MED-Midwest Medical Edition-November 2014

NOVEMBER

2014

Vol. 5 No. 7

Patient Portals The Future of Communication New Aneurysm Treatment in Sioux Falls Cost-Saving Strategies for Your Practice Aberdeen to Get New Cancer Services South Dakota and the Upper Midwest’s Magazine f or Physicians & Healthcare Professionals

One number accesses our pediatric surgical specialists, any problem, anytime.

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your 24-hour link to pediatric specialists for physician-to-physician consults, referrals, admissions and transport service.

Orthopedics Pulmonology Gastroenterology & GI Surgery Cardiology & Heart Surgery

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Midwest Medical Edition, August, 2014.indd 1

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Midwest Medical Edition

Contents

By Alex Strauss

Patient

Portals

Volume 5, No. 7 ■ November 2014

Regular Features 4 | From Us to You

The Future of Communication

5 | MED on the Web

The Medical Mysteries of Vampires, Supporting Caregivers, Call for Writers

Patient Portals are more than a requirement for meaningful use. Experts say, if chosen and used properly, they can also be a tool for more efficient practices, better communication, and improved health for patients. Here’s how some local providers are making them work

8 | News & Notes

New doctors, certifications, clinics, and more

32 | Wine Marketplace

MED Welcomes Award-Winning Prairie Berry!

34 | The Nurses’ Station Nursing News from Around the Region

35 | Learning Opportunities Upcoming Conferences, Events, and CME Opportunities

In This Issue

page

6 | The Many Possibilities of Integrated Security

18

■ By Bryan O’Neal

26

12 | Could Your System Be Infected Without Your Knowing?

Data Protection at the Point of Sale

■ By Eric Buzz Hillestad

ew Facility Will Bring New N Cancer Services to Aberdeen

16 | Bridging the Gap Between You and Your Patient ■ By Mike Winkleman and Jeffrey Nasers

Sponsored Feature

Midwest Medical Edition

23 | Sioux Falls Surgeon Featured in National Journals

14

for Aneurysm Inventions

27 | Technology Provides a Bridge for Cardiology Patients at Children’s

28 | Caring for Cancer Survivors in Your Practice

22 Clinical Spotlight:

New online program gives providers tips and tools to manage the unique needs of cancer survivors.

29 |

Healthy Jewelry Practices for Gemstones

30 |

Dr. Keith Hansen Awarded First Endowed Chair by USDSM

■ By Christopher A. Eads

31 | Protect Your Business from Data Theft: Why cyber safety is not just for the “big guys” ■

By Tracy Dahl-Webb

ost Saving Strategies C for Medical Practices The experts at DT-Trak have tips for a more efficient and profitable practice.

New Treatment Option for Giant Cerebral Aneurysms / The new Pipeline

On the

procedure at Sanford offers hope to patients who may not previously have been considered surgical candidates

COver

From Us to You Staying in Touch with MED

I

t has been just over a year since MED jumped full-force into the digital realm with a new, interactive website, a regular email newsletter, and a digital edition of our print magazine. During that time, we have learned a great deal about the power – and the pitfalls – of technology.

We know that many of you are on your own technology journey, as you work to meet the requirements of meaningful use and prepare your practice and your patients for a greater focus on digital communication. Patient Portals, systems that allow patients to interact with practices via the internet, are an increasingly important piece of the puzzle. Whether you have already launched your own portal or are just beginning the process, this month’s cover feature with some area providers who already have them should give you some food for thought.

Of course, we recognize that digital technology is only one aspect of medicine. This issue also features articles on new procedures, new research, and new services being offered in South Dakota, Iowa, Nebraska, and the rest of our coverage area.

If you have news or information you would like to share with your colleagues across the region, there is no better tool than MED. Whether you want to announce your new location, showcase a new service, share a hobby, start a conversation, or even or grow your online presence, we can help. Get in touch at info@MidwestMedicalEdition.com or through our website, where news and event updates are continually being posted.

With gratitude for your readership, your contributions, and your support for the sponsors who allow us to bring you this publication at no cost.

—Steff and Alex

Publisher MED Magazine, LLC

Sioux Falls, South Dakota

VP Sales & Marketing

Editor in Chief

Design/Art Direction

Steffanie Liston-Holtrop

Alex Strauss

Steffanie Liston-Holtrop Alex Strauss Angela Corbo Gier Corbo Design

Photographer Kristi Shanks Web Design Locable

digital media director

Jillian Lemons

Contributing Writers

Tracy Dahl-Webb Christopher Eads Eric Buzz Hillestad Jeffrey Nasers Bryan O’Neal Michael Winkleman

Liz Boyd Caroline Chenault John Knies Staff Writers

Contact Information Steffanie Liston-Holtrop, VP Sales & Marketing 605-366-1479 Steff@MidwestMedicalEdition.com Alex Strauss, Editor in Chief 605-759-3295 Alex@MidwestMedicalEdition.com Fax 605-213-0432 Mailing Address PO Box 90646 Sioux Falls, SD 57109 Website MidwestMedicalEdition.com

2015 Advertising / Editorial Deadlines Jan/Feb Issue December 5

June Issue May 5

March Issue February 5

July/ August Issue June 5

April/May Issue March 5

August 5 November Issue October 5 December Issue November 5

Sep/Oct Issue

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

MED’s Steffanie Liston-Holtrop at September’s SDAHO Convention in Rapid City. Thanks to all those who stopped by and took the first ever MED survey! (There’s still time to access the survey online for a chance to win!)

©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.

Midwest Midwest Medical Medical Edition Edition

on the

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Now More than a Magazine, A Medical Community Hub

Can’t wait for the next MED?

You can read MED Magazine up to two weeks earlier than print by accessing the digital issue on the MED website. Look for the December issue after November 25. Click on the link on the right side of the MED homepage to read on your Apple or Android device and enjoy the added bonus of live links, too! (Plus, sign up for notification of the digital issue, right in your Inbox)

Only on our website! ◆W in a Diamond for Christmas Take our brief online survey and you’ll automatically be entered in a drawing for a $500 diamond necklace from Riddle’s Jewelry, just in time for the holidays!

◆ Int eractive Directory – Find and

Vampires: Delving Into the Medical Mystery The medical mysteries of the known world have long fueled fires of the superstitious.

Brandy Schillace, PhD, a researcher at the Dittrick Musum of Medical History has just released Villagers, a book exploring the medical mysteries that surround the idea of vampirism. The author sheds new light on public fear and fascination with vampires as she delves into the symptoms and physical side effects of diseases such as syphilis and diabetes.

Helping Those Who Help Your Patients Caregiver stress is a common and increasing problem among the family members who care for aging patients when they are not in your office. But experts say you can help support these important care partners, potentially improving their health and that of the patients they care for. A Sioux Falls home care company offers tips for preserving caregiver health and sanity.

MED is Looking for Web Writers

connect with area businesses and add yours to the list. It’s easy and free to put the web to work for your practice with a listing and link in MED’s online directory.

◆ C alendar of Events – Find local events from CME opportunities to celebrations, open houses, conferences, seminars and fundraisers. Add your own event for free and reach thousands of MED readers.

◆ Bac k Issues of MED – Need to find an article you have seen in MED? Every issue is now available in an easy-toaccess digital format. Click the ‘Archives’ button on the MED home page.

MED is looking for physicians and other healthcare professionals who would like to submit articles for publication on our rapidly growing website. All subjects and ideas welcome. If you are a healthcare professional with something to say, let us help you spread your message. Contact us at Info@MidwestMedicalEdition.com to find out how.

November 2014

Find links to these articles andMidwestMedicalEdition.com more on the MED homepage.

5

The Many Possibilities of Integrated Security

By Bryan O’Neal

S

ecurity. When you think about protecting your workplace (and the people and resources inside it), what comes to mind? Cameras, alarms, access control—perhaps? There are so many components and applications to physical security in a healthcare environment, it’s difficult to pinpoint them all. Physical security has gone beyond locking the door to the medicine. Security today has evolved to include infant tagging, patient management, intrusion detection, mass

notification, parking management, visitor management, asset management and panic alarms. The list can be overwhelming and the notion of implementing all of these systems can be downright scary.

After you get past the fear, the questions begin. Where do you begin? How do you justify each of the components? What technology do you use? Who maintains it?

As with most security, physical security is generally risk-based and incident driven.

In other words, organizations work through a process of worst-case outcomes and what

has been observed to identify problem areas.

These are often unique to each organization and require such an approach to address them.

