one of many rural towns with an aging hospital–where they are in talks to develop what Beckenhauer says may be a sort of “super clinic”. ■

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29

The Building and Flow of Medical Credentialing

By Lavonne McKee

T

HERE IS A FLOW in which the initial medical credentialing is done and within this flow there are four steps. Step one is the national level, step two is the state level, step three is the local level and step four is the regional level. Each step is built upon the previous step, creating a work flow in which this process is completed.

STEP ONE – THE NATIONAL LEVEL The follow items are building blocks to this step and must be completed in this step.

♦ National Provider Identifier number ♦ medical credentialing portfolio ♦ DEA license, ♦ Malpractice Insurance ♦ Board certification or a letter stating you’ve been granted to sit for your specialty boards

♦ Self-query to the National Practitioner Data Bank

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STEP TWO – THE STATE LEVEL

STEP FOUR – THE REGIONAL LEVEL.

There are only two building blocks to this level

You’ll need to have your clinical privileges and

but in order for it to go smoothly the first step

information to apply for third party payer

should be built and the information placed in your

reimbursement. This level is an extensive level

medical credentialing portfolio.

in paperwork and the credentialing specialist

♦ State medical license ♦ State controlled substance license (if required by the state and applicable to your specialty)

STEP THREE – THE LOCAL LEVEL To start this step, it is required for you to have completed both steps one and two.

♦ Hospital and clinical privileges.

Note: The clinic privileges is most likely where

at your practicing facility may help you with this endeavor.

As you build and complete each step of the credentialing process, the downward flow of third party reimbursement will follow. ■ Lavonne McKee is found and President of Credentialing USA based in Alcester, South Dakota.

you will be practicing, they need to have a full copy of your medical credentialing

MED QUOTES

portfolio on file so they may be a certified facility. The clinic where you choose to practice will let you know where you need to receive hospital privileges, this is where you’ll need to apply for hospital privileges.

“

The most beautiful thing we can experience is the mysterious. It is the source of all true art and science.

— Albert Einstein

”

Midwest Medical Edition

Physician Sunshine Act Opening the Windows on Physician Financial Involvement with Medical Product Manufacturers

P

By Scott Leuning

HYSICIANS HAVE long played an important role in the development and use of medical devices and new pharmaceuticals. For many years, the financial role that physicians had with medical manufacturers was kept behind the scenes.

However, in 2010, as part of the Affordable Care Act (ACA), the Physician Payments Sunshine Act (“Sunshine Act”) was enacted into law. Under this provision of the ACA, medical product manufacturers became required to disclose to the Centers for Medicare and Medicaid Services (CMS) any payments or other transfers of value made to physicians or teaching hospitals. The Sunshine Act also requires certain manufacturers and group purchasing organizations (GPOs) to disclose any physician ownership or investment interests held in those companies. The data collected

by CMS will be published annually in a publicly-searchable database.

It is not uncommon for there to be a financial relationship between medical product manufacturers and physicians, ranging from free meals to consulting or speaker fees to direct research funding.

Those relationships can have positive outcomes, particularly in the area of medical research, where consulting and research funding is often the impetus for the development of new devices or drugs.

However, those financial relationships can also create conflicts of interest, or at least perceived conflicts of interest, on issues such as what is the incentive behind a physician’s decision to utilize a certain medication for his/her patients. The purpose of the Sunshine Act was to create transparency with respect to the financial relationship between medical device and drug manufacturers and the physicians who use and promote their products. It imposes penalties ranging from $1,000-$10,000 for each payment that a manufacturer or GPO fails to

report, with a maximum annual penalty of $150,000.

One of the primary concerns regarding the Sunshine Act is that merely disclosing the amount of payments received by any particular physician does not distinguish between “appropriate” physician-industry interaction and payments from industry for “inappropriate” physician support of a product or device. ■ Scott Leuning is an attorney with Goosmann Law Firm.

For a deeper look at the impact, and potential pitfalls of the Sunshine Act, read the full version of Scott’s article on our website.

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March 2016

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31

Effective Solutions

for Weight loss and Heart Health

By Holly Swee

T

HE LATEST research presents a new way of thinking about beef: Lean beef can be part of a solution for heart health and weight loss.

A new study was published in the American Journal of Clinical Nutrition by researchers from Penn State University, which concluded that animal protein foods – including lean beef – can be just as effective as plant proteins in achieving weight loss and improving risk factors for metabolic syndrome as part of a heart-healthy dietary pattern1. You may have heard about the DASH (Dietary Approaches to Stop Hypertension) dietary pattern that is considered the “gold standard” heart-healthy diet that features fruits, vegetables, low-fat dairy and protein, predominantly from plant sources, and limits red meat and sweets. The DASH dietary pattern is a commonly prescribed diet by physicians to help reduce cardiovascular disease risk factors in their patients.

However, there is a growing body of evidence that shows lean beef can be part of a hearthealthy diet, too.

Research from Penn State University previously published in the American Journal of Clinical Nutrition and the Journal of Human Hypertension demonstrated that eating lean beef, as part of a heart-healthy dietary pattern rich in fruits, vegetables and low-fat dairy, can significantly help reduce blood pressure 2 and reduce levels of total and LDL “bad” cholesterol 3. It should be noted that this evidence suggests that it is the total protein intake–not the type of protein–that is instrumental in reducing blood pressure as part of a DASH-like dietary pattern. ■ Holly Swee, RD, LN, is Director of Nutrition & Consumer Information at the South Dakota Beef Industry Council

32

1 Hill AM, et al. Type and amount of dietary protein in the treatment of metabolic syndrome: a randomized controlled trial. Am J Clin Nutr 2015;102:757-70.

2 Roussell MA, et al. Effects of a DASH-like diet containing lean beef on vascular health. J Hum Hypertens 2014;28:600-5.

