MED-Midwest Medical Edition- September/October 2013

Vol. 5, No. 6

2013 September October

Midwest Medical Edition

Gain without pain Ergonomics in the Medical Workplace • Warning for SD Doctors: Time for a Software Upgrade?

• S tress-busting

Treadmill Desks

• Black Hills

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Midwest Medical Edition

Contents

page

Gain without pain

September / October 2013

Regular Features 2 | From Us to You

By Alex Strauss

4 | NEW! MED on the Web

Ergonomics in the Medical Workplace

Find out how you can be a part of our growing on line community

8 | News & Notes News and announcements from around the region 30 | The Nurse's Station Local awards, SDNA Conference

Hospitals are looking for ways to make the job of practicing medicine less physically taxing. Not only do human-centered designs and work practices (think robotic-assisted surgical systems, adjustable screens, and better stools) improve the wellbeing of practicing physicians, but evidence suggests that, by helping them avoid stress or repetitive use injuries, such designs can also lengthen their careers.

32 | Grape Expectations To Serve Like a Pro, Consider the Temp – By Heather Taylor Boysen

33 | Learning Opportunities Upcoming Symposiums, Conferences, CME Courses

In This Issue 4 | Contemplating 2014 and the Affordable Care Act – By Dave Hewett Is the Press Trying to Trick Me? 16 |

– By Alex Strauss

21 | Regional Health Extends Palliative Care to Hospitals 22 | Tips for More Effective Recruiting

5 WIs arning: it Time to

– By Tim Wieber Vol. 5, No. 6 6

2013 2013

Vol. 5, No.

$40 million in Community Benefit

24 | Sioux Falls Specialty Hospital to Pilot Study

Upgrade Your Software?

er Se pte mb Oc tob er

23 | Sioux City Hospitals Provide Over Midwest

Medical

anaging the 17 MHealth of Your IT

Edition

24 | Avera Receives National Innovator Award 25 | Aberdeen cardiologist utilizes robotic-assisted stent placement in procedural first

26 | Sanford World Clinics: Primary care in Ghana and Beyond

Ergonom •

Throughout the Day

e Med ics in th

Sponsored Feature

kplace ical Wor

6

SD ing for W arn Time Doctors: ftware for a So ? de Up gra sting S tre ss- bu ll De sks • Treadmi Hills B lack y • Compan vider Keep s Pro hy IT Healt

– By Kathleen Christiansen

29 | Protein at Breakfast Helps with Satiety

Golden West Technologies Helps Physicians Practice Medicine in the Digital Age

inain a G t p u o with

28 | Health Information Exchange: A (Relatively) Painless Option

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South Da

kota an

– By Holly Swee

Note: A MED “Sponsored Feature” is a commissioned and sponsored promotional article.

d the Up

est ’s per Midw

Magazin

e for Ph

ysicians

& Healt

hcare Pro

fessiona

ls

Walking Workstations Help Stop Caregiver Stress in its Tracks – By Tana Phelp

On the

COver

From Us to You

Staying in Touch with MED

A

s the weather cools and the world moves from the slower-paced ‘summer mode’ into the Publisher MED Magazine, LLC

busyness of fall, we at MED are excited to announce Sioux Falls, South Dakota that ‘change is in the air’. With this issue, we offi VP Sales & Marketing Steffanie Liston-Holtrop Editor in Chief Alex Strauss

cially launch our new, interactive web presence – a home on

Design/Art Direction Corbo Design the Internet that is designed to perfectly complement and Photographer Kristi Shanks

Web Design 5j Design enhance your experience of the print version of MED. In addiSteffanie Liston-Holtrop

Contributing Editor Darrel Fickbohm tion to an Interactive Calendar into which you can put your Copy Editor Hannah Weise

own events for free, ‘MED on the Web’ will feature a local

Contributing Writers Heather Boysen Kathleen Christiansen medical business directory, extended interviews, a searchable Dave Hewett database of past articles, blog posts from area medical profes Sarah McQuade sionals, and opportunities for you to join the conversation and Tana Phelps Holly Swee maximize your own web presence. We hope that you will Tim Wieben check us out, leave a comment, and check back often as MED’s Staff Writers Liz Boyd Caroline Chenault web presence evolves in the coming months.

John Knies Alex Strauss In this month’s cover story, we focus on the ways in which ergonomic improvements at area hospitals may be extending Contact Information the professional lives of doctors. This issue is also jam-packed Steffanie Liston-Holtrop, VP Sales & Marketing with news, information and expert advice to make your life 605-366-1479 Steff@MidwestMedicalEdition.com easier and your practice more profitable. Looking to add a Alex Strauss, Editor in Chief partner? You’ll find tips for better recruiting. Want to improve 605-759-3295 Alex@MidwestMedicalEdition.com your heart health or trim your waistline? You’ll love our article Fax 605-271-5486 on the growing trend of walking workstations. Concerned Mailing Address PO Box 90646 Sioux Falls, SD 57109 Website MidwestMedicalEdition.com about technology in the office? We’ll tell you why you may need a software upgrade and introduce you to a Rapid City company that can ‘virtualize’ your IT. 2013 Advertising / Editorial Deadlines Please remember that if you have news to report, a story Jan/Feb Issue June Issue Sep/Oct Issue December 5 May 5 August 5 to tell, a memory or a talent to share, or even if you’ve just March Issue July/ November Issue read a good book, MED’s 5,000 physician readers want to February 5 August Issue October 5 June 5 know. Email us at info@MidwestMedicalEdition.com.

April/May Issue December Issue March 5 November 5 In the meantime, we invite you to pour a glass of your favorite beverage (chilled to the right temperature, of course) Reproduction or use of the contents of this magazine is prohibited. and savor your new issue of MED.

©2011 Midwest Medical Edition, LLC Here’s to cool nights and golden days, Midwest Medical Edition (MED Magazine) is committed

—Steff & Alex to bringing our readership of 3500 South Dakota area

As MED develops new ways to inform and engage, watch for this symbol to guide you to expanded coverage, additional content, and opportunities to join the conversation online.

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.com

Correction: In the July/August issue, Dr. Verlyn Nykamp was incorrectly identified as a vascular surgeon. He is actually cardiovascular surgeon.

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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Midwest Medical Edition

on the

Now More than a Magazine, A Medical Community Hub MidwestMedicalEdition.com

Log on Now! Online Directory, Using MED’s online Directory, powered by Locable, you can find and connect with area businesses that cater to healthcare providers. It’s easy and free for businesses and providers to be included in the Directory. With ongoing updates to our business identity solution tools, we make it simple to get the most out of

As part of MED’s continuing commitment to serve the communication needs of our wide and diverse medical community, we are expanding our online presence.

With the recent launch of our new website, MED is adding fresh ways to interact with the timely and important stories and notable people that drive medicine in our region. Stay connected and go behind the scenes with MED to get to know medicine in South Dakota, Minnesota, Iowa and Nebraska even better. Comment on articles, take part in surveys, publicize an event, share your knowledge, and help create a showcase of what makes this medical community unique.

• Comment on articles • Participate in local surveys • Promote an event • Track meetings and CME courses • Join the conversation!

the constantly-changing online environment. Being a part of MED online allows you to engage the online community in new ways and put the web to work for your practice.

Online Calendar Our online Calendar feature makes it easy to find and share local events specifically for heathcare professionals, so you will never miss a meeting or course you wanted to attend. You can even list your own upcoming event – such as an office open house or a presentation for colleagues – for free.

You can also learn more about MED’s creators, advisors and contributors, see additional photos, read in-depth interviews, look up past issues, and enjoy articles we reserve just for the web. With so many ongoing medical advances in our region and the continual influx of new doctors and supporting businesses, we hope you will check back often to join the conversation and stay in touch.

September / October 2013

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3

Contemplating 2014

and the Affordable Care Act

By Dave Hewett, SDAHO

Please take a moment and contemplate the following: • All the patients you see have some form of public or private insurance coverage • They receive that coverage regardless of what you or your colleagues have treated them for in the past • The premiums paid by your patients between the ages of 18 and 64 differ no more than a factor of “3” assuming they bought the same insurance product

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C

ertainly, this is not reflective

of the patient population you currently treat. But it will be approximately your patient population beginning this coming January 1.

January 1, 2014 is a watershed deadline date for the Affordable Care Act (ACA). It is on that date, just a few short months from now, that fundamental changes to how people receive health insurance coverage in this state and in this country will be implemented. Mandated coverage, narrow premium rate bands based almost exclusively on age, and no medical underwriting is the future. Of course there are a lot of other things related to how people get their health insurance coverage like health insurance exchanges and requirements for employers. But, I believe the most basic reforms to healthcare coverage are embodied in these three elements of the ACA. The reforms are so fundamental that many have chosen to take a “wait and see” approach to anticipating the real impact of

these reforms. The truth is that we don’t know if everyone will adhere to the mandate or just pay the $95 or 1% of income penalty (whichever is greater). We don’t know if there will be enough healthy 20-somethings signing up for coverage to offset increased expenses associated with those who are being treated for expensive medical conditions. We aren’t sure just how premium subsidies will work with products sold through public health insurance exchanges. But what we do know is that the coverage landscape will be a lot different in less than four months.

We also know that not everyone will be covered in South Dakota. As long as the State delays Medicaid eligibility expansion, at least childless adults with incomes between 53% and 100% of poverty will lack coverage. And who knows what those between 100% and 138% of poverty will do.

But for many South Dakotans, they will have access to affordable coverage and a reason to pursue that coverage.

So here is the physicians’ clinic

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challenge. How much does your office assist the uninsured patient who comes into your office? Do you offer them literature about the public health insurance exchange? Do you help them enroll? Or do you just bill them and hope they can pay the bill? If your patients need coverage, please refer them to www.HealthCare.gov.

From the provider community perspective it seems like we have been meeting ACA- related deadlines for longer than we can remember. So, as providers we may have become somewhat callous and indifferent to the deadlines ahead.

The January 1, 2014 ACA-related deadlines may be a little outside of the physician’s public policy realm. But they are fundamental to healthcare as we know it in South Dakota and the rest of the nation and deserve your directed attention. Are you ready for 2014? ■ MED Quotes “ Every disease is a physician.”