Regardless of the organization, however, a good place to start is with the key stakeholders. They should provide input on what is most at risk for them and provide examples of what has been observed or perceived as risk scenarios.

Armed with information, it is possible to deploy one or several technologies that can accomplish a reduction of risk. A physical security specialist can help identify the technology that works together to create the most effective solution. Take, for instance, the technology advances in IP cameras. They now have embedded processors that provide analytics. This smarter way to manage video can let you know when you need to pay attention to your security cameras. Picture an alert you retrieve on your phone, allowing you to observe someone entering a secure area, like your medical distribution system.

Analytics can provide specific responses based on events and types of alarm conditions, allowing you to focus your energy on your critical job duties.

By using open standard, IP-based technology, healthcare organizations can integrate security solutions to leverage existing security investments while increasing the possibilities for a safe, secure facility. ■ Bryan O’Neal is a healthcare technology consultant at Golden West Technologies in Rapid City, SD.

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Midwest Medical Edition

November 2014

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7

Happenings around the region

South Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska

News & Notes

Avera

Jonathan C. Olegario, MD, and the Olegario Medical Clinic in Mitchell

have signed an employment contract with Avera Queen of Peace Hospital. The Olegario Medical Clinic will now be called Avera Medical Group Internal Medicine Olegario Clinic and will relocate to 1222 East 7th Ave. (formerly Dr. Robert McWhirter’s clinic).

A contribution from the Avera Sacred Heart Foundation will help the Yankton Police Department keep its officers and the public safe in the immediate aftermath of a trauma incident.

The foundation recently donated approximately $2,900 to the police department for the purchase of trauma kits that can be used for injuries in the field if emergency medical personnel are unavailable.

Approximately 20 of the kits were bought and distributed to every police response vehicle and to members of the department’s special response team.

Avera Health Plans has received Health Plan Accreditation from the National Committee for Quality Assurance, an

independent, not-for-profit organization dedicated to assessing and reporting on the quality of managed care plans and other health-related programs.

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Arvin L. Santos, MD, FASN, FACP, has been named a fellow of the American Society of Nephrology and the American College of Physicians. Dr. Santos

is among the first-designated fellows of the ASN. Dr. Santos is a Nephrologist with Avera Medical Group Nephrology Sioux Falls and is medical director of outpatient dialysis services for Avera McKennan Hospital & University Health Center. He holds a medical degree from De La Salle University School of Medicine, Cavite, Philippines, and completed residency in internal medicine at Carney Hospital, Boston and fellowship in nephrology at the University of Vermont Fletcher Allen Health Care, Burlington. He is certified by the American Board of Internal Medicine and American Board of Internal MedicineNephrology.

Dr. Richard Holm of Brookings, South Dakota is this year’s recipient of the South Dakota Academy of Physician Assistants (SDAPA) ‘Supervising Physician of the Year’ Award.

This award was established to honor a practicing South Dakota physician who works with PAs. Dr. Holm is a strong supporter of the PA profession as a preceptor for students and has spoken at SDAPA conferences on many occasions.

Holm is Board Certified in Internal Medicine and Geriatrics and practices at Avera Medical Group in Brookings, SD

Avera Medical Group has opened its newest Sioux Falls location at 69th and Cliff. The

new clinic is home to 12 providers in family practice, pediatrics and OB/GYN. The facility is also an Avera Breast Center site for screening mammography, and on-site X-ray and lab are available.

In addition, Avera has announced plans to integrate behavioral health services with primary care at this location. In total, the 48,000 square foot clinic employs 50 people.

The Northeast South Dakota Healthcare Foundation has started building Milbank’s new $23 million healthcare campus.

The 75,000-square-foot facility located on 18 acres in east Milbank will bring the hospital and clinic under one roof and provide easy access to the 25 local and specialty providers that serve the Milbank healthcare community. Like many of the area’s newest healthcare facilities, the new Milbank Area Hospital Avera medical campus has been designed with a heavier focus on outpatient care.

Black Hills CareChex, a division of Comparion, has ranked Black Hills Surgical Hospital in the top 5% nationally and #1 in Market in the following

categories: Medical Excellence – Overall Surgical Care, Medical Excellence – Major Orthopedic Surgery, Patient Safety - Joint Replacement, and Patient Safety – Major Orthopedic Surgery.

Certified Fund Raising Executive International has named Angela Kliewer a Certified Fund Raising Executive.

Kliewer is the Director of the Rapid City Regional Hospital Foundation. Individuals granted the CFRE credential have tenure in the profession, education, demonstrated fundraising achievement and a commitment to serve not-for-profit organizations.

They have also passed a rigorous written examination.

Timothy Ungs, MD, a board certified physician in occupational medicine, public health, general preventive medicine and aerospace medicine has joined Regional Health. Dr. Ungs

is also a certified independent medical examiner and medical review officer.

M. Behnan Sahin, MD, joined the Regional Cancer Care Institute in September. Dr.

Sahin comes to Rapid City from the University of Minnesota Medical Center in Minneapolis where he was a Staff Medical Oncologist/Hematologist for 10 years. Dr. Sahin received his medical degree from Hacettepe University Hospital in Ankara, Turkey. He was fellowship trained in Hematology at the University of Wisconsin and in Medical Oncology at the University of Minnesota.

Midwest Medical Edition

Family medicine physician Thane Gale, MD, has joined the staff of Regional Medical Clinic. Dr. Gale

graduated from the American University of the Caribbean School of Medicine in Cupecoy, St. Maarten. After medical school, Dr. Gale completed his residency at the Center for Family Medicine in Sioux Falls. He joins Kathryn Barrett, MD, and Stephen Tamang, MD, at Regional Medical Clinic– Aspen Centre, 640 Flormann St.

Steven Stocks, MD, an internal medicine physician with Regional Medical Clinic-Aspen Centre was recently honored with the 2014 Physician Award for Professional Excellence.

Nominated by medical students working within Regional Health, this award recognizes physicians who exceed expectations in the area of professionalism and support a learning environment.

Sanford School of Medicine students said in their nomination, “Dr. Stocks is an exemplary physician. His dedication to his patients and the education of medical students goes above and beyond the average physician.”

Sanford Five research studies have been selected to receive grant funding through a partnership between South Dakota State University and Sanford Health.

The collaborative research on human nutrition, weight management and other dietaryrelated areas addresses the key objectives of Profile by Sanford.

Sanford Health is providing $250,000 and SDSU obtained an additional $170,000 through the South Dakota Board of Regents Research and Development Innovation program to bring the total collaboration with Sanford to $430,000 for the 2015 fiscal year Sanford Heart Hospitals in Bismarck, Fargo, and Sioux Falls have received high recognition from the American College of Cardiology, the National

Cardiovascular Data Registry–Get With The Guidelines Platinum Performance Achievement Award for 2014. The award recognizes that Sanford has reached an aggressive goal of treating these patients to standards set by the American College of Cardiology/ American Heart Association.

An increasing number of soonto-be mothers and babies will soon benefit from a Sanford Health program that aims at enhancing the pregnancy and birthing experience. A $6,000

grant from the South Dakota Chapter of the March of Dimes will increase the number of participants enrolled in Centering Pregnancy, a group that brings expectant women with similar due dates together for group prenatal support, education and healthcare services.

November 2014

Sanford Health and Sport Testing, Inc. have announced an

agreement that makes Sanford the official sports medicine and research partner of Sport Testing, an athletic-assessment technology company based in Toronto, Canada. The relationship gives Sport Testing access to the expertise of Sanford’s roster of orthopedics and sports medicine providers and research arm.

Sanford Health physician and scientist Michelle Baack, MD, has been awarded a grant totaling nearly $600,000 from the National Institutes of Health for research focused

on preventing cardiovascular disease in the offspring of diabetic mothers. Baack’s five-year project is entitled “Lipotoxic effects of maternal diabetes and high fat diet on the developing heart”. Baack is a neonatologist at the Sanford Children’s Specialty Clinic and also runs a lab in Sanford’s Children’s Health Research Center.

Sanford Worthington is pleased to welcome Naomi Bach, RN, CWOCN, CFCN, CNP to its team as a Wound Ostomy Continence Nurse Practitioner. Ms. Bach is

a graduate of St. Luke’s College and Briar Cliff University in Sioux City, Iowa and the family nurse practitioner program at Clarke University in Dubuque. She will work in the Outpatient Treatment and Infusion Center. Her role includes inpatient and outpatient wound care, ostomy care, nurse education and outreach to other Sanford facilities when needed.