3 Roussell MA, et al. Beef in an Optimal Lean Diet study: effects on lipids, lipoproteins, and apolipoproteins. Am J Clin Nutr 2012;95:9-16.

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Midwest Medical Edition

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33

“It Gives You a Bigger Voice”

By Alex Strauss

L

UKE MERKEL HAD only been out of pharmacy school for three years when he began to realize that life had more in store for him.

“I knew that if I was going to leave my mark and pursue something I was passionate about, it was going to be in the healthcare administration arena rather than in the more traditional clinical side of things,” says Merkel.

But when he looked around his organization, one thing was clear: Leaders had more letters by their names.

“I have never been one who believes that you should need an extra degree to prove you’re qualified for something,” says Merkel who was then the Pharmacy Operation Coordinator at Avera McKennan Hospital in Sioux Falls. “But it shined through pretty clearly at Avera that to go places and to be considered for promotion, you had to come to the table prepared with more than just ‘I’m a good learner’.”

When he decided to pursue his MBA (with encouragement from his superiors), Merkel says he considered online programs, but decided on the University of Sioux

34

Falls Healthcare MBA for a more personal experience that he could still do without leaving town. He started in September of 2013.

“The fact that I was regularly interacting with both the professors and the other members of my cohort, who had a wide variety of backgrounds, was one of the most valuable parts of the program,” says Merkel. “We were all learning from each other all the time. It really helped me grow my network and open up opportunities that I never would have had otherwise.”

Because his cohort was relatively small, Merkel was careful to come to every class well-prepared, ready to share his own experience and knowledge with his fellow students. Like other area healthcare professionals, he says the ‘give and take’ of the USF program gave him not only an understanding of crucial business fundamentals, but also a better understanding of himself, his goals, and his potential.

“The program really helped me to be more open to new opportunities and experiences,” says Merkel. One of those opportunities came his way in the last couple of months, when he was hired as

Pharmacy Clinical Specialist for Avera Health Plans.

“At Avera Health Plans, I’ll be able to use what I learned in the MBA program, as well as my clinical pharmacy skills,” says Merkel. “From the business side of things, understanding how a health plan really works is going to serve me well.”

Finally, beyond the business knowledge he’s gained, Merkel says completing the Healthcare MBA program while maintaining his job and other responsibilities gave him a big boost in confidence.

“It really gives you a bigger voice. I am so much more well-versed and well-rounded now.” ■

Midwest Medical Edition

Learning Opportunities

Spring 2016 March 21 – 22 8:00 am - 6:00 pm 7:30 am - 12:00 pm

4th Annual Regional Health Sports Medicine Symposium Location: The Lodge at Deadwood Information: Education@Regionalhealth.com, 605-755-8015 Registration: Regionalhealth.com/sportsmed

March 31 8:15 am - 4:00 pm

Avera Transplant Institute Symposium Location: Prairie Center, Avera McKennan Information: averaeducationevents@avera.org, 605-322-7879 Registration: Avera.org/conferences

April 7 4:00 pm - 10:00 pm

Mercy Women’s Night Out Location: Sioux City Convention Center Tickets: www.VisitSiouxCity.org Information: www.mercysiouxcity.com/womens-night-out-486

April 8 8:00 am - 4:00 pm

15th Annual Avera Pediatric Symposium Location: Prairie Center, Avera McKennan Information: Avera Education Events, 605-322-7879 Registration: Avera.org/conferences

April 13 7:30 am - 4:00 pm

24th Annual Avera Trauma Symposium Location: Sioux Falls Convention Center Information & Registration: Avera.org/conferences

April 21– 22 8:00 am - 3:30 pm

SDHIMSS/SDHIMA Spring Forum Location: University Center, Sioux Falls Information: eknippling@brookingshealth.org

April 27 - 29 8:00 am - 5:00 pm

SDMGMA Spring Conference Location: Holiday Inn City Centre, Sioux Falls Information and Registration: sdmgma.org

April 29 - 30 8:00 am - 6:00 pm

10th Annual Sanford Sports Medicine Symposium Location: Ramkota Hotel & Conference Center, Sioux Falls Information: 605-312-7808

April 29 8:00 am - 4:30 pm

Edith Sanford Breast Center Symposium Location: Sanford Center, Sioux Falls Information: Jessica.Aguilar@sanfordhealth.org

May 6 8:00 am - 4:30 pm

21st Annual North Central Heart Vascular Symposium Location: Sioux Falls Convention Center Information & Registration: Avera.org/conferences

May 11 8:30 am - 4:00 pm

UnityPoint Health-St. Luke’s 42nd Annual Perinatal Conference Location: UnityPoint Health-St. Luke’s Auditorium, Sioux City Information & Registration: unitypoint.org/siouxcity/services-professional-eduction.aspx

SAVE THE DATE

June 24 - 25 — 38th Annual Sanford Black Hills Pediatric Symposium

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

Brian Aamlid, MD

Jason Anderson, DPM

David Hoversten, MD

Jason Hurd, MD

A BETTER GAME PLAN

Matthew Anderson, MD

C. Dustin Bechtold, MD

Hillary Becker, MD

Geoffrey Haft, MD

Gregory Neely, MD

Adam Nichols, DPM

Kristofer Kimber, MD

Chad Kurtenbach, MD

Robert Van Demark, MD

Timothy Walker, MD

Bradley Reeves, MD

Verle Valentine, MD

When your patient sustains an injury or suffers from chronic joint pain, put Sanford into your game plan of care. From non-surgical techniques to total joint replacement, this entire team of experts is here to help our medical colleagues like you with: Sports medicine 路 Total joint 路 Foot & ankle 路 Hand 路 Pediatrics

Call (605) 328-2663 to refer a patient.

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