Warning:

HealthPOINT, the regional extension service charged with helping practices implement Meaningful Use of EHR software, says it may be time to upgrade your office computer software. The following information was released by HealthPOINT Discontinued Support on August 9th: of Windows Products Microsoft has announced that support Causes Non-Compliance for its Windows XP software, as well as its for Meaningful Use Office 2003 software, will end on April 8, 2014. In a nutshell this means that computers continuing to operate using Windows XP or Office 2003 after April 8 will no longer receive security updates. This means that computer systems that are running this software will become prime targets for malicious programs and hackers.

In addition to the system information being at risk, these computer systems will become non-compliant with HIPAA; specifically 164.308(a)(5)(ii) which states that you must implement procedures for guarding against, detecting, and reporting malicious software.

Because these systems will be non-compliant with HIPAA they will no longer meet the Meaningful Use objective 15 (for eligible professionals) and 14 (for eligible hospitals); which requires meaningful users to protect electronic health information created or maintained by the Certified EHR technology through the implementation of appropriate technical capabilities.

In order to continue to receive Meaningful Use incentive payments, and to avoid potential HIPAA violations, HealthPOINT strongly encourages organizations using the above mentioned Microsoft products to upgrade their systems to newer versions of the products. ■

It May Be Time for a Software Upgrade

— Irish Proverb

September / October 2013

MidwestMedicalEdition.com

5

Walking Workstations Help Stop Caregiver Stress in its Track

By Tana Phelps

Cross Blue Shield, Google, Facebook and Mutual of Omaha.

Healthcare workers are not protected from the metabolic woes of inactivity, especially if their jobs – as radiologists, administrators or clerical personnel – require sitting and working at computers for long hours. If healthcare workers cut the time spent parked on their rear, they can lose a few pounds, stress less and have more energy. Developing healthier habits may even make them better able to care for patients.

Could treadmill desks be right for your organization?

Consider the pros and cons: ◆ Better health. Logging miles improves

cardiovascular health and circulation, causing more feel-good hormones to reach the brain—reducing stress and depression. Don’t think you have time?

One Mayo Clinic doctor uses a treadmill workstation for dictation, phone calls and typing into electronic medical records between seeing patients. ◆ Fewer insurance claims. Prolonged

The TrekDesk is one example of a treadmill desk.

S

tand up. That’s the first thing

you should do if you’re sitting while reading this magazine.

Then, start walking.

Researchers have declared that our tubewatching, hunched-over-the-computer, stuck-behind-the-steering-wheel lifestyle is making us sick. Linked to an increased risk of diabetes, heart disease, cancer and

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premature death, experts call this health epidemic the “sitting disease,” and even suggest that sitting is the new smoking.

Some companies are encouraging employees to stand up and fight the trend – no pun intended – by offering standing and treadmill desk options. Such forwardthinking employers include the National Institutes of Health, Mayo Clinic, FBI, Blue

sitting requires the body to use less blood sugar and burn less fat, increasing the risk for developing cancer and diseases, which can impact insurance claims. A medical transcriptionist in New York lost 35 pounds in one month—thereby reducing her breast cancer risk—by strolling along at 1.5 mph while typing physician notes. ◆ Q uality, efficient work. For radiolo-

gists who read imaging scans while walking, research suggests that accuracy results are no worse than when

Midwest Medical Edition

images were interpreted while sitting.

Plus, marketing and finance employees are more likely to have quick, efficient phone calls and type lesslengthy emails when active versus sedentary.

Cost. Any treadmill can be used to make a treadmill desk, though many manufacturers now provide models that are specific for desk use, without handrails and equipped with motors that are designed to run for long hours at slow speeds. These can range from a couple hundred dollars to $5,000.

Liability. Walking workstations are designed to only go as fast as 3.0 mph, so strenuous activity isn’t an issue. If you’re concerned, have employees who use treadmill desks sign a waiver similar to one for a company gym. ■ Tana Phelps is a marketing specialist at Cassling, a Midwest healthcare company that provides local imaging equipment sales and service, and

Looking for a better way to manage risk?

Get on board.

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, physician 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.

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Happenings around the region

South Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska

News & Notes Avera Radiologists John P. Haas, MD, and Alan J. Walton, MD have joined the Avera Queen of Peace Medical/ Dental Staff. Dr. Haas earned his Medical Degree and Internship from Creighton University School of Medicine and completed his Residency and Fellowship in Musculoskeletal Radiology at the Mayo Clinic. Dr. Walton earned his Medical Degree from the University of Wisconsin, Madison, and completed an Internship and Residency at St. Luke’s Medical Center in Milwaukee. He is Board Certified by the American Board of Radiology. He has been providing locums coverage in Wisconsin.

The Commission on Cancer (CoC) of the American College of Surgeons (ACoS) has granted ThreeYear Accreditation with Commendation to the cancer program at the Avera Queen of Peace Cancer Center.

Eric Larson has been named Director of the Pharmacy Department of Avera Queen of Peace Hospital.

Larson was educated at the University of Kansas where he earned his BS in Pharmacy in 1989 and his Doctor of Pharmacy in 2004. Larson has been active in the implementation of a number of Avera-wide initiatives including MedSafe and Bedside Medication Verification.

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Veronnica Smith, Administrator, Avera Brady Health and Rehab, received the 2013 ACHCA Facility Leadership Award from the American College of Health Care Administrators (ACHCA). Smith assumed the role of Administrator at Avera Brady Health and Rehab in 2000. She is a Fellow in the American College of Health Care Executives and serves on the Council of Long Term Care for the South Dakota Association of Healthcare Organizations.

Kassy Youmans is the new physician recruiter for Avera Sacred Heart Hospital (ASHH).

Youmans is available to provide support and assistance for physician recruitment activities for the entire Avera Yankton region. Youmans is a Parkston native and graduate of the University of South Dakota with a bachelor’s and master’s degree in business administration.

Avera Medical Group Ear Nose & Throat Yankton Audiologist, Dr. Kendra Neugebauer, was recently named as South Dakota’s representative to the American Speech-LanguageHearing Association (ASHA) Audiology Advisory Council.

This position requires her to meet with South Dakota Congressmen to advocate for the needs of the hearing impaired.

Current issues being advanced by the advisory council are the Hearing Aid Assistance Tax Credit Act, the Congressional Hearing Health Caucus and the Medicare Audiology Services Enhancement Act.

Avera Queen of Peace Hospital acquired University Physical Therapy on July 1. The outpatient rehab center is now called Avera University Physical Therapy.

Avera Medical Group Audiologist Matthew Rumsey, Au.D., FAAA, CCC-A, recently attended the 21st Iowa Conference on the Management of the Tinnitus Patient at the University of Iowa. This meeting was designed for audiologists, physicians, nurses and psychologists interested in helping people dealing with tinnitus or ringing in their ears.

Dr. Julie Reiland, breast surgeon with Avera Medical Group Comprehensive Breast Care, has been invited to serve as a member of the faculty of MedStar Georgetown University Hospital’s Breast Cancer Coordinated Care 2014 Conference. The event will be held in Washington, DC, on Feb. 20-22, 2014. Dr. Reiland will present a lecture titled, “The Obese Patient from the Breast Surgeon’s Perspective,” and will participate in a Mock Oncoplastic Tumor Board Panel, in which she will present a case including history, mammograms, MRI, pathology, images and photos.

Dr. Hesham Elgouhari, hepatologist with Avera Medical Group Liver Disease Sioux Falls, received the University of South Dakota Sanford School of Medicine 2012-2013 Department of Internal Medicine Service Award for outstanding service as passionate faculty. Dr. Elgouhari and Dr. Mumtaz Niazi, hepatologist with Avera Medical Group Liver Disease, also received recognition from South Dakota Gov. Dennis Daugaard for teaching future physicians.

Dr. Molly Uhing, Ob/ Gyn specialist with Avera Medical Group Obstetrics & Gynecology Sioux Falls, received the Sioux Falls Family Medicine Residency Clinical Teaching Award for 2013. This award is presented annually to a Sioux Falls Family Medicine Residency clinical faculty member. Dr. Uhing received her MD from Sanford USD School of Medicine and completed an Ob/Gyn residency at the University of Kansas School of Medicine. She is board certified by the American College of Obstetricians and Gynecologists.

Midwest Medical Edition

Avera McKennan Hospital & University Health Center has been awarded a Community Value Leadership Award by Cleverley + Associates. This award recognizes the value a facility provides to the community by measuring financial viability, facility reinvestments, maintenance of a low cost structure and high quality patient care at reasonable prices.

Avera McKennan and the Avera Heart Hospital also earned the designation of Community Value Five-Star Provider, an award that goes to hospitals that achieve a Community Value Index score in the top 20 percent of all hospitals in their group. This is the fifth time Avera McKennan has received this award since 2008.

Avera McKennan has received a number one ranking in South Dakota from U.S. News & World Report for a second consecutive year. Avera McKennan was also nationally ranked No. 48 in gynecology and received high-performing status in 10 medical specialties including cancer, diabetes and endocrinology, ENT, gastroenterology and GI surgery, geriatrics, nephrology, neurology and neurosurgery, orthopedics, pulmonology, and urology.

Black Hills Six physicians recently entered Rapid City Regional Hospital’s three-year Family Medicine Residency Program. They are Logan Frederickson, DO, and Devin Higgins, DO, Des Moines University College of Osteopathic Medicine; Jaron Miner, DO, and Jaclyn Pohlers, DO, Kirksville College of Osteopathic Medicine; Michael Nielson, DO, Arizona College of Osteopathic Medicine; and Brandy Tarap, MD, Ross University, Roseau, the Commonwealth of Dominica, West Indies.

The 24th annual Great Black Hills Duck Race raised over $98,000 for the Children’s Miracle Network this year. The race took place on July 28 and included 18,000 sponsored ducks. One hundred percent of the funds are used to provide services and equipment for ill and injured children in the Black Hills area served by Rapid City Regional Hospital.

The Department of Veterans Affairs (VA) announced in July that more than 65,000 claims nationwide, or 97 percent of all claims over two years old in the inventory, have been eliminated from the backlog.

This is a result of the initiative launched in April to expedite disability compensation claims decisions for Veterans who have waited a year or longer. The initiative was centrally managed at the national level and involved all VA regional offices working claims on behalf of Veterans across the country, not just those in their geographic area or state.