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Amornopol Anuwatworn, MD and Shenjinng Li, MD/PhD are the two newest fellows in the Sanford School of Medicine Cardiovascular Fellowship program. Dr. Anuwatworn

received his medical degree from Chulalongkorn University Faculty of Medicine in Bangkok, Thailand.

Dr. Li received his MD/PhD from the Second Military Medical University in Shanghai, China.

With their addition, the program now has six fellows. The Sanford School of Medicine Cardiovascular Fellowship is a three year program, which began in 2012, and is accredited to two fellows per year.

Family Medicine physician Alboury Sow, MD, has joined the team of healthcare providers at Sanford Worthington. Dr. Sow received

his medical degree from Universite Cheikh Anta Diop de Dakar, Senegal, Africa. He completed his Family Medicine residency at Morehouse Family Medicine Residency Program in Atlanta.

Dr. Sow is fluent in English and French. He is board eligible and will take his exam in November 2014.

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South Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska

News & Notes Siouxland Ashley Neils, MD, has joined UnityPoint Clinic Family and Internal Medicine at Sunnybrook Medical Plaza.

UnityPoint Clinic is part of UnityPoint Health which also includes UnityPoint Health – St. Luke’s and UnityPoint at Home.

Neils received her MD from the University of Texas-Houston School of Medicine and completed her residency in Sioux City, Iowa at the Siouxland Education Foundation. She is board certified in Family Medicine and has special interest in infectious diseases, allergies, labor and delivery, and women’s health.

Dave Smetter has been appointed Vice President of Communications and Community Development for Mercy Medical Center – Sioux City. In his new

position, he will provide executive leadership, direction and strategic planning for Mercy’s Strategic Business Plan, Mercy’s Foundation and Fund Development, and Communications including Public Relations, Marketing, Regional Advocacy & Public Policy, and Volunteer Services. In the early to middle 1990s, Smetter served as Mercy’s Director of Marketing & Communications, known at that time as Marian Health Center.

MED Quotes

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Mercy Medical Center-Sioux City has received the American College of Cardiology’s NCDR ACTION Registry–GWTG Platinum Performance Achievement Award for 2014.

Mercy is one of only 256 hospitals nationwide to receive the honor.

To receive the ACTION Registry– GWTG Platinum Performance Achievement Award, Mercy consistently followed the treatment guidelines in the ACTION Registry–GWTG Premier for eight consecutive quarters and met a performance standard of 90 percent for specific performance measures.

continued

Becky Wittrock, Physician Assistant for Baum Harmon Mercy Clinics in Primghar, Paullina, Hartley and Sutherland, Iowa has been named the recipient of the annual Catherine McAuley Excellence Award for 2014. The

award was given to Wittrock at Mercy Medical Center’s Employee Recognition Open House in September. Baume received her bachelor’s degree from the University of Iowa and completed her PA degree at the University of Wichita where she graduated with honors.

The Trauma Center at Mercy Medical Center has been verified

UnityPoint Health – St. Luke’s welcomes new staff to the marketing department. Suzie

Fischer has joined the St. Luke’s marketing department as a Senior Marketing Communication Specialist. Sara Fay has joined the department as a Marketing Communication Specialist The on-site blood bank at UnityPoint Health – St. Luke’s has been granted accreditation

by AABB. To achieve this

accreditation, St. Luke’s on-site blood bank underwent an intensive on-site assessment by the AABB assessors in which it met or exceeded accreditation standards for medical, technical and administrative performance

as a Level II Trauma Center by the Verification Review Committee, an ad hoc committee of the Committee on Trauma of the American College of Surgeons.

Other Physicians Vein Clinics and LazaDerm Skincare Centre are celebrating their first year of business in Watertown, South Dakota. Owner and Medical

Kent Olson, Administrator and CEO of Philip Health Services, Inc., in Philip, South Dakota, was elected Chairperson at the Annual Business meeting of the South Dakota Association of Healthcare Organizations.

Olson served the last year as Chairperson-Elect of SDAHO. A native of North Dakota, Kent earned his MBA from the University of Phoenix and his BS in accounting from Moorhead State University The Sioux Falls VA broke ground on the long-awaited new free-standing surgical suites in September. This building

is expected to be completed in June 2016 at a cost of 7.9 million dollars. Once completed, the new space will increase the number of operating rooms to four and will allow for more optimal patient flow. This project is one of several in progress or soon-to-be completed at the medical center to improve care and services for Veterans.

Director Lornell E. Hansen II, MD, and his staff would like to thank everyone for their support.

Dr. Hansen works closely with Jamie Grant, CNP and their new addition, Jeff Heier, MD to provide patients with expertise across a wide range of venous, laser, and cosmetic procedures. Other clinic locations include Sioux Falls, South Dakota and Sioux City and Sioux Center, Iowa.

A merry heart doeth good like medicine. — King Solomon

Midwest Medical Edition

Dr. Angela Gulbranson and the staff at Visions Eye Care & Vision Therapy Center of Sioux Falls are pleased to announce the addition of their 3rd optometrist, Dr. Ashley Gentrup. Dr.

Gentrup is a graduate of Southern College of Optometry in Memphis, Tennessee.

She is residency trained in pediatrics and binocular vision and has a passion for helping children and adults who struggle with strabismus, amblyopia, binocular vision issues and learning-related vision problems. She graduated with Highest Honors from the University of Nebraska with a BS in Sociology. She is a native Nebraskan.

Looking for a better way to manage risk?

Get on board.

The Center for Disabilities has named Dr. Eric Kurtz as the new Leadership Education in Neurodevelopmental and Related Disabilities (LEND) director. He succeeds Dr.

Joanne Van Osdel who retired in July.

Dr. Kurtz has previously served as the Center’s Clinical Operations director, Autism Spectrum Disorders Program director, Discipline Head for Autism and Related Disorders with LEND, and is Assistant Professor of Pediatrics. He has many years of clinical experience providing specialized psychological services in clinical, school, and forensic settings. The South Dakota LEND program is housed within the Center for Disabilities at the University of South Dakota Sanford School of Medicine.

At MMIC, we believe patients get the best care when their doctors feel confident and supported. So we put our energy into creating risk solutions that everyone in your organization can get into. Solutions such as medical liability insurance, clinician well-being, health IT support and patient safety consulting. It’s our own quiet way of revolutionizing health care.

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

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

Log on!

November 2014

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11

Could your system be infected without your knowing?

Data Protection at the Point of Sale

By Eric Buzz Hillestad

W

hen you think of Point-of-Sale malware, many people immediately think of the Target breach from recent history. Most people do not think of their local gas station, grocery store, hospital, or pharmacy. In reality, these systems are generally more vulnerable to malware than big stores like Target.

Point-of-Sale malware or POS malware is malware that is written specifically for exfiltrating customer payment data for networks in which these POS systems reside.

POS malware has been successful due to its ability to elude most antivirus programs. It works by scraping the memory within the POS system and compiling those memory scrapes into an encrypted file. It can also capture key strokes. It then uses a command

and control interface to communicate with the attacker responsible for the infection.

The attacker can send the collected data back to their command and control servers any time via a simple command.

The various versions of the malware have been known to infect Java and Flash and can further inject malicious stubs into explorer.exe. This is a technical way of saying that it can further hide itself from your antivirus software. Meaning that if you are relying on antivirus alone for protection, you might not ever know you were infected. The intent of this malware is to hang on as long as possible giving the attacker as much card data as they can get before being discovered.

The worst part about this malware is that, currently, it seems to be running wild across the globe. The NCICC (National

Cybersecurity and Communications Integration Center) as well as US-CERT (United States Computer Emergency Readiness Team) have been warning businesses about it since October of 2013. The United States Secret Service is currently tracking infections “compromising a significant number of major enterprise networks as well as small and medium businesses” as recently as August 22, 2014. Any organization that believes it is infected with Backoff, LAST, NET, or any other variant of POS malware should contact their local US Secret Service Field Office.

Unfortunately, protecting your organization against these types of malware threats is not easy and that is precisely why attackers use these attack vectors. Restricting user account access on systems is a good start. Uninstalling software that is not specifically needed for a business function can also help. Egress firewall filtering can prevent this malware from sending data out of your network. Additionally, application whitelisting and configuration change management can stop this malware dead in its tracks as well as some second generation firewalls.

Ask your IT folks about these security controls today. They could save you from a breach if implemented correctly! ■ Eric Buzz Hillestad is Partner at Secure Healthcare Solutions, LLC and Principal Consultant.

MED Quotes Medicine is a science of uncertainty and an art of probability.

— William Osler

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Midwest Medical Edition

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Cost Saving Strategies for

Medical Practices With expenses rising faster than revenues, how can a medical practice limit spending while still providing the same quality of care to clients? By changing and implementing a few little strategies that end up saving a lot.

In a medical practice, time is of the essence. Efficiency is key. In order to reach maximum efficiency, it may be time to break the routine and evaluate the workflow, says Natalie Bertsch, co-owner of DT-Trak.

Bertsch, along with fellow co-owner Jewel Kopfmann, have been working with medical practices to simplify the key elements of front and back office operations.

A way to ensure maximum productivity is finding out where time is spent. Make a list of all tasks completed throughout the day and note the time spent on each. The next step is to evaluate the workflow and review the importance of each task. Then, divide these tasks into three columns: Do, Delegate, and Delete. Items in the “Do” category are things only you can undertake. As appropriate, delegate tasks to an employee to allow you to focus on the items that only you can

Top 5

Tips to an Efficient Practice

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accomplish. Finally, stop doing the tasks that do not provide any value to the practice.

Everyday expenses are another area to evaluate for savings opportunities. It is often believed that a less expensive item saves money. However, in the long run that is not always the case. In order to maximize profitability, it is important to reinvest in the practice. This does not only include the cost of equipment or tools. It is equally important to invest in staffing choices and training.

First, hiring right and taking quick action to solve a hiring mistake is critical. The team must work together in order to be effective and team members must have the right skill sets for the job. Allowing open communication between staff and leadership will minimize challenges and increase satisfaction, especially when a team member has a concern or a solution to a workflow issue.

Once the right players are on the team, it is also important to continue to constantly reinvest in each staff person. Continuing education, professional development, or leadership seminars will not only bring in fresh ideas to improve profitability but may

1

Natalie Bertsch

Jewel Kopfman

also reinvigorate the participant.

Through education, a practice is better able to maximize revenue, while at the same time, minimize audit exposure. As an example, DT-Trak offers a very cost effective training tool in DT-Tester, a prep tool for ICD-10. This tool provides training, testing and feedback for staff members to improve their compliance accuracy.

“Everyone is busy today and often times education and training are overlooked and that is unfortunate because in most situations they are profit enhancers” says Kopfmann. “DTTester is a convenient way for everyone to stay up to date with the needs of their practice while still getting their workload completed.”

Break the routine to learn better ways of doing things.

2 Work smarter by investing in people and education.

3 Outsource tasks that can be done more efficiently by others.

4 Invest in the future by utilizing interns.

5 Go green – be digital as often as possible.

Sponsored Feature

Midwest Medical Edition

But having the right staff and education can only go so far in helping a practice become more profitable. Overtime is often a major issue for practices, but this is something that can be solved two ways.

Better-trained staff will help save money by working more efficiently. However, not all staff members can or should provide every service, and recruiting and hiring another team member may not be cost effective. This is where outsourcing can be an attractive alternative. Outsourcing

November 2014

can be a variable expense that fluctuates with business conditions and provides the specific expertise required.

Bertsch and Kopfman also suggest utilizing interns. Not only do they want experience, but they can assist with appropriate tasks often handled by staff, freeing up valuable time to focus on more critical issues. Additionally, internships are an easy way to invest in the future of the medical industry.

Finally, go green! Utilizing technology is another way to reduce expenses and help

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save our environment. Technology makes a paperless office possible, saving time and money on filing, copying, and reducing office supplies. Tablets are mobile, easy to use, and can improve the patient’s experience by having information readily available.

“It’s always easiest to suggest ways of changing, but often hard to actually put these changes into practice,” says Bertsch.

“However, sometimes we must spend money before we can make money and invest time before we can save time.” ■

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Bridging the Gap Between You and Your Patient

By Michael Winkleman and Jeffrey Nasers

P

atient engagement has become a top priority for healthcare, largely because of the implementation of the Affordable Care Act (ACA), which has put the process on center stage. Industry leaders have been studying, analyzing and reporting user data to track trends. We are getting a clearer picture of what healthcare needs to look like in order to meet the industry’s expectations.

But many questions circle around the topics of engagement: How do we effectively engage patients? With time constraints and limitations, how do we educate patients?

One solution may be the patients themselves. Some patients are willing and able to contribute to the dialogue on how to best engage with them. Medical practices can begin the conversation by reaching out to those key patients. In other industries, customer engagement is required to stay competitive in the market. They study their target demographic, ask for feedback from focus groups, and measure results through metrics to determine how best to meet

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consumer demands. Should the process be any different for healthcare?

Fortunately, the ACA has created a dialogue among consumers. Before the ACA, healthcare wasn’t necessarily on consumers’ minds and health insurance wasn’t competitive. Now, consumers are looking at rates and choosing coverage to suit their needs and ensure their quality of life. Studies suggest that patients who are more informed and engaged in making healthcare decisions with their physicians are healthier and spend less on healthcare, allowing physicians to focus on meeting the needs of more critical cases.

With the use of technology on the rise and the expectation of accessibility, the time has come to utilize patient feedback to its fullest potential. This process can start by engaging with patients before and after they leave your facility. This is your chance to market to patients in a way that will prompt them to respond.

For instance, websites and mobile apps can be used to bridge the gap between medical professionals and their patients. There are medical facilities that are already using their web presence as a way to educate and

engage. Through educational links and access to medical records, many patients are beginning to feel more connected with their healthcare providers.

Trends show that making medical records available to patients through the web greatly empowers patients to understand how they can take action and have more informed conversations with their physician. According to a survey by Accenture, 41% of patients would choose a different physician if their current physician did not provide them with access to their medical records.

Educational resources on the facility websites allow patients to be better prepared before they arrive for an appointment. Instructional videos can walk patients through a procedure, helping to put them at ease about what they can expect. Having frequently asked questions readily available on the website can further inform the patient. Granting access to forms as printable documents that patients can complete before they arrive can streamline the admission process. These are examples of successful patient engagement tactics that demonstrate results and can help set your facility apart from the rest.

Marketing to patients is now a vital part of the industry. Today, more and more American’s are concerned about what healthcare means to them. With the implementation of the ACA, consumers are now paying attention. ■ Michael Winkleman is the CEO and Director of New Business Development and Jeffrey Nasers is the Public Relations and Content Strategist at 724 Factory, a leader in Medical Branding and Marketing.

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Patient Por and the Future of Provider/Patient Communication

Any provider who has implemented a patient portal knows that the Field of Dreams line “if you build it, they will come” does not apply.

In fact, getting patients to actively engage with a patient portal system, which is needed to meet meaningful use requirements, is forcing many practices to take a new look not only at portal systems and their capabilities, but also at the meaning of the word “marketing”.

“We make patients aware of our portal at the time of registration,” says Kelly King, Director of Nursing at Sioux Falls Specialty Hospital in Sioux Falls. SFSH implemented the patient portal offered through its EMR provider, McKesson Paragon, about 6 months ago.

“When they register, we describe the portal, what they can do with it and how they access it. Inpatients are also made aware of the portal during our daily rounds.”

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The Power of a Portal Through a patient portal, patients can get online access to their health information, including diagnoses, medication lists (in total and by condition), allergies, and recent test results. Depending on the system configuration, they may be able to access a summary of their most recent visit, including the topics discussed and the provider’s recommendations. Some may also include the date and time of the next visit and a list of scheduled tests.

To meet requirements, the portal must provide secure two-way communication between the patient and the medical office, including the ability to ask questions of providers and get answers.

Patients must also be able to request appointments, refill prescriptions and see test results. While not all of these capabilities have to be

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rolled out at once, the AMA recommends that providers look for portals that include the ability to: • Provide medication lists, lab, and test results • Respond to prescription refill requests • Exchange secure messages between providers and patients • Access online statements and pay bills • Request or schedule appointments Like many providers, SFSH is in the process of ramping up its system’s capabilities. “Since this is a newer process, our short term goal would be to provide access to even more health information and to allow people to pay their bills,” says King. “The long term goal would be pre-surgical registration online.”

Some patient portals offer additional conveniences like the opportunity to access a family member’s records by proxy. “If my mother is 90 years old and is ill, I can get access to those records and can be an advocate for my mother,” says Allison Wierda Suttle, MD, Chief Medical Information Officer at Sanford Health. The same can happen with a child. A parent using Sanford’s MyChart, for example, could access and download a child’s current immunization records to send along to camp.