Midwest Medical Edition

.com September / October 2013

My HealtheVet, the VA online personal health record program, recently launched a new feature to help Veterans manage their healthcare. With the VA “Blue Button®”, Veterans can view, print, and download their My HealtheVet personal health information and save to a computer or external device. Then they can choose to share their information with their health care teams, caregivers or others. My HealtheVet’s goal is to promote health and wellness, and to engage Veterans to be more active participants in their overall healthcare.

Dr. Loren Janke, a VA Black Hills Health Care System (BHHCS) Clinical Pharmacy Specialist, was promoted to the rank of Colonel in the Air Force Reserve after 28 years of military service. Colonel Janke is the Individual Mobilization Augmentee (IMA) to the Command Biomedical Sciences Corps (BSC) Executive, Office of the Command Surgeon, Air Education and Training Command (AETC), Randolph AFB, Texas. He has been a Clinical Pharmacy Specialist at VA BHHCS for six years.

Cardiologist Rajesh Pradhan, MD, has joined Regional Heart Doctors in Rapid City.

Dr. Pradhan received his MD from the College of Medical Sciences in Nepal and did his internal medical residency at the Reading Hospital and Medical Center in West Reading, Pennsylvania.

He completed a fellowship in cardiovascular diseases at Thomas Jefferson University Hospital in Philadelphia.

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James A. Gilbert, Jr., MD, has been named Physician of the Quarter for Customer Service Excellence at Rapid City Regional Hospital (RCRH). Dr. Gilbert is an emergency medicine physician and Emergency Department Chief. He has been a member of the Medical Staff at RCRH for 14 years and was nominated by his colleagues.

Rapid City Regional Hospital has been ranked as one of the best hospitals in South Dakota and honored for high performance in several specialty areas by U.S. News & World Report. U.S. News ranked Rapid City Regional Hospital in the top three hospitals in South Dakota and as a high-performer in diabetes and endocrinology, ENT, gastroenterology and GI surgery, geriatrics, nephrology, and pulmonology.

Emily Brick was recently recognized as Rapid City Regional Hospital’s (RCRH) Employee of the Year for 2012. Brick works as an Academic Affairs Liaison for the Family Medicine Residency Clinic and has been employed with the organization since 2007. The Employee of the Year is considered to be the highest honor among the 3,338 employees working at RCRH.

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South Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska

News & Notes Neurosurgeon Elijah Wogu, DO, has joined the clinic staff at Regional Medical Clinic. Dr. Wogu received his DO from Western University of Health Science College of Osteopathic Medicine in Pomona, California and completed a residency and fellowship at Arrowhead Regional Medical Center in Colton, California.

Larry Veitz, CEO of Spearfish Regional Hospital, has been appointed to serve on the American Hospital Association’s Board of Trustees and as the Chairperson of AHA’s Regional Policy Board (RPB) 6. Veitz will serve a three-year term beginning January 1, 2014. Currently, Veitz serves on AHA’s Regional Policy Board 6. Veitz is the second South Dakota hospital administrator to serve on the AHA Board of Trustees.

Rapid City Regional Hospital’s (RCRH) Cardiac Program has received the American College of Cardiology Foundation’s NCDR ACTION Registry– GWTG Platinum Performance Achievement Award for 2012. They are one of only 197 hospitals nationwide to do so. The award recognizes RCRH Cardiac Program’s commitment and success in implementing a higher standard of care for heart attack patients and signifies it has reached an aggressive goal of treating these patients to standard levels of care as outlined by the American College of Cardiology/American Heart Association clinical guidelines and recommendations.

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Sanford The 2013 Sanford Health Employee of the Year list honored 31 model employees from the organization. Sanford Health staff nominate fellow employees who consistently demonstrate exceptional performance and show a relentless pursuit of perfection through the Sanford values of courage, passion, resolve, advancement and family.

In 2014, the University of South Dakota Sanford School of Medicine and Sanford Health will launch a surgery residency program focusing on general surgery, including surgery in rural areas. The five-year general surgery residency program will include 15 surgery residents who experience a range of hands-on experience and training with rotations in general surgery, including rural surgery at communitybased and federal hospital systems in Sioux Falls, Yankton and the VA. It will be the fifth rural focus program in the nation for general residency and the only surgical residency in South Dakota.

Two Sioux Falls research projects have been selected to receive funding from the Sanford Seed Grant Research Fund, established in 2011 to grow and evolve unfunded research ideas of Sanford clinicians. The proposals were selected based on the criteria of purpose and priority, scientific integrity, potential for future funding and feasibility. The recipients include: Angela Myers, MD, Michael Kruer, MD, & Patricia Crotwell, PhD, Sanford Children’s Specialty Clinic/Cytogenetics Lab (Sioux Falls), “Mapping novel genes for undiagnosed pediatric neurological diseases.” Using the resources and expertise within the Sanford Genetics Laboratory, this study will map currently undiscovered gene mutations that lead to inherited neurological diseases of childhood in highly genetically informative families.

continued

Kirstin Williams, NP, & Keith Miskimins, PhD, Sanford/ USD Medical Center/Sanford Research (Sioux Falls), has published “Pilot study using metformin to reduce cardiac toxicity in breast cancer patients.” The objective of this study is to determine if co-administration of the medications metformin and doxorubicin in breast cancer patients receiving adjuvant therapy will reduce the number of patients who develop a significant change in left ventricular ejection fraction (LVEF).

Two Fargo-based researchers also received funding.

The National Institutes of Health (NIH) has awarded Sanford Health geneticist and movement disorders researcher Michael Kruer, MD, a five-year, $860,000 grant to support his research on genetic forms of juvenile Parkinson’s disease and dystonia. The grant is one piece of Sanford’s growing Pediatric Movement Disorders Clinic, which is led by Dr. Kruer. The grant will allow Dr. Kruer to continue his exploration of the molecular basis of movement disorders through the use of yeast and mouse models.

Dr. Kruer is a pediatric neurologist and associate scientist at the Sanford Children’s Health Research Center.

Hy-Vee /Sanford Legends raised a record $165,000 in 2013, pushing the total for the annual event past $1 million. The 2013 amount, which was the highest in the history of the event, brings the money raised by the Hy-Vee/Sanford Legends grant program to a nine-year total of $1,123,000. The goal of the Hy-Vee/ Sanford Legends program is to provide a learning opportunity for young studentathletes to grow and be inspired in the world of sports by providing different sporting clinics and camps.

Sanford Health launched Same Day service in July. It is available for appointments in family medicine, internal medicine, pediatrics, and obstetrics and gynecology. When patients call the Same Day phone line, a scheduler connects them with the appropriate clinic so they can be seen as quickly as possible. Same Day appointments are treated the same as an office visit at the providing clinic.

Sanford Medical Center has received recognition as a certified center for treatment of Atrial Fibrillation through the Society of Cardiovascular Patient Care.

The National Science Foundation (NSF) has awarded Sanford Research and Augustana College a three-year, $320,000 grant to establish a Research Experiences for Undergraduates site for the exploration of topics in cellular and molecular biology. The NSFREU grant will offer $5,000 stipends to 10 students for participation in 10-week research programs. Campus housing is provided and participants will also receive a $750 travel stipend to attend national cellular and molecular biology conferences where they can display their research and learn from other scientists and researchers.

Sanford USD Medical Center’s trauma center has been reverified as a Level II Adult Trauma Center and Level II Pediatric Trauma Center by the American College of Surgeons Committee on Trauma. Sanford USD Medical Center is the only Pediatric Level II Trauma Center in the region. The level II verification for pediatrics includes the ability of Sanford Children’s Hospital to offer services such as pediatric surgery, pediatric intensive care and other services for children affected by traumatic injuries.

Midwest Medical Edition

Happenings around the region

Four NCAA Division II men’s basketball teams will visit the Pentagon by Sanford Health in November as part of the inaugural Sanford Pentagon Basketball Showcase. Augustana College, Northern State University, the University of Central Missouri, and Missouri Western State University will compete in a four-game showcase on November 9 and 10. The Pentagon is scheduled to open in September and will hold a series of grand opening events throughout October and November. The facility is part of the Sanford Sports Complex in Sioux Falls.

Sanford Aberdeen Medical Center, Sanford USD Medical Center and Sanford Medical Center Fargo have received Most Wired designations. The award list is based on Health Care’s Most Wired survey, an industry-standard benchmarking study which measures the level of information technology (IT) adoption in U.S. hospitals and health systems. Sanford Health has installed electronic medical records (EMR) systems in 30 of its hospitals. In addition, more than 1,000 physicians use the EMR in Sanford Clinics. In the next twelve months, Sanford Health will add five more hospitals, 200 more physicians and the Sanford Health Plan to its EMR. Future plans also call for including Home Health on the same EMR.

An HPV vaccine engineered by Sanford Research’s John Lee, MD, and his team for Etubics Corporation has received a $1.03 million grant from the National Institutes of Health move to into clinical trials. In October, a study led by Lee and published by Cancer Gene Therapy indicated an Etubics drug (Ad5 [E1-, E2b-]), when used in conjunction with chemotherapy and radiation, successfully improved long-term survival of animals expressing HPV. The vaccine targets head and neck cancers.

September / October 2013

Siouxland Inpatient Acute Rehab at UnityPoint Health – St. Luke’s has been named among the top acute rehab facilities nationwide for attaining superior patient outcomes.

Performance measurement system Uniform Data System awarded St. Luke’s with its “Top Performer Award”.

St. Luke’s received a 96% ranking compared to nearly 800 acute rehab facilities from across the United States for helping patients meet their goals and return home.

The Mercy Medical Center Foundation has chosen Dr. Mike Wolpert as the 2013 recipient of the Dr. George G. Spellman Annual Service Award.

Dr. Wolpert is a general surgeon and has served the Siouxland community for over 30 years. Dr. Wolpert has served as Trauma Medical Director at Mercy Medical Center, and currently serves on the Medical Staff Credentials Committee as well as the South Dakota State Medical Association. He was nominated for the award by his colleagues at Midlands Clinic, P.C.

Charles Murphy, MD, Radiation Oncologist at the June E. Nylen Cancer Center, is now Board Certified in Radiation Oncology by the American Board of Radiology. Dr. Murphy joined the Nylen Cancer Center in 2012.

He earned his MD, completed an internal medicine internship and did his radiation oncology residency at the University of Iowa Carver College of Medicine.

He recently began offering Stereotactic Body Radiotherapy for the treatment of Lung Cancer.

Cardiothoracic surgeon Tayfun Gurbuz, MD, has joined Mercy Medical Center Sioux City.

Dr. Gurbuz has been performing surgery at Mercy Medical Center since February, 2013, when he joined the staff as a visiting physician. Dr. Gurbuz earned his MD at Hacettepe University Medical School in Ankara, Turkey and completed a surgical residency at Saint Joseph Hospital in Denver and a cardiothoracic residency at the University of Tennessee Health Sciences Center in Memphis. Dr. Gurbuz completed his cardiac surgery fellowship at the Albert Starr Academic Center for Cardiac Surgery in Portland, Oregon and is board certified in general surgery and cardiothoracic surgery.

Mercy Medical Center has announced a $16.8 million investment in its critical care and imaging services. The

investment includes renovation of the current intensive care units and installation of one of the largest MRIs in the region, the 3.0 Tesla (3T). The addition was announced at an August 20th press conference.

Children’s Care Occupational Therapist and Assistive Technology Coordinator Arlen Klämm earned the specialty certification of Seating and Mobility Specialist from the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA). Klämm is already a RESNA-certified Assistive Technology Professional. He is the first in the state of South Dakota and one of only 122 in North America to receive this specialty certification.

The Orthopedic Institute now provides the coflex® Interlaminar StabilizationTM Procedure, an innovative technology for treating spinal stenosis. The coflex® Interlaminar StabilizationTM Procedure is the only minimally invasive solution for spinal stenosis that provides instant stabilization of the segment with motion preservation, while maintaining the height of the forearm. The procedure is less invasive and traumatic to the tissues, and has better outcomes than patients undergoing spinal fusion, allowing patients to recover and return to daily activities quicker.

Other Brookings native Heather Van Meveren is the new CFO of Brookings Health System. For the past year, VanMeveren has served as a certified public accountant (CPA) at Nelson & Nelson CPAs, LLP in Sioux Falls. Prior to that, she was the director of corporate accounting at Sanford Health and spent one year at Sanford USD Medical Center as a financial analyst. Van Meveren holds a bachelor’s degree in accounting from Huron University and an MBA from Colorado Technical University.

MidwestMedicalEdition.com

11

Gain

By Alex Strauss

M

edicine can be a risky profession.

According to the CDC’s National Institute for Occupational Safety and Health, healthcare workers experience musculoskeletal disorders at a rate exceeding that of working in construction, mining and manufacturing. In addition to lifting and positioning increasingly heavy patients, many of these injuries occur as a result of being forced to spend many hours working in awkward positions. 1 The problems don’t necessarily take years to develop and are not confined to older workers. A 2008 UK study of Ob/Gyn residents found that more than a quarter of them sustained some type of injury to their hands, wrists, shoulders, necks, and lower backs during the course of their training.2 Back problems from spending hours on their feet and from bending over are common among all types of surgeons. And a 2012 study found that office-based procedures are no easier, suggesting that “there is considerable risk of musculoskeletal injuries of physicians/surgeons performing office-based surgeries”.

12

Midwest Medical Edition

Maria Bell, MD

Without Pain “We do our procedures standing, often in non-ergonomic positions, trying to focus on small movements of our fingertips while the rest of the body is frozen,” says Sanford Interventional Cardiologist Adam Stys.

Stys says the problems often start during cardiology fellowship training, where orthopedic injuries are five times more common than they are among practicing cardiologists.

“Cardiology Fellows would start in June and

by April everyone would be crying getting up in the morning because of back pain.

Many would not even be able to complete a full rotation.”

The awkward stance is exacerbated by the fact that interventional cardiology procedures are performed while wearing a heavy lead apron to protect against radiation exposure.

A 2006 survey of interventional cardiologists found that more than half experienced significant spine injuries by their 20th year of practice.3 They also have three times the number of cataracts seen in the general public and an elevated rate of left-sided brain tumors due to radiation exposure.

So it’s no surprise that Dr. Stys and his colleagues at Sanford have gladly embraced the advantages of robotic technology. With robotic assistance, the surgeon can manipulate wires and catheters from a seated position behind a radiation-safe console.

“There are so many advantages to robotics in this setting,” says Stys, who uses the technology primarily to perform balloon angioplasty and input stents. “Radiation exposure is practically zero when you are sitting behind the console shield. Orthopedic problems are reduced because you can take the lead off and sit comfortably in an armchair. And visibility is better, so eye strain is reduced as well.”

Stys says up to 80 percent of balloon procedures and stent placements can now be done with the help of the robot, which offers advantages for patients in terms of decreased blood loss and lower infection risk. Stys says that, while the technology is not yet perfect, it is a major step in the right direction for reducing injuries among interventionalists.

Robotics in Surgery “Once I switched to robotics, my injuries went away,” agrees gynecologic oncologist Maria Bell, MD, who developed upper back and shoulder issues after she began performing laparoscopic procedures more than eight years ago. “Ergonomically, that was not a great transition.”

Like the Corindus CorPath robotic system used by Dr. Stys and his colleagues, the daVinci surgery system that Bell now uses cradles her head, taking the pressure off of

1 Preventing Back Injuries in Health Care Settings, September 22nd, 2008, NIOSH Science Blog 2 Hermanson, JE and Choi, SD, “Study of musculoskeletal risks of the office-based surgeries”, 2012, Work.

3 Machan, L, “A web based survey of neck and back pain amongst interventional radiologists”, 2001, J Vasc Interv Radiol,

September / October 2013

Dr. Maria Bell’s shoulder problems resolved after she began using the da Vinci robot for gynecologic oncology procedures.

Photo courtesy Sanford

Robotics in Cardiology

Photo courtesy Sanford

Ergonomics in the Medical Work Place

MidwestMedicalEdition.com

By allowing him to work without a lead apron, Interventional Cardiologist Dr. Adam Stys says robotics are saving his back.

Photo courtesy Regional

n

I absolutely believe that I will be able to operate longer because of robotics . . .

Adjustable carts take the pain out of computer work for anesthesiologist Troy Nesbit

13

Beyond Robotics Installing robotic systems is not the only way area hospitals are attempting to make life easier and more comfortable for physicians. Barry Degen, Administrative Director of Perioperative services at Rapid City Regional Hospital, says even lower tech improvements can make a big difference over the long haul.

“Usually, if you make people more comfortable, they do better work and are more efficient,” says Degen. Given that a large number of repetitive use injuries in all professions are blamed on computer use – and computers are becoming as common as stethoscopes in the healthcare environment – many of Regional’s ergonomic improvements focus on computer work stations. Even something as simple as putting computers with tiltable screens on adjustable-height carts and providing dual screens at dictation stations can make order input and note-taking easier and reduce eye and neck strain.

“Just like everyone else, doctors have to spend more and more time on computers,” says Degen. “Having multiple computers

14

Photo Courtesy Sanford

Dr. Adam Stys

Photo Courtesy Regional

Photo Courtesy Sanford

means that, whether they are 5'.5" or 6'.8", they can access a computer that can be adjusted for them.

There is never a need to bend over or strain.”

The hospital has also invested in items such as Dr. Maria Bell new stools, including bariatric stools with lumbar support, to better accommodate doctors of all shapes and sizes. In the operating room, multiple monitors can be turned and tilted for a clear view without neck strain. In the hospital’s three integrated operating rooms, doctors can even adjust lights and other controls with voice Barry Degen activation. Suspending equipment from the ceiling on floating booms means no one had to maneuver around cords on the floor. And pneumatics make the high-tech beds easier to raise, lower and tilt for the best, most physician-friendly angle.

“The monitors in the OR and anesthesia machines that rotate are great,” says Regional anesthesiologist Troy Nesbit. “We can be doing procedures from any angle and can look up and see a monitor. This is especially helpful in the heart room. When there are so many screens, everyone in the room can easily see what’s going on.”

Nesbit says he also appreciates the fact that the hospital has invested in lighterweight aluminum anesthesia carts and in chairs with adequate lumbar support.

“Because you are sitting in there all day long, the back support is really important. It’s also nice not to have to move this big cart all over.”

Many technologies, such as the Glidescope, which uses a fiberoptic camera to make difficult intubations easier, have benefits for both doctors and patients. “Because you can see so much better with the Glidescope, we are able to keep the patient in one position and not have to maneuver all around. It is easier for us and more efficient.” ■ Photo Courtesy Regional

her neck and shoulders. While it makes straightforward hysterectomies more comfortable to perform, the robot is especially appreciated during major, multi-hour procedures such as ovarian debulking.

“If you don’t have the robot, you have to position your body in such a way or use leverage to get the angle you need,” says Bell. “You have to use six times the force to grasp something and bring it out.”

Robotic technology is not only making life more comfortable for doctors like Bell and Stys now, but Bell says that, by preventing injuries, the more ergonomic approach is also likely to lengthen her career.

“I absolutely believe that I will be able to operate longer because of robotics than I would have been able to otherwise,” she says.

With the national numbers of surgeons approximately the same today as it was in 1993, while the patient population has steadily grown, longer surgical careers may be more important than ever. “We really need to protect our surgeon population,” says Bell.

Dr. Troy Nesbit

Usually, if you make people more comfortable, they do better work and are more efficient.

Barry degen

Midwest Medical Edition

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September / October 2013

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15

Is the Press Trying to Trick Me? (and other concerns for doctors who talk to the media) Excerpted from Physicians and the Press by Alex Strauss

I

can’t tell you the number of

times that, heading into an interview with a physician, just before I gave the signal to my photographer to start recording, the doctor leaned across the desk and said, “Now, no trick questions, OK?” This was inevitably followed by a nervous chuckle.

The light-hearted nature of the delivery notwithstanding, not only does a comment like this subtly undermine the rapport you want to establish with the person who is going to share your words with their audience, but it speaks to a deep misunderstanding and public distrust of the news media largely perpetrated by – who else? – the media.

Despite what you may have seen on prime time television, read in a novel, or seen in a movie, reporters are almost never not out to get you. With the possible exception of investigative journalists – and, presumably, you are going to be well aware of it if you are being ‘investigated’ – the vast majority of reporters are totally on the up and up and devoted to journalistic excellence. (Or at least competence, depending on how quickly the deadline is looming.) For a reporter, the bare minimum required in order to be considered ‘competent’ is getting the story right. Putting your source on the spot is definitely not the way to do that.