Most medical offices and hospitals choose to use a patient portal offered by their EMR vendor, for ease of implementation and seamless integration of data. But experts warn providers not to be pressured to use any system that doesn’t fully meet their needs. They recommend that practices evaluate outside portal providers if the one that comes with their EMR system does not seem right for their needs and goals.

Midwest Medical Edition

tals

Promoting Communication “Our primary goal is that there is a two-way street of communication,” says Jon Crow, Director of SFSH. “Our goal is to engage patients in their care and their outcomes. With a patient portal, they can ask questions at any time and we can give them prompt answers.”

“It is a great tool for engaging patients,” agrees Dr. Wierda Suttle.“This lets you be more of a mentor to the patient. It’s about shared decision making. Patients are more apt to do what we recommend, if they are engaged. And the more robust the portal, the more engaged they will be.”

David Klocke, MD, Chief Medical Officer for Regional Health in Rapid City, says portals may benefit the profession in a less obvious way, too. “Having a portal in place increases patient engagement, but it also raises the bar for doctors,” says Klocke. “When I walk in to see a hospitalized patient, I know that they may already know their lab results, so I better know them, too! Things are very acute and very dynamic. As a provider, it keeps me on my toes.”

Getting Patients to Use it But it is not enough to simply have a patient portal in place. Providers are also required to show that 5% of patients are actually using the system and even the best systems are unlikely to engage patients without promotion. A great patient portal is not worth much to the practice or to patients if patients won’t use it. At the very least, healthcare IT providers recommend that the portal be advertised on posters, pamphlets, and in billing statements.

Most practices with portals now also promote them at registration and check-out, but other points of contact, such as when patients call to refill a prescription or to make a new appointment, may also present opportunities to promote the system and the advantages it offers (no time spent ‘on hold’, can use it any time of day or

November 2014

By Alex Strauss night, etc.) Physicians and nurses also have to be part of the process, promoting the portal in their one-on-one contacts with patients.

“We can create incentives for people to go there,” says Dr. Klocke. “For instance, they can see their labs right away or communicate with their provider easily. You can also do things like provide wellness tips through the portal. The easier and more attractive you can make it for patients, the more likely they are to use it.”

Risks and Benefits While some practices may worry about whether their patients are tech-savvy enough to use a patient portal, King says SFSH, which provides primarily orthopedic procedures like joint replacements, had no doubts. “Our patient surveys are all sent via email and we have found that there are very few people who do not have an email address,” says King.

Other providers worry that the capacity for patients to send emails will have them inundated with messages to answers. But

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research done on doctors and nurses who are actively using a patient portal system finds that this is not the case. In fact, since a provider can often answer a batch of patient emails in a fraction of the time it would take to have even one phone conversation (and at a time that is convenient for the provider), these systems can be used to help improve workflow and free up time.

Providers are sometimes concerned about patients seeing sensitive test results before they have a chance to talk to their doctor. Many hospitals, including Sanford, handle this by not providing these kinds of test results right away. But Dr. Klocke says even this situation is not necessarily as bad as some practitioners think it will be.

“Doctors don’t always believe it, but the data bears it out,” says Klocke. “Patients actually praise the fact that they were able to see their mammogram results right away and not have to wait a week. It is true that there is a risk of a patient misinterpreting the data, but it may also drive them to the Internet to do research. That is not a bad thing and may create a basis for our conversation.” ■

19

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New Treatment Option for Giant Cerebral Aneurysms

Photos courtesy Sanford.

Clinical Spotlight

Jitendra Sharma, MD, performing a Pipeline procedure at Sanford in Sioux Falls.

By Alex Strauss

P

atients in the region suffering from giant brain aneurysms, many of whom may once have been considered untreatable, now have a viable and minimally invasive treatment option in Sioux Falls. The treatment, known as the Pipeline procedure, is being offered at Sanford by the region’s only interventional neurologist, Jitendra Sharma, MD, of Sanford Neurology.

Already known for his method of coiling aneurysms to reduce the likelihood of rupture, Dr. Sharma performed the area’s first procedures using the Pipeline Embolization Device this summer, under the guidance of a proctor.

Pipeline has been approved by the FDA as an alternative to clipping a cerebral aneurysm during an open surgical procedure or coiling. Only about 15-20% of cerebral aneurysms are amenable to one of these two treatment options and Dr. Sharma says that neither is a particularly good option for people with the largest brain aneurysms. “What we often see in patients with giant aneurysms that we treat with coiling, is that we may have to go back in later and put in more coils,” says Dr. Sharma.

During a Pipeline flow diversion procedure, a microcatheter is threaded past the aneurysm and the device is deployed across the neck of the aneurysm in the parent blood vessel. “The Pipeline device is essentially a stent,” explains Dr. Sharma. “You don’t even have to go inside the aneurysm. It allows you to deploy in the blood vessel and actually divert blood away from the aneurysm.”

Once the device is in place, the body itself takes over the healing process. “In six months, the vessel begins to shrink and in another six months, the vessel is remodeled,” says Dr. Sharma. To assist in the remodeling process, patients are typically on Plavix or aspirin for a period of time.

The Pipeline device is especially helpful in patients with the

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largest brain aneurysms (over 10 mm) since these aneurysms tend to put pressure on different parts of the brain and cause unpleasant symptoms. Placing a coil in such an aneurysm could actually increase that pressure and those symptoms. But Sharma says shrinking the aneurysm with the Pipeline flow diversion procedure reduces that pressure and helps resolve symptoms.

Pipeline requires a high level of expertise and is currently only being offered in larger centers and those with unique expertise.

Sanford is the only center in the region to offer it.

A brain aneurysm ruptures about every 18 minutes in the US and nearly half of these cases are fatal. ■

Midwest Medical Edition

Laser Tattoo Removal System Now Available in Sioux Falls A new type of laser tattoo removal system that promises to completely remove unwanted tattoos of any color in half the time is now being used in Sioux Falls. LazaDerm Skincare Centre, which has offered tattoo removal for years, has recently added the PicoSure laser to their arsenal of tattoo removal lasers. Lornell Hansen II, MD, owner and Medical Director of LazaDerm, says the new system is the first to enter the tattoo-removal market since Q-Switched lasers, which had been considered the gold standard for removing tattoos.

Q-switched lasers were designed to break up tattoo ink particles with thermal energy but were limited in the number of colors they could successfully remove. As a result, some patients – especially those with tattoos in shades of green or blue – were left with a mark like a bruise or faded smudge, even after multiple trea ments.

In contrast, PicoSure delivers ultra-short pulses of energy to break down tattoo ink and skin spots into tiny particles that can be absorbed and eliminated by the body more easily and quickly.

“No tattoo color is safe now. We can eliminate them all,” says Dr. Hansen, who calls the system the “Ferrari of tattoo lasers”. “There is nothing as advanced as the PicoSure on the market right now,” he says.

Hansen says he acquired the PicoSure after seeing it at an Aesthetics Conference in July.

According to Cynosure, the makers of the PicoSure system, 20 percent of people regret their tattoo and tattoo removals climbed by 43% in 2012 alone. Contact LazaDerm for more information on the PicoSure system. ■

Sioux Falls Surgeon Featured in National Journals for Aneurysm Inventions

Sioux Falls physician Patrick Kelly, MD was recently published in a pair of national journals for two unique methods to treat aneurysms. Devices he invented were highlighted in the Journal of Vascular Surgery and Vascular.

November 2014

The first study, published by the Journal of Vascular Surgery, demonstrates the effectiveness of a device that was created using off-the-shelf components. Kelly and his team built two custom grafts to seal off thoracoabdominal aneurysms. The stents were placed in 14 people with a 100 percent survival rate.

The benefits of the stent graft created by Kelly are that it could be replicated off the shelf and be safer to implant and may have more favorable f low characteristics when compared to what is currently offered in industry-sponsored clinical trials.

In a separate study that appeared in Vascular, Kelly

used more physician-assembled grafts to successfully repair aortic arch aneurysms in two patients. The custom-made grafts restored appropriate blood flow and debranched the aneur ysms in both patients. There was no treatment currently available for the two patients other than an open surgery, which neither of the patients were candidates for.

“These mechanisms for treating aneurysms become incredibly important when dealing with patients who have significant co-morbidities and cannot participate in a wide-array of more invasive treatment options,” said Kelly.

“In both studies, we used components already on the market

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to construct novel grafts that proved to be quite effective.”

Kelly is a board-certified and fellowship-trained vascular and general surgeon. He holds dozens of patents or pending patents for medical devices and has served as a principal investigator for several clinical trials. ■

Log on for more on Kelly’s devices and links to these journal articles.