In all of my training as a medical journalist (including grad school and years worth of national conferences) and more than two decades in the field, I never once encountered

16

a health reporting colleague whose intentions were less than responsible. Health reporters and the news organizations that employ them generally want to do their jobs efficiently under time pressure, get their facts straight, avoid the influence of third parties (i.e., advertisers), and disseminate health information that will improve the lives of their intended audience. Sound familiar?

What If the Story is Wrong?

Like all humans, sometimes reporters do get it wrong. Without the benefit of medical education, or, in some cases, even health reporting experience, and with a producer or editor breathing down their neck to finish the story or article NOW, mistakes happen.

Whether it was a disconnect between you and the interviewer, insufficient time on the reporter’s part to study and understand the subject matter, or simply shoddy workmanship, when a story or article in which you played a role is wrong, it can feel like a betrayal.

While false health or medical information should never stand uncorrected, it is important to remind yourself, before you make the call or send the email, that the error was almost certainly unintentional. All journalists worth their salt will absolutely want to know if they had their facts wrong, will be appropriately contrite, and will make every effort to publish a correction. This is not the time to disavow any future involvement with

the media or undermine the work you’ve done to attract their attention in the first place. On the contrary, it is just further evidence that the media, and the public they serve, need the medical knowledge you possess.

If, after you explain the error via email or phone call, you still do not feel satisfied that the reporter understands or acknowledges the mistake, you may use your discretion as to whether or not you wish to work with that particular reporter again or whether it is worth it to take your complaint up the chain of command in the news organization. Just as not everyone is cut out for medicine, not every journalist can be a great health reporter.

NOTE: Failing to fully grasp or express the nuances of a complex medical topic does not necessarily constitute irresponsible reporting. Remember, it is the journalist’s job to find that sometimes-elusive nugget of relevance and express it at the level of her audience. Depending on the level of sophistication of that audience, that often entails condensing and simplifying complex information. Would it fly at a medical conference?

No. But is it necessary to help the audience hear and understand the importance of the information? Absolutely. ■ Physician and the Press: a Doctor’s Guide to Working with the Media By Alex Strauss will be available through Amazon, Barnes & Noble and other book sellers this winter.

Midwest Medical Edition

Managing the Health of Your IT

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There was a time when the height of communication technology for most doctors was an office telephone and a pager. Medical records contained reams of paper and keeping them secure meant locking the records room.

Today, most healthcare professionals are working with not only sophisticated phone and pager systems, but multiple office and home computers and various mobile devices that are often used in both settings. Managing this increasingly complex network of tools and ensuring they are all HIPAA compliant, work with the EMR system, and support the goal of “meaningful use” can be a job in itself – one that can either help or hinder the primary job of physicians: providing quality healthcare.

“All of your communications have to be compliant, but, ideally, the things that make it compliant shouldn’t get in your way at all,” says Katie Fleming, Business Development Manager at Golden West Technologies.

Rapid City-based Golden West Technologies has been on the ground floor of medical communications and technology in the region since it introduced its paging service in 1984.

That was followed a year later by the answering service which has become the foundation of a business that now encompasses all facets of medical communications and digital technology.

“The bottom line is, if a doctor or medical facility is considering anything to do with technology… their computers, network, servers, communication, data security, answering service, etc., we can help them with it,” says Fleming.

How Golden West Technologies Helps Physicians Practice Medicine in the Digital Age 17

Mobility at Work

IT image.jpeg

The High-Tech Medical Office Insuring compliance in your communications S ecure wireless networks – the key to mobility

Tablet computers – more flexible and easier than laptops

Answering Service – customized and compliant miSecureMesssages – the text-based alternative to pagers

Remote servers

and monitoring can replace on-site IT

18

Mobility has become a critical buzzword in medicine. To work efficiently in the fast paced environment of a modern medical office or hospital campus, healthcare professionals must have the freedom to move – not only around an exam room, but also with ease from room to room or even from one building to the next, without losing their connection to patient data.

“Providers are always moving between offices, between floors, in route to the hospital, etc.,” says Golden West Sales Manager James Van Loan. “Reliable, secure wireless and mobile technologies are very important, both at the healthcare facility and when they leave it.” Van Loan says his company specializes in assessing, setting up, and helping to maintain wireless networks within offices or across whole campuses, so that providers never lose the allimportant wireless signal.

“Building a good wireless network is about understanding the traffic patterns and creating some higher availability,” says Van Loan. “You have to have more than one access point [i.e., wireless router], so that, if one goes down or is out of range, your device would automatically connect to another one. It is a lot more efficient and convenient if the doctor doesn’t have to re-login to the EMR system, just because he walked downstairs.”

Tablets Trump Laptops In the exam room or at the patient’s hospital bedside, mobility can simply mean being able to move freely and interact with patients naturally, while maintaining the ability to record important data, search the patient’s electronic medical record, view imaging studies, or even consult a remote specialist.

Golden West’s answer is a tablet computer with a unique hand grip that

attaches to the back side, allowing the user to hold it securely in one hand, even while interacting with a patient. Van Loan says this ease of use is a big part of why tablets are quickly replacing laptops as the tool of choice in patient care situations.

“It has to do with that experience between practitioner and patient,” says Van Loan.

“Laptops can be kind of large and clunky and if a doctor is sitting at one, he or she may spend more time interacting with the computer than with the patient. With the release of Windows 8, the touchscreen technology on these tablets is much better, so there is less need for typing.”

The newest Windows operating system also makes it easier and faster to move between different applications on the computer. Van Loan says tablet technology is now so advanced that high definition video conferencing (such as with a specialist in another location) is possible, even on less expensive machines.

Customized Answering Service Of course, the job of a physician does not stop when he or she leaves the office or hospital campus. A secure, consistent wireless signal on site is only half the battle. Keeping doctors connected – to each other, to medical data, and to patients – when they are away from their office is just as critical.

“We make this easy by providing each client with a single phone number that is associated with their account. They can forward as many different lines to that number as they want to and they will all come in to us,” says Bobbi Wells, Golden West’s Answering Service Supervisor. The company’s unified approach to answering service can be utilized 24 hours a day, just after hours, or as needed.

Golden West’s Rapid City-based telephone operators have special expertise in medical calls and are HIPAA trained and compliant. Thanks to fully-customized scripting and options like having patients patched through to the doctor or be greeted with a pre-recorded message for

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“Ideally, the things that

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”

in your way at all.

Katie Fleming Business Development Director

James Van Loan Sales Manager

Bobbi Wells Answering Service Supervisor

non-emergencies, Wells says the answering service can function as a seamless extension of the physicians’ office. And with a full range of technology at their fingertips, agents can relay messages via email, phone, pager, fax, text message or voicemail, in any order or frequency. Messages can even be categorized to cut down on Monday morning overwhelm.

“Maybe they are getting 100 emails that they have to go through,” says Wells. “We can label them with subject lines like ‘Urgent – Patient Need Call Back’ or ‘Routine Scheduling’ to make it easier. Little things like that can turn into big efficiencies for people.”

Secure Text Messaging

The Network Operations Center in Rapid City can monitor distant computer networks and firewalls 24 hours a day, 7 days a week, allowing medical offices to ‘virtualize’ much of their IT.

“ Little things… can turn to big efficiencies for people.”

September / October 2013

For answering service clients with the new miSecureMessages app, the answering service can now send even sensitive patient information directly to a doctors’ smart phone.

“It really improves the quality of information that can be included,” says Wells of the app that Golden West has recently begun offering. “With miSecureMessages, we can include things like the patients’ name and date of birth and the provider can reply back to us with detailed information, so there is two-way communication.”

Available for Android, Apple and BlackBerry devices, the cloud-based miSecureMessages app appears on the users’ phone or tablet like a texting program. But, because messages are encrypted in transit and stay on a secure server, no sensitive information is ever stored on the phone itself.

If the smart phone is ever lost or the passcode compromised, miSecureMessages can be disabled remotely, making it impossible for any unauthorized person to access the service or see any messages.

In addition to integrating seamlessly with Golden West’s answering service, miSecureMessages can take the place of a paging system. It can also be used independently of the answering service as a way of communicating sensitive data within a group, making it ideal for secure inter-office messaging. miSecureMessages users pay a monthly fee based on the number of phones to be included on the plan. The system has been used successfully in several other markets for more than a year and allows for secure texting to anyone who has the plan.

MidwestMedicalEdition.com

19

Golden West’s Rapid-city based answering service includes operators with expertise in handling medical calls and HIPAA compliance.

The ‘Virtualized’ Network With so much sensitive data being managed and exchanged digitally, security, which has always been a concern in medical offices, is even more critical today. This is one reason that a growing number of medical offices – even those that have had their own IT department or person – are leaning more heavily on a partner company to help manage their increasingly complex information technology needs.

“Technology has advanced to the point where you no longer have to have your own IT person on site,” says Golden West’s Business Development Director Katie Fleming. “It is now possible to virtualize your entire network.”

With Golden West as a technology partner, medical offices can take advantage of their expertise to optimize and monitor an existing computer network and servers. If a file is lost, it can be recovered. If there is a fire in the server room, applications can be reloaded onto new devices. Golden West can even host a business’ entire computer system in its Rapid City data center, eliminating the need for the office to maintain and monitor onsite servers.

With a reliable Network Operations Center to monitor the network and firewalls 24/7 for a predictable monthly fee, Van Loan says the arrangement can alleviate stress, reduce risk, and improve efficiency.

“There is a lot that doctors often don’t realize in terms of making their technology investment pay off effectively,” says Van Loan. “We start by helping them find and improve any basic security issues they have and putting policies in place to keep them secure. But we also recognize that security is an ongoing effort and not just a one-time fix. That is why we are less of a service provider and more of a value-added partner. “ “It is vital to understand what the stumbling blocks are in a particular office,” adds Fleming. “Our technology team is very experienced in the healthcare industry. They understand the kind of information they are managing and they know how to make sure that technology is an asset and not something that detracts from providing quality care.” ■

“ It is a lot more efficient if the

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”

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20

Regional Health Extends Palliative Care to Hospitals Regional Health is

now offering palliative care services to patients and families at Rapid City Regional Hospital (RCRH) and other hospitals in the Regional Health System. Although Regional has offered palliative care services for several years through its hospice programs in Spearfish and Rapid City, this is the first time Regional has offered hospital-based palliative care.

Regional Health’s Palliative Care program consists of a multi-disciplinary team of physicians, nurses, advanced practice clinicians, counselors, pharmacists, chaplains and ethicists. The team designs short-term and long-term growth plans for patients dealing with serious illnesses, in an effort to decrease stress, manage symptoms, be more satisfied with their healthcare and gain a greater sense

of control. The group, based at RCRH, provides inpatient consults to patients and families Monday through Friday.

“Palliative Care is greatly needed in our community to provide excellent patient-centered symptom management with all types of life-changing illnesses,” said Dr. Jeanne Berry, Team Lead for the Palliative Care program.

“Patients and families have expressed their gratitude to the Palliative Care team members who have assisted them with all aspects of care (mind, body and spirit).”

According to The Center to Advance Palliative Care, approximately 90 million Americans are living with serious and chronic illnesses, such as cancer, heart disease, diabetes, Parkinson’s, stroke, and Alzheimer’s.

Palliative care to relieve symptoms, pain, and stress can be provided alongside curative treatment and is appropriate at any age and any stage of a serious illness.

“For patients receiving news of a life-changing diagnosis or illness, palliative care offers time and attention utilizing a multidisciplinar y treatment approach to care,” said Stacey Schaefer, Assistant Director, Hospitalist Se r v ices-Pal l iat ive Care. “Our focus is to provide as much relief as possible from symptoms and to improve the quality of life for both the patients and their families.”

In additional to its new hospital-based palliat ive care services, Regional recently received a grant to implement a palliative care team for cancer patients at the John T. Vucurevich Regional Cancer Care Institute. ■

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September / October 2013

MidwestMedicalEdition.com

Local Research Focused on Lab Mice Published in National Journal A study addressing how location

and sex can affect mouse models in scientific research authored by Sanford Research’s David Pearce, PhD, was published in the July issue of Scientific Reports.

“Location- and sex-specific differences in weight and motor coordination in two commonly used mouse strains” focuses on the migration of Pearce’s mouse colony from the University of Rochester (NY) to Sioux Falls after his move to Sanford Research in 2009.

Pearce found the shift in environment caused changes in the weight, motor coordination and motor learning capability of mice. Additionally, those changes also varied between male and female mice.

Differences between Rochester and Sioux Falls included, for example, diet and slightly adjusted testing protocols.

In general, the mice in Sioux Falls were heavier and slower than those in Rochester. Pearce’s study reveals why scientists performing the same mousemodel research in two different labs may experience different outcomes.

“We have long thought that environmental factors can have an effect on behavioral experiments, which has caused us to wonder how well we can reproduce experiments in different settings,” said Pearce, Sanford Research’s vice president and chief operating officer. “In our move from Rochester to Sioux Falls, we found that many factors, including local diets and handling procedures, had a significant influence on how our mice models reacted.”

Pearce is one of the world’s top researchers of Batten disease and leads the Pearce Lab for Genetically Inherited Diseases of Children. ■

21

I

7 Tips for More Effective Recruiting

By Tim Wieben, CMPE

n these difficult times for

hiring physicians, I am often asked, “What do we need to do to make this [i.e., a new hire] happen”? I see clients struggle with the process of searching, screening, interviewing and finally hiring new doctors. But there are some steps you can take to make the process smoother and more efficient for everyone.

Think of the process of recruitment like dating. Dating can be difficult and timeconsuming and can involve rejection. But it’s worth it since the ultimate goal is to find that perfect person with whom to spend your life. Likewise, as you recruit, keep in mind the things that felt good about dating, how you interacted, and what “worked” to help things click with your date.

One of the biggest problems I see is clients who enter the recruiting process without a plan. They simply decide one day that they need another doctor. But if you are going to attract quality candidates, a plan is a must. It is never too early to plan for your needs, taking into consideration retirement, patient demand, and sometimes termination.

Your motto should be “BE Prepared”. Here is a list of tips to streamline the process and help you “BE Prepared”:

1 Identify the need, short term and long term Before you begin the process, you must decide how immediate your need is and whether or not you are able or willing to wait for the right new person.

2 D evelop a one-page description of the responsibilities and expectations 3 Name a Contact Person Identify a contact person (administrator, HR, in-house person or a physician) who will be the contact for prospective new doctors.

Provide the person’s name, address, phone, email and texting information to every physician you contact. Make sure the person is available to take the calls and respond in a timely fashion. Because residents’ schedules may not align with the rest of us, recruiting is a 24/7 process. Prepare accordingly.

4 Be ready for phone calls I recommend using all forms of communication, but recognize that you can get far more information about a candidate in a phone call than you ever can from text or email. In addition, some residents have shared with me that they are getting 30+ mail pieces a week in addition to texts and emails.

Recently, a residency program director said they get so many opportunities that some are never even reviewed. The message? Make time for the phone call, but be realistic about your expectations. Asking what prompted their response is a good place to start.

5 E xplain what sets your practice apart 6 Outline the package This includes compensation, length of the contract, whether or not this is an employed situation or partnership opportunity, etc. If it is a partnership, explain the time table and expectations. This is about more than money.

Remember : “If they come for money, they will leave for money.” Other items to touch on include: n List of benefits, life, health, disability,

malpractice, VAC, CME, pension, profit sharing, money for CME. n Relocation assistance and how much n Signing bonus, how much and when is it paid? n Can your organization use visa candidates? n Call schedule, IP vs OP, weekly work expectations n Student loan money

7 Develop an information packet This is a packet to be sent to potential candidates after you have mutual interest. It should include a personal letter from your recruitment point person, as well as information from the local Chamber of Commerce, hospital, schools, shopping attractions, community recreational activities, your practice information listing physicians and specialties, locations and website information. Include the practice description for the opportunity and don’t be cheap – send it overnight special delivery.

These tips are a good starting point to set the framework for a successful recruitment.

Remember: There is no “easy recruit”. When done right, the process demands time, effort, commitment, and a plan in order to “close the deal”. ■

Tim Wieben, CMPE, is President and CEO of North Dakota-based Medical Recruitment Associates, Inc.

22

Midwest Medical Edition

Sioux City hospitals provide over $40 million in community benefit Mercy Medical Center—Sioux City

provided $23.9 million in community benefit and UnityPoint Health – St. Luke’s another $17 million in community benefit according to a recently completed assessment by Iowa Hospital Association (IHA).

The IHA report shows that Iowa hospitals provided community benefits in 2012 valued at nearly $1.6 billion. Community benefits include services and programs such as health screenings, support groups, immunizations, nutritional services and transportation programs.

According to the IHA report, St. Luke’s reported nearly $3.8 million in charity care as well as $1 million in subsidized health or community services that, while necessary to Siouxland, generate thousands of dollars in losses each year. Mercy reported $5 million in charity care in addition to $9.4 million in subsidized health and community services.

The two hospitals reported over $12.1 million in Medicaid losses or unreimbursed costs associated with treating Medicaid.

Community benefits are the basis of community hospitals’ non-profit tax exemption status and are not for marketing or promotional purposes. ■

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Regional Urgent Care Expands to Second Location Regional Health has expanded its urgent care and occupational medicine offerings by opening a second Regional Urgent Care location. The former RapidCare clinic on Knollwood Drive was acquired from Robert Preston, MD, who offered urgent care and occupational medicine services at the facility for more than 20 years.

“Since opening our first urgent care

September / October 2013

location last fall, it has always been Regional Health’s goal to grow into other areas of the community,” said Charles Hart, MD, President and CEO of Regional Health.

“Dr. Preston’s RapidCare clinic has been a staple in Rapid City for more than two decades and we are so proud to continue the good work done there.”

The clinic’s current supervising physician, Douglas Everson, MD, will continue

MidwestMedicalEdition.com

in this role for Regional Urgent Care, which will also take ownership of RapidCare’s occupational medicine business. The clinic will continue to offer a full line of urgent care services, including on-site laboratory and X-rays. Medical records for RapidCare patients will be immediately available at any Regional Urgent Care location.

The new Regional Urgent Care is open seven days a week. ■

23

Sioux Falls Specialty Hospital

to Pilot Patient-Centered Care Study Sioux Falls Specialty Hospital has been invited by the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality to participate in a research study to identify and disseminate best practices for improving patients’ hospital experiences.

“It’s truly an honor to be asked to work with such a prestigious institution, and to improve patient care not only within our own hospital, but across the nation,” says Kelly

King, RN, Director of Nursing at SFSH. Based on a recent national analysis of publicly available data on the performance of U.S. hospitals, SFSH was ranked 6th nationally for patient-centered care and identified as a “top performer” in the Staff Responsiveness domain.

The patient-centered care model seeks to establish patient satisfaction through more open patient-provider communication, treating patients as informed decision-makers about their own healthcare. At SFSH, patients and their families are involved in all aspects of their care, and empowered to seek the best solution for the management or treatment of any health condition, while the overall patient-centered environment at SFSH is physically and emotionally conducive to a caring and compassionate experience.

The care model implemented at SFSH is patient-centered, which involves centering care on the needs of the patient and not around the needs of the healthcare delivery system itself.

As the practice of medicine has evolved in how patients are treated and viewed, the patientcentered care model focuses on the patient as an individual and unique person with diverse needs, not a medical condition to be treated.

The Johns Hopkins study is funded by the Agency for Healthcare Research and Quality (AHRQ) and will culminate in a national conference on September 26th and 27th where Quarter Page Horizontal 3.875 x 5.275 SEPT 2013_Layout 1 8/12/2013 5:27 PM Page 1

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top-performing hospitals will be invited to present and be recognized for their work.

SFSH is being recognized for its patientcentered hospital practices, specifically for Quality Improvement, Infection Control, Surgical Services and Nursing Services.

Sioux Falls Specialty Hospital provides care at three specialty centers: Surgery, Pain Management and Imaging. Primary Care and Digestive Health are also provided through its partnership with Midwest Family Care. ■

Avera Receives National Innovator Award The Avera Cancer Institute at Avera

McKennan Hospital & University Health Center has been awarded the 2013 (ACCC) Association of Community Cancer Centers Innovator Award, sponsored by GE Healthcare. The award honors ACCC members that have exhibited “forward-thinking strategic planning and developed pioneering programs and replicable models” in cancer patient care.

The Avera Cancer Institute was awarded for its creation of the Rural Chemotherapy Project, a quality improvement project established to implement unified chemotherapy administration standards across 45 sites— both within and outside of the Avera system.

To accomplish this, Avera’s Rural Chemotherapy Committee created a process that included a mandatory educational webinar and completion of a chemotherapy preparation and administration checklist for all sites.