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Dr. Paul Van Heukelom and Cindy Pirrung, RN, provide an eEmergency consultation.

Avera eCARE Celebrates Milestone Anniversaries Avera eCARE recently celebrated two milestone anniversaries – the 10th anniversary of the eCARE program and the second anniversary in the specialized eHelm virtual hospital in northeastern Sioux Falls.

Avera eCARE harnesses interactive video and computer technology to extend specialty care from the “virtual hospital” in Sioux Falls throughout a 545,000-squaremile area across eight states. Having impacted more than 210,000 patients, the system has saved an estimated $143 million

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in healthcare costs. As an early adopter of telemedicine in the 1990s, Avera has more than 20 years of experience with this technology.

“To our knowledge, no one else in the world is doing what we’re doing in a rural setting,” said Deanna Larson, Senior Vice President of Quality and eCARE, Avera Health.

Avera eCARE has several distinct arms that serve varied needs: eICU, eConsult, eEmergency, ePharmacy, eLTC and eUrgent Care-Correctional Facilities.

Instead of hallways of patient rooms, the virtual hospital is marked by computers with multiple monitors, interactive video cameras, and phones. The staff is made up of emergency medicine physicians, intensivists, pharmacists, advanced practice providers and specialized nurses, as well as a well-rounded support team.

In 2004, Avera implemented Avera eICU – the first eCARE service. eICU connects “wired beds” at outlying facilities to decision-support software and critical care experts at the hub in Sioux Falls. Since its

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Photos courtesy Avera.

A view of the Avera eICU.

inception, it’s estimated that 1,182 patients that would have been predicted to die by mortality predictions have left the hospital alive. eICU serves 29 sites with 93 “wired beds.” eConsult was formed out of Avera’s existing telemedicine care, allowing patients to have long-distance, face-to-face visits with specialty providers.

Over the past year, 7,900 eConsult visits have saved patients from driving an estimated 2.6 million miles. ePharmacy and eEmergency were launched in 2008 and 2009, respectively, thanks to grant funding of $11.5 million through the Helmsley Charitable Trust. At the touch of a button, staff at a local emergency room can consult with emergency medicine physicians at eHelm. eEmergency serves 90 hospitals, providing support for serious conditions such as heart attack, stroke, respiratory distress and traumatic injury.

T h rough ePhar macy,

November 2014

pharmacists provide medication oversight for new prescriptions, any time of the day or night, taking into account a patient’s medical condition, age, weight and allergies as well as possible drug interactions. ePharmacy, serving 58 sites, has circumvented 22,000 serious safety events and saved $58 million in healthcare costs.

In 2012, eLTC and eUrgent Care-Correctional Facilities were developed to provide virtual urgent care services to long-term care and prison populations.

“If there could be a physician of every specialty in every location, that would be optimal for the patient. Unfortunately, that’s not reality. The best we can do is to have a virtual physician presence providing the expertise to improve outcomes for the patient.

That’s what we’re doing through Avera eCARE,” said Donald Kosiak, MD, Avera eCARE Medical Director. ■

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New Facility Will Bring New Cancer Services to Aberdeen Construction has begun on the new $13 million home of the Avera Cancer Institute Aberdeen – the Coach Don & Carmen Meyer Center of Excellence.

The new 27,500-square-foot building will be constructed south of the southeast wing of Avera St. Luke’s Hospital at the corner of Fifth Avenue and Penn Street in Aberdeen. The initial project will be one floor, with the capacity to add three additional floors in the future.

Service enhancements will include public education and screening programs, increased research and clinical trials, genetic counseling via telemedicine, a

social work program, alternative medicine options, and several subspecialty clinics, including endocrinology, medical oncology, pediatric oncology support, radiation oncology and rheumatology. Multi-specialty clinics for breast, lung and colon cancer also are being planned. A new $3.4 million linear accelerator will be housed in the building as well.

“We’re currently seeing more than 17,000 patient visits each year for cancer care,” says Todd Forkel, Regional President and CEO of Avera St. Luke’s Hospital. “As our population ages, we expect that number to rise significantly. This new facility will

accommodate the cancer care expertise and technology of today, and for decades to come.”

The late Coach Don Meyer of Aberdeen expressed his gratitude for the cancer care he received and committed time and resources to the capital campaign, “Avera Cancer Institute Aberdeen, Mission of Hope and Healing.” It was announced in April that then new cancer facility would be named after the Meyers in honor of this commitment. The local fundraising campaign has a goal of $6.1 million, with the $7.4 million remainder to be funded by Avera St. Luke’s Hospital. ■

National Award Recognizes Local Doctor’s Contribution to Vascular Education J. Michael Bacharach, MD, clinical professor of medicine at the University of South Dakota and section head of vascular medicine and peripheral vascular intervention at North Central Heart Institute, is being honored with a national award for his leadership in endovascular education. He is being recognized by VIVA (Vascular Interventional Advances) at the group’s annual conference in Las Vegas in November.

Dr. Bacharach is an interventional vascular medicine specialist who has led the proliferation of minimally invasive therapies for patients with aortic, cerebrovascular, and peripheral vascular diseases. Dr. Bacharach has written extensively on the topic of

26

non-cardiac vascular diseases and in an internationally known lecturer.

According to VIVA, the annual LIVE award recognizes vascular specialists “who have dedicated their professional careers to educating students, post-graduate trainees, and peers in all aspect of vascular medicine and intervention”.

VIVA is a not-for-profit organization dedicated to advancing the field of vascular medicine and intervention through education and research. The group holds an annual multidisciplinary vascular education conference for physicians and healthcare professionals dedicated to treating patients with vascular diseases. ■

J. Michael Bacharach, MD

Midwest Medical Edition

Technology Provides a Bridge for Cardiology Patients at Children’s Hospital & Medical Center in Omaha Seven children have been the recipients of donor hearts in transplant surgeries performed at Children’s Hospital & Medical Center in Omaha, Nebraska, since April 2013. Two of the transplants occurred within a 48-hour time span in early October 2014.

The need for transplantation stemmed from a variety of conditions including complex congenital heart disease that could not otherwise be repaired, and several forms of cardiomyopathy.

In the case of an infant with dilated cardiomyopathy, the cardiac transplant team used a ventricular assist device (VAD) prior to surgery. “A VAD can be a bridge to transplantation,” says James Hammel, MD, FACS. Dr. Hammel is the William H. Fleming, MD, Endowed Chair in Pediatric Cardiothoracic Surgery and clinical service chief of Cardiothoracic Surgery at Children’s. “We support the patient as well as we can until a heart is available. If general supportive care is not enough, we can consider using a VAD as a bridge to get that child to transplantation.”

A small group of children who present with viral myocarditis that can lead to progressive heart failure and the need for transplantation can also benefit from additional support, says Steven J. Kindel, MD, director of Advanced Heart Failure & Cardiac Transplantation at Children’s. “It’s a potentially reversible disease where we typically use extracorporeal membrane oxygenation (ECMO) for two or three weeks to determine whether transplantation is necessary. If it takes a month or longer to recover, we could employ a VAD.” Children’s Hospital & Medical Center has received the Award for Excellence in Life Support for 2014 from the Extracorporeal Life Support Organization. This award recognizes the medical center’s excellence in patient care through the use of highest quality evidence-based ECMO measures, processes and structures.

ECMO can be initiated quickly and provides excellent short-term circulatory support, but long-term ECMO use can increase the risk of pneumonia, skin break down, weakened muscles and stressed immune and clotting systems. “That’s the opposite of what we want, which is to rehabilitate a child before transplant to reduce the risks,” says Dr. Hammel. VADs have their own accompanying risk of complications.

“We have experience using these devices and are prepared if a case demands it, but we believe many patients can avoid a VAD if they are managed carefully,” Dr. Hammel says. ■

November 2014

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Caring for Cancer Survivors in Your Practice The American Cancer Society is offering

Dr. Charles Hart, winner of the 2014 SDAHO Distinguished Service – Healthcare Professional Award.

an eLearning program on cancer survivorship

Regional Health Leaders Recognized at SDAHO

specifically for primary care providers. The Cancer Survivorship E-Learning series for Primary Care Providers features content on: ❤ The role of clinical generalists and specialists in providing follow-up care to survivors of adult-onset cancers ❤ How to manage long-term and late physical and psychosocial effects of cancer and its treatments ❤ Survivorship care planning and care coordination The series is available at no cost and offers continuing education credits for

Five individuals and Rapid City Regional Hospital were recognized for their leadership and contributions to healthcare at the annual South Dakota Association of Healthcare Organizations (SDAHO) Conference in September.