“Avera excels at providing quality care, nearby home, and we feel like this project helps us reach this goal, especially at our rural locations,” said Crystal Enstad, Infusion Center Manager at Avera Cancer Institute in Sioux Falls.

ACCC 2013 Innovator Award recipients will be recognized at the ACCC 30th National Oncology Conference in Boston in October.

Both ACCC and GE Healthcare will highlight the selected innovative programs to oncology care providers as well as to the broader health care community across the country. ACCC is the leading national multidisciplinary organization that sets the standard for quality care for patients with cancer. ■

Midwest Medical Edition

Aberdeen cardiologist utilizes robotic-assisted stent placement in procedural first Aberdeen interventional cardiologist Puneet Sharma,

“As physicians, we have so many unknowns coming our way...

MD, recently made history by utilizing the CorPath Vascular Robotic System to provide a procedural first in the nation. For the first time in the United States, Dr. Sharma utilized the vascularrobotic system with an acute heart-attack patient faster than the national treatment time standard.

“The ‘door to balloon’ time for this acute heart attack patient’s procedure was completed in 68 minutes,” said Dr. Sharma. “The acceptable nationwide standard for ‘door to balloon’ time for a patient experiencing a heart attack is 90 minutes to prevent further heart damage.”

The CorPath 200 robotic-assisted system is the only FDA cleared robotic-assisted technology to aid interventional cardiologists in placing stents and balloons in patients with coronary artery disease (CAD). CorPath systems were recently installed at Sanford Aberdeen Medical Center and at Sanford Heart Hospital in Sioux Falls thanks to a grant from The Leona M. and Harry B. Helmsley Charitable Trust. The two locations were the fifth and sixth in the nation to get the technology and the first in this region.

“This technology improves rural access and quality as fewer patients will need to travel out of this area for advanced specialty care,” said Dr. Sharma.

During a traditional catheterization procedure, physicians utilize x-ray guidance to manually push a catheter through the coronary arteries. The CorPath 200 System by Corindus Vascular Robotics enables physicians to make very precise robotic-assisted movements during these critical heart procedures. The physician uses a joystick to perform procedures, precisely advancing catheters, angioplasty balloons and stents to clear the blockage and restore blood flow.

It gives the physician improved visualization and reduces procedure time. Dr. Sharma also noted that direct patient benefits of utilizing the robotic system include less x-ray exposure and contrast and greater precision in placing the stent. ■

Midwest the MED on Medical

Web Edition .com September / October 2013

Watch for expanded news on our website.

MidwestMedicalEdition.com

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25

Sanford World Clinics

Providing Essential Primary Care in Ghana and Beyond A view of the street outside the Sanford clinic in Cape Coast

A unique culture

The best way to provide healthcare to a child is to improve a mother’s health.

Nowhere is that statement more accurate than in the sub-Saharan country of Ghana, says Ann Mays, Sanford Health’s Director of Clinical Services for the Sanford World Clinics initiative.

In 2007, Sanford Health launched the Sanford World Clinics initiative to develop pediatric primary care clinics in the U.S. and around the world in areas lacking such services. Sanford determined that in many emerging countries, the most effective way to improve the health of children is to treat the entire family.

26

So Sanford expanded its mission to include the potential for hundreds of community clinics in emerging markets to provide primary care for children and adults.

“You can’t separate the child from the family,” says Mays. “If a mother dies, a child is considered an orphan. They don’t go to school. They don’t get fed. It fits our mission to treat the whole family.”

In January 2012, Sanford also began providing a permanent healthcare infrastructure in the African country of Ghana.

Currently, Sanford has four operational clinics, with plans to complete an initial network of 10 clinics in the next two to three years.

Ghana has a great need for medical services. Nationwide, there are only two physicians and nine nurses or midwives for every 100,000 patients in the country.

“People can wait in lines for hours,” says Mays. “There’s a lot of traditional medicine and spiritual healing. People who don’t have access to care may go to someone who is not properly trained.”

In Ghana, malaria is the number one cause of death, with 4.1 million cases treated annually. Women of childbearing age are at great risk for a variety of health problems.

The rate of maternal deaths during pregnancy is high, as many as 350 women out of every 100,000 pregnancies. And one out of 12 children will die before their fifth birthday.

Ghana is considered an emerging country, but the social and economic culture can be challenging. The country is working to revamp its National Health Insurance Scheme and much of the records are primitive. Only 71 percent of births are registered and there is no integrated data collection system.

Improving the system Sanford has made investments to clinic infrastructure, as well as clinical and operational enhancements. A great deal of effort is focused on improving patient workflow to ensure providers can see patients as efficiently as possible.

At Sanford’s facilities, patients do not encounter the long waits as they would at other facilities in Ghana. At one Sanford facility, three to four doctors see an average of 1,300 patients per week.

Midwest Medical Edition

One of Sanford’s most important enhancements with its Ghana clinics is implementing one of the first Electronic Medical Record (EMR) platforms in that country. The EMR ensures patients’ records and history are immediately accessible.

“Now no matter which clinic they go to, we have a patient chart,” says Mays.

Sanford’s World Clinics initiative also concentrates on empowering and educating medical professionals to do their job. Sanford provides training to help make up for a lack of standardization of medical education in the area.

World Clinics officials provide standardized financial and operational processes, and needed supplies and equipment. They also teach infection prevention and control, medication administration, assessment skills and standard treatment guidelines to protect patients who come through the doors.

“We work to institute a culture of safety,” says Mays. “We’ve been fortunate to build an administrative team to lead our operations and clinical services locally. They want to give back to their country and improve the care provided there.”

A long-term goal is moving beyond treating the urgent cases – malaria, skin infections, respiratory tract issues, wounds and diarrhea – to do real preventive work, she says.

A new initiative will be piloted at one of the clinics later this year to offer pre-natal and reproductive health services for women. By

September / October 2013

The staff of the Mankessim clinic

offering education and standardized medical care prior to giving birth, the clinics can start encouraging more preventive care and reach out to more women and families.

“We are doing great things in Ghana, working the way we need to, taking small steps,” says Mays. “We’ve laid foundations and we’re teaching. You drop one pebble in the water and see the ripples it creates.” ■

MidwestMedicalEdition.com

27

By Kathleen Christiansen

Health Information Exchange: A (Relatively) Painless Option

B

y now, most providers are well aware of the goals and challenges associated with Health Information Exchange (HIE) and managing Electronic Health Records (EHRs). You have probably read the articles, heard the success (or otherwise) stories, and done some research. You have undoubtedly considered the challenges of implementing and upgrading your own IT system and you may be feeling a little overwhelmed.

Two options that can help make the road toward smother exchange of information a little less bumpy are South Dakota Health Link’s Point of Care Exchange and/or DIRECT Services. A program of the South Dakota Health Department, South Dakota Health Link is a network that electronically connects hospitals, federally-qualified health centers, primary care providers, specialists, labs and pharmacies in the South Dakota region.

The Point of Care Exchange, Health Link’s real-time query-based exchange service, enables providers to find information on

a patient from other connecting clinics, potentially improving efficiency by: ◆ Connecting participating providers in real

time with a limited set of information from their patients’ electronic patient chart across a secure network ◆ Providing critical information immediately – whether during a routine visit or medical emergency, eliminating the need for phone calls, faxes and mailing of charts and records ◆ Streamlining office processes away from traditional paper-based systems, reducing the chance of errors and improving efficiency Similarly, Health Link’s DIRECT is a secure and efficient state-wide messaging service that allows for the exchange of referrals, reports, and other patient care documentation between providers who know each other and have a relationship of trust. Over 700 providers at 49 South Dakota

From Of

ved were ser e W Message ers on suit pap today. a patient

Phone E-mail

healthcare facilities, including 17 ambulatory, 12 behavioral health, 11 long term care, and 9 hospitals, are now using DIRECT to help meet Meaningful Use Stage 2 requirements.

The DIRECT messaging service allows hospital to distribute action lists with the summary of care files upon discharge to referring physicians or caregivers with the confidence that the message will be securely received.

From the clinic side, providers (radiology, clinics, and labs) are able to work around the EHR interfacing obstacle by sending and receiving messages through DIRECT. DIRECT allows clinics to receive referrals and authorizations and transmit result messages to any organization with a DIRECT address.

Qualified South Dakota medical providers are eligible to receive free DIRECT messaging through 2014. This includes both new and current South Dakota Health Link DIRECT users. ■ Kathleen Christiansen is the HIE Management Analyst for South Dakota Health Link.

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8/8/13 5:36 PM

Midwest Medical Edition

Protein at Breakfast Helps with Satiety throughout the Day

By Holly Swee, RD, LN

P

rotein is a powerful nutrient that is

important not just at dinner, but throughout the day. Recent research published in the American Journal of Clinical Nutrition suggests that eating a protein-rich breakfast, including high-quality proteins like beef and eggs, leads to improved appetite control and satisfaction throughout the day, which could help combat obesity. For example, study participants who consumed a high-protein breakfast experienced a significant reduction in unhealthy evening snacking.1 Animal proteins – such as lean beef – are complete highquality proteins that contain all the essential amino acids your body needs for optimal health. Even better, a 3-oz serving of lean beef is about 150 calories on average and provides about half (48 percent) of the Daily Value for protein.

Lean beef is also a naturally rich source of 10 essential nutrients and is a perfect partner for everyday breakfast favorites like whole grains, fruits, vegetables and low-fat dairy, making it a simple way to start your day in a balanced way. 2 To access the study, go to: http://www.ncbi.nlm.nih.gov/ pubmed/23446906. To learn more about lean beef’s nutritional benefits, please visit BeefItsWhatsForDinner.com or BeefNutrition.org. ■ Holly Swee is Director of Nutrition & Consumer Information with the SD Beef Industry Council.

1 Leidy HJ, Ortinau LC, Douglas SM, Hoertel HA. Beneficial effects of a higher-protein breakfast on the appetitive, hormonal, and neural signals controlling energy intake regulation in overweight/obese “breakfast-skipping” late-adolescent girls. Am J Clin Nutr 2013 Feb 27 [Epub ahead of print].

2 U.S. Department of Agriculture, Agricultural Research Service, USDA Nutrient Data Laboratory. 2012. USDA National Nutrient Database for Standard Reference, Release 25. Available at: http://www.nal.usda.gov/fnic/foodcomp/ search/.