Dr. Charles Hart

Dr. Charles Hart was honored with one of the highest awards, the SDAHO Distinguished Service Award – Health Care Professional. Dr. Hart’s career spanned over four decades in Rapid City where he successfully integrated nine hospitals, two specialty hospitals, six senior care facilities, 24 clinics and five regional urgent care centers Tim Sughrue

is led by national experts and features a

The American College of Healthcare Executives (ACHE) Regents Award recognized Rapid City Regional Hospital CEO and COO for Regional Health Network Tim Sughrue with the Senior Level Healthcare Executive Award. This award recognizes Fellows or Diplomats of ACHE for their leadership, accomplishments and contributions to ACHE and healthcare in South Dakota.

cancer survivor story.

Mark Schulte

physicians, physician assistants, nurse practitioners, and nurses. New content will be added on an ongoing basis. Each webinar

the American Cancer Society and the George

ACHE also recognized Mark Schulte, Administrator and CEO of Sturgis Regional Hospital and Senior Care, with the Early Career Healthcare Executive Award. This honor recognizes Affiliates of ACHE for their capability in developing leadership activities in the College.

Washington University Cancer Institute and

Jennifer Gholson

The course consists of 10 self-paced modules. The National Cancer Survivorship Resource Centers is a collaboration between

is funded by a five-year cooperative agreement through the Centers for Disease Control and Prevention. More than 3,800 individuals from 50 countries have already accessed the series. ■

Log on for more information on the series and a link to the program website.

The South Dakota Health Information & Management Systems Society (SD HIMSS) recognized Applications Supervisor Jennifer Gholson of Regional Health with their SDHIMSS Chapter Achievement Award 2014. This award recognizes an individual who demonstrates a commitment to the HIT industry. Gholson led efforts with HIMSS national, and starting from a blank canvas, updated the chapter’s entire web presence.

Jennifer Schmaltz

The South Dakota Healthcare Financial Management Association awarded Jennifer Schmaltz with the William G. Follmer Bronze Award. Schmaltz is the Budget and Reimbursement Supervisor for Regional Health and has been with the organization for seven years.

Rapid City Regional Hospital

Finally, LifeSource recognized Rapid City Regional Hospital for outstanding support and ongoing commitment to saving lives through organ and tissue donation with the Tissue Donation Partner of the Year award. In 2013, Rapid City Regional Hospital was one of the top five hospitals in the LifeSource Donation Service Area for tissue donation. ■

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Midwest Medical Edition

Healthy Jewelry Practices for Gemstones

By Christopher A. Eads

Jewelry is more than just a financial investment; it is a cherished reminder of memories and emotions from the events of our lives. The longevity of something so precious is largely dependent on the lifestyle of the wearer and how it is worn. However, like anything else, It is recommended that a professional jeweler inspect your jewelry every six months to spot potential problems and keep it looking its best. However, between professional inspections, there are some things you can do to maintain your jewelry on your own. jewelry requires maintenance to maintain its health.

Gemstones come in a variety of colors

and types. Different gemstones often require different care. For exampl e, emeralds and opals are very susceptible breakage and shouldn’t be worn when doing activities where they might easily be struck on something. If you are uncertain, ask your jeweler about your particular care requirements.

Gemstones, much like wood and wool, are a product of nature that may be enhanced for color and beauty. Different gemstones may

Gemstones, especially organic stones like pearls, can be damaged by exposure to chemicals. Avoid exposing your jewelry to chlorinated chemicals, perfumes, hairspray, hand lotions, and cosmetics. Some of these chemicals can cause irreparable damage to gemstones and their settings. Experts recommned that jewelry by the last thing put on in the morning and the first thing taken off at night.

have different treatments; it is therefore advisable to speak with your jeweler regarding any additional care your gemstone jewelry may require.

Christopher Eads is an Accredited Jewelry Professional G.I.A., with twelve years industry experience.

Riddle’s Jewelry offers jewelry inspection services free of cost, even if your jewelry wasn’t purchased from us.

Please come and see us, we’d be happy to answer any questions you might have.

November 2014

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Dr. Keith Hansen awarded first endowed chair by USD Sanford Medical School The University of South Dakota Sanford School of Medicine has awarded its very first endowed chair position.

Dr. Keith Hansen, a reproductive endocrinologist in Sioux Falls and longtime faculty member at the University of South Dakota Sanford School of Medicine, has been named the recipient of the Karl H. Wegner, MD, Chair in Medicine. It is a three-year appointment.

A native of Wall, South Dakota, Hansen is the chair of the Department of Obstetrics and Gynecology at the medical school. He received his medical training at Washington University in St. Louis, Missouri and subsequently practiced and held faculty appointments at medical institutions in Virginia, Georgia, Maryland

MED Quotes

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and Washington, DC. In 1998, he returned to South Dakota to practice medicine and teach at the USDSM in Sioux Falls. Dr. Hansen has served in a variety of significant roles at the medical center, including his current role as chair of the OB/GYN department.

The endowment to create the Karl H. Wegner, MD, Chair in Medicine was established by the late Dr. Karl H. Wegner with the support of his wife, Margaret Cash Wegner. Karl Wegner began teaching at the medical school in 1962 and served as dean from 1974 to 1980. He also served as chief of pathology at Sioux Valley Hospital, now Sanford Health. Dr. Wegner died in April, 2014. ■

Medicine rests upon four pillars – philosophy, astronomy, alchemy, and ethics. — Paracelsus

Midwest Medical Edition

Protect Your Business from Data Theft Why cyber safety is not just for the “big guys”

By Tracy Dahl-Webb

I

n December, 2013, consumers were rocked by the news that Target, one of the nation’s largest retailers, had suffered a massive data breach.

Up to 40 million credit card accounts were affected by the data breach, and Target says 70 million customers lost private information as part of the breach.

The cost to Target is an estimated $420 million, plus $100 million to upgrade their security systems. Banks and credit unions spent $200 million re-issuing credit cards to affected consumers. And the loss to Target’s reputation is incalculable.

So, why should small- and-mediumsized businesses be concerned? Surely the data thieves are focused on big fish like Target and not on smaller companies.

In fact, the thieves slipped into Target’s system through a smaller company – an HVAC contractor, whose connections to Target’s computer systems were used to upload malware, which was then used to steal consumer information.

“The moral of the story is that a security

November 2014

breach at a small company – Fazio Mechanical has an estimated $12.5 million in revenue – caused a half-billion dollars in damage and the costs are still adding up,” wrote James Fields, owner and President of IT service provider Concept Technology and IT staffing company Scout Staffing.

A recent report by the New York Attorney General stated that reported data security breaches more than tripled between 2006 and 2013. But, according to The Marsh & McLennan Cyber and Data Security Risk Survey of 2013, nearly twothirds of respondents said they discussed IT security at an executive level only two or fewer times a year and one in seven (14 percent) never discussed it at all.

Cyber security is becoming too big an issue to simply hand off to the IT department. Protecting personal as well as business information should be a company-wide, cultural value and employees at all levels should be aware of best practices to prevent data theft.

When data thieves do strike, cyber liability policies can protect companies from these costs by providing both first party and third party coverage. Cyber insurance policies don’t only protect you from the costs of business disruption in the

MidwestMedicalEdition.com

event of a data breach. They also provide a roadmap on what companies should do when a breach is discovered. The best policies have a 24-7 call line, by which carriers can put business owners in touch with experts, legal counselors, and other resources. And policies can help defray legal costs if lawsuits are brought by federal or state regulators.

Every company – and every person – has an amazing amount of data at their fingertips every day. Being smart about protecting yourself against data theft is simply part of doing business in today’s world. ■ Tracy Dahl-Webb is an insurance agent and consultant at Howalt+McDowell Insurance, a Marsh & McLennan Agency.

Log on for more on the difference between first party and third party coverage and see a list of article references.

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WINE MARKETPLACE WINE FACTS In 1998, Prairie Berry became the second winery in South Dakota to be awarded a commercial winery license. Today, we’ve received 808+ awards on nearly 60 wines, with our Red Ass Rhubarb recently earning its 100th award.