Regional HealtH

Recognized for Best Practices

Congratulations!

Several Regional Health employees were selected to share their research and best practices with health care professionals from throughout the United States at the 2013 Premier Breakthroughs Conference and Exhibition in San Antonio, TX.

Premier Presenters

susan mcKinney, rn, eICU Quality Coordinator, Rapid City Regional Hospital, Using Protocols to Standardize Care Across South Dakota -Our Story sandra Ogunremi, DHA, Administrator / Proj Mgmt, Regional Health Physicians, Creating a Lean System and Improving Overall Satisfaction Lynn simons, Director of Patient Services, Sturgis Regional Hospital, Continuity of Care = Improvement in Patient Satisfaction and Quality Pat Herr and susan mcKinney, rn, eICU Quality Coordinator (Susan McKinney), Avera (Pat Herr) / Rapid City Regional Hospital (Susan McKinney), Relationships? How to Build Successful Relationships Between Remote Teams Denise stover, Director of Clinical Informatics, Regional Health, Modified Early Warning Score (MEWS) - What’s your patient’s number? sandra Ogunremi, DHA, Administrator / Proj Mgmt, Regional Health Physicians Onboarding and Orientation = Physician Satisfaction and Retention James Keegan, mD, Regional Health, Leading the Country (Top 1%) for Pneumonia Readmission Success Factors Daniel mendez, Director of Education and Development, Regional Health, Hardwiring Organizational Performance Standards: Creating a Culture of Accountability

Premier POster BOArD Presenters

sarah Blenner, Assistant Director of Obstetrics, Rapid City Regional Hospital, Photo Bytes

Kathleen Jedlicka, Discharge Call Nurse, Rapid City Regional Hospital, Post Discharge Calls Lori Lewis, Data & Training Specialist, Rapid City Regional Hospital,Improving Employee Health Processes susan mcKinney, rn, eICU Quality Coordinator, Rapid City Regional Hospital, When Seconds Count-Establishing Hospital-Wide Screening Tools For Sepsis rita Haxton, Vice President of Patient Care, Rapid City Regional Hospital, A Local Development Initiative to Improve Mental Health Care Access Vivian Derby, Clinical Quality Coordinator, Rapid City Regional Hospital, Geriatric Fracture Program: Getting the Right Crew on the Ship Cecil LaGrande, Supervisor of IT Technical Services Help Desk, Regional Health, How Helpful is Your Help Desk tammy Burke, Clinical Informatics Specialist, Regional Health, Use What You’ve Got to Get What You Want! sonja Love, Clinical Informatics Coordinator, Regional Health, Carpe Diem with the Physician randee mason, Director of Clinical Integration, Regional Health, Growth and Evolution of a Transitional Care Program Barbara Drapeaux, Supervisor of Clinical Operations, Regional Health Physicians, Co-Piloting for Patient Care

MED Quotes “ Asthma is a disease that has practically the same symptoms as passion except that with asthma it lasts longer.” —Author Unknown

September / October 2013

www.regionalhealth.com/premier

MidwestMedicalEdition.com

19860-0813

29

The Nurses’ Station Nursing News from Around the Region

The annual South Dakota Nurses Association

Fact:

According to data from the Bureau of Labor Statistics, nurses are at higher risk that construction laborers to sustain work-related musculoskeletal disorders. In addition, the increased use of computers, both at work and at home, has increased the risk of cumulative trauma disorders (also called repetitive strain injuries).

Source: Bureau of Labor Statistics, www.bls.gov

Convention will take place October 6 – 7 at the Ramkota hotel and Convention Center in Aberdeen, SD. This year’s theme is “All Aboard the Hub City Express for a Glimpse into the Future of Nursing”. Visit our website at www.

MidwestMedicalEdition. com for a calendar of upcoming events for health professionals.

Rapid City Regional Hospital Announces Mickelson Award for Nursing Winner | Marie Fullenkamp recently received the 2012 George S. Mickelson Award for Nursing Excellence at Rapid City Regional Hospital (RCRH) .

Fullenkamp works as a Hospice Registered Nurse and has been employed at the hospital for 15 years.

Fullenkamp’s commitment to her profession and desire to continue to learn and grow led her to work in the Home Care division. Her strong assessment skills, calm, and insight have earned her a reputation as a respected resource in Home Care. Fullenkamp is recognized as a teacher and mentor for new employees, nursing students and medical students.

RCRH managers nominate nurses to receive this honor. All nurses, except nursing administrators and managers, are eligible to receive the award. The award was established in honor of Gov. George S. Mickelson and seven other distinguished South Dakotans who died in a plane crash in 1993. Fullenkamp was honored at a recent employee celebration. ■

30

Gunwall Honored with Rapid City Regional Hospital’s

DAISY Award for Nurses

Greg Gunwall has received a DAISY Award for Extraordinary Nurses at Rapid City Regional Hospital (RCRH). He has been a Registered Nurse in the Orthopedic, Neurology, and Surgical Unit for four years.

Gunwall was nominated for the award by a patient’s family. The nomination stated Gunwall kept the family informed during the patient’s treatment, updated them on what the medical equipment was recording, what the treatment was, and what results were expected.

DAISY is an acronym for “diseases attacking the immune system.” The DAISY Award was established by the DAISY Foundation in California in memory of J. Patrick Barnes who died at age 33 of an autoimmune disease. The Barnes family was so touched by the clinical skills, care and compassion of the nurses who cared for Patrick, they created this award to say thank you to nurses everywhere. The DAISY Award has grown into an ongoing recognition program in partnership with healthcare organizations, now in seven countries, celebrating the extraordinary skill and compassion nurses bring to patients and families every day.

RCRH honors one extraordinary nurse each month with a certificate, pin, tote bag and a Healer’s Touch sculpture hand carved by artists of the Shona Tribe in Africa. ■

Midwest Medical Edition

Building Miracles for Kids is dedicated to making a positive difference in the lives of sick and injured children. Our goal is to bring everyone in the community and building industry together to help us build a miracle home. The proceeds of the sale of the home will be donated to the Children’s Miracle Network at Sanford Children’s Hospital. Building Miracles for Kids aims to help the most important people in our community: the children.

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Grape Expectations

To Serve Like a Pro, Consider the Temp

By Heather Taylor Boysen

S

erving wine should be easy.

After all, you just need to open the bottle and pour into a glass right? It would be so much easier if wine labels gave you instructions on the proper serving techniques of whatever is in the bottle, but I’ve yet to see a bottle with that amount of detail on the label. I’ve had debates with fellow oenophiles regarding the proper use of stemware and whether to decant a wine or not. But the one thing I will not compromise on in any debate is the proper serving temperature of wine.

The serving temperature of wine greatly influences the aroma, body and flavor of whatever wine is in your glass. Serving a wine too warm can lead to only tasting the alcohol and bitterness in the wine, while serving it too cold will mask the acidity or sweetness. Many people serve their white wines too cold and their red wines too warm, but it is a problem that is easily fixed.

Room temperature should never be taken into consideration when determining what the proper serving temperature is for wine.

The idea that wine should be served at “room temperature” actually comes from medieval Europe. During that period of European history when winemaking knowledge grew and people began passing around texts of their knowledge, a chateau or estate’s “room temperature” was most likely in the range of 50-65 degrees. Since most of us don’t live in a cold, drafty castle, most room temperatures today are more in the 68 to 70 degree range.

This is at least 5 degrees warmer than any bottle of red should be served.

Not only must one take into consideration room temperature, but a refrigerator can also greatly influence the flavor of wine. A standard refrigerator at proper temperature is between 35 and 38 degrees which is almost

32

10 degrees colder than the appropriate serving temperature for any white wine. The actual temperature spectrum for serving wines ranges between 45 and 65 degrees, so you can see how room temperature and refrigerator temperature can really wreak havoc with serving temps!

An obvious solution to the temperature dilemma would be to purchase a wine refrigerator that can be zoned internally to accommodate whatever wine you choose to put in the fridge. If you don’t have the space for a wine refrigerator, here are a few rules of thumb: Bold red wines such as Cabernet Sauvignon, Bordeaux, Shiraz/Syrah and Rhone wines can handle a serving temperature up to 65 degrees. Pinot Noir, Chianti, Beaujolais and Zinfandel should be served at temps between 55 and 60 degrees. At home, I often put our red wines in the fridge anywhere from 30 to 45 minutes prior to serving.

This will impart a little chill and get rid of unwanted or what I call “hot alcohol” flavors and aromas in the wine.

This is particularly important when you have a red wine with high alcohol content. It will significantly reduce that burning feeling you might get that feels like you’ve just taken a shot of vodka!

If you feel you’ve chilled your red too much, just let it warm up in the glass a little bit and enjoy.

Full bodied whites such as Chardonnay should be served at around 50 to 52 degrees. If these big whites are served too cold, all of the wonderful creamy and buttery flavors will be muted and the true flavor will not be revealed. If it is a Chardonnay that has

temperature “ofThewineserving greatly influences the aroma, body and flavor of whatever wine is in your glass.

”

been fermented in stainless steel vs. oak, then the temp can be reduced a few more degrees as they handle colder temperatures better than the oaked products.

Lighter whites including Sauvignon Blanc, Chablis and Pinot Gris/ Grigio can handle colder temperatures as well and a cooler serving temperature will complement the lively zip of these whites. About 45 degrees is a good serving temperature for these varietals. Sparkling wines including Champagne, Moscato and Prosecco as well as still dessert-style wines are lovely served chilled to around 40 to 45 degrees. If you have kept your white wine in your refrigerator prior to serving plan on taking them out about 15 minutes before you serve them so they are not too cold. ■

Midwest Medical Edition

Learning Opportunities September — October September 13 8:00 am – 4:00 pm Diabetes Care Conference

October 4 8:00 am – 4:40 pm 13th Annual Child Abuse Conference

Location: Sanford Center, Sioux Falls Information: Rhonda.jensen@sanfordhealth.org Registration: www.sanfordhealth.org

Location: Ramkota Conference Center, Sioux Falls Information: Elizabeth Groff, 605-333-2200 Registration: www.sanfordhealth.org

September 18 – 20 SDAHO Annual Convention

October 4 8:00 am – 4:15 pm 2013 Avera Women’s Health Conference

Location: Sioux Falls Convention Center Information: www.sdaho.org, 605-361-2281

September 19 & 20 Upper