WINE TO WATCH New to Prairie Berry Winery are our Anna Pesä wines, traditional dry wines crafted to connect the beauty and heritage of our family’s past with the possibilities of today. Before immigrating to the Dakota Territory in the late 1800s, Anna Pesä made wines for her family in Moravia, Czechoslovakia. Today, her great-great-granddaughter Sandi Vojta continues that tradition at Prairie Berry Winery, creating wines of exceptional quality, rich with tradition. The first releases in the Anna Pesä collection are currently available at Prairie Berry East Bank as wine on tap:

Anna Pesä Chardonnay: This lightly oaked chardonnay begins with notes of bright grapefruit and earthy grass with a light finish and a hint of refreshing lemon.

Anna Pesä Zinfandel: This wine offers notes of blackberry,

anise and spicy pepper.

Anna Pesä Cabernet Sauvignon: This wine offers notes

of black cherry, cedar and light vanilla.

Sponsored by Prairie Berry Winery and Prairie Berry East Bank

ONE ON ONE

Sandi Vojta, Prairie Berry Winery Co-Owner and Winemaker Q: Which wines should be on the table this holiday season to pair with traditional holiday dinners?

A: Mulled wines are always fun

options to bring to holiday gatherings. They fill the home with a wonderful fragrance and offer warmth and a delicious taste to enjoy before or after holiday dinners. Our mulling spice is made at our winery in Hill City and features a warming blend of spices including allspice, cinnamon and cloves as well as dried orange peels.

The mulling spice is available at Prairie Berry East Bank and on our website, prairieberry.com. As far as wines to pair with holiday dinners, you can’t go wrong with a variety to cover the various taste preferences of your guests. Of our Prairie Berry Winery wines, I recommend Lawrence Elk, our semi-sweet black currant wine, Deadwood, our semi-dry black currant wine, and Pheasant Reserve, our dry merlot.

Q: How about to pair with pumpkin pie or other traditional holiday desserts?

A: Sweet wines are the best to pair with sweeter desserts.

A fun pairing and a way to bring a new tradition to holiday dinners is to add a wine and cheese course to the meal. For example, try our Calamity Jane wine paired with our Kick Ass compote spooned over fresh goat cheese. We offer a range of wine and cheese pairings at both of our locations and our associates can work with you to find the perfect pairings for your next party.

Q: What is the best way for someone who is unfamiliar with Prairie Berry Winery wines to explore your offerings?

A: There are several ways to learn more about and explore

WINEMAKER’S CORNER Wine on Tap

Prairie Berry Winery is the first winery in the state to offer wine on tap at our new location, Prairie Berry East Bank, in Sioux Falls. Kegged wine reduces waste and helps maintain superior quality by protecting the wine from oxidation. This preservation helps ensure that each guest who samples our tap wine can experience the wines as they were intended to taste.

our wines. The best way to become more familiar with our wines is to stop in at Prairie Berry Winery in Hill City or Prairie Berry East Bank in Sioux Falls. Our associates can work with you to find wines that match your preferences. We offer free wine tastings at our tasting bar in Hill City and wine flights for purchase at Prairie Berry East Bank. We recommend that you explore the range of our award-winning wines from sweet to dry and from our fruit wines to our grape wines. Last, our Generation5 Wine Club is an opportunity to take your Prairie Berry Winery wine experience to the next level.

Midwest Medical Edition

Experience Prairie Berry East Bank

Downtown Sioux Falls’ favorite spot to enjoy award-winning wines, craft beers, artisan cuisine and more.

Explore our Fermentation Bar, Kitchen and Marketplace to sip, savor, and enjoy all the flavors of Prairie Berry.

BOOK YOUR NEXT EVENT WITH US!

Downtown Sioux Falls | 322 East 8th St. | 605.496.7175 | PrairieBerry.com/EastBank

The Nurses’ Station

Yankton Hospice Nurse a Finalist for National ‘Nurse of the Year’ Award

Nursing News from Around the Region

Everything’s Coming up DAISIES Chris Clayton, CNP, who works in cardiology at Sanford Medical Center, was recently recognized with a Daisy Award. Her nomination says that she has been “an invaluable asset in framing and guiding the evolution of professional nursing practice at Sanford Medical Center.” She is described as “a quiet but very influential leader” who is “highly regarded by the entire interdisciplinary community”.

Deb Risser, RN, and Jeremy Bigge, RN, have received Daisy Awards at Rapid City Regional Hospital. Risser has been an RN in the Emergency Services department for one year.

The mother of a young patient with a serious trauma injury nominated her for her kindness during the family’s trip to the emergency room. Risser cared for the injured child, but also calmed the fears of the child’s parents who said, “Deb may have only been in our lives for a matter of a few hours but the impression she left on our lives will last forever.”

Bigge has worked in the Progressive Care Unit for three years. A patient’s wife nominated Bigge for the Daisy Award and wrote: “Jeremy responded quickly to my husband’s needs, didn’t waste time, but always took time to answer questions. Always efficient and approachable, he went the extra mile. My husband has had innumerable catheterizations and stents and much more, so we both know outstanding care. Jeremy speaks to excellence in nursing.”

■

Mary Pistulka, RN, Hospice Nurse for Avera@Home in Yankton, South Dakota, is one of 10 finalists for the National Association for Home Care & Hospice “Nurse of the Year” Award.

Pistulka, the only nominee from South Dakota and the wider region, is among other nominees from Arizona, California, Kansas, Maine, Maryland, Nevada, New York, Ohio and Virginia.

Pistulka has been an Avera hospice nurse in Yankton for 26 years. She was the lead nurse for the development of the hospice program in Yankton, and continues to grow the program. ■

USD Health Sciences Associate Dean elected to national post June Larson, MSN, RN, ANEF, associate dean of the University of South Dakota School of Health Sciences, has been elected to serve on the National League of Nursing’s Board of Governors.

The Board of Governors provides leadership and guidance to the National League of Nursing, the voice of nursing education in the United States, and the premier organization for nursing faculty, schools of nursing and leaders in nursing education.

“We are very proud of Dean Larson’s significant achievements and the deserved recognition from her peers as a national leader in nursing and health sciences education,” said Michael Lawler, Ph.D., M.S.W., Dean of the University of South Dakota School of Health Sciences. ■

New Faces at St. Luke’s College Deb Juffer has joined St. Luke’s College UnityPoint Health as an associate professor for the division of nursing education.

In her new role, Juffer will be teaching the professional development course for students in the Associate Degree Program as well as teaching the nursing research and education in healthcare courses in the Bachelor Degree Program.

34

Courtney Greene has joined St. Luke’s College UnityPoint Health as an instructor for the Division of Nursing Education. In her new role, Greene provides clinical lab instruction for first year nursing students.

Greene is also employed as a registered nurse with UnityPoint Clinic Occupational Medicine.

Teresa Kelley has joined St. Luke’s College UnityPoint Health as an assistant professor for the division of nursing education.

In her new role, Kelley will be providing instruction in the Neurological/Psychiatric and Pharmacology course as well as teaching Health Assessment and Leadership courses online in the Bachelor Degree program.

Midwest Medical Edition

Learning Opportunities November – February November 7 32nd Annual North Central Heart Fall Symposium

8:00 am – 5:00 pm

Location: Sioux Falls Convention Center

Registration: Avera.org/conferences

Information: 605-977-5311

November 14

CNOS Foundation Orthopaedic & Sports Medicine Symposium

7:30 am – 3:00 pm

Location: Stoney Creek Inn, Sioux City

Information & Registration: Ruth.Klein@CNOS.net, 605-217-2817

November 21 7th Annual Denny Sanford Pediatric Symposium

8:00 am – 5:00 pm

Location: Sanford USD Medical Center - Schroeder Auditorium Registration: SanfordHealth.org

Plan Ahead . . .

February 7, 2015

2015 Avera Nuclear Medicine Conference

8:00 am – 12:30 pm

Location: Prairie Center, Sioux Falls

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

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SANFORD HEALTH CHOSEN AS ONE OF 34 NATIONAL CANCER INSTITUTE COMMUNITY SITES IN THE U.S. $7.1 million grant combines the latest knowledge on cancer research and treatment for patients.

The National Cancer Institute’s Community Oncology Research Program (NCORP) selected Sanford Cancer Center as the only community site in South Dakota.

Jonathan Bleeker, MD

As the North Central Plains community site, Sanford will work alongside NCORP research bases. Together, we will be able to develop and deliver the latest clinical trials relevant to our patients in order to improve their outcomes. This partnership will ensure that more patients have the opportunity to experience advanced, state-ofthe-art, research-based cancer care close to home.

The face of expertise. The face of cancer care. cancer.sanfordhealth.org

John Lee, MD

200-46350-0957 9/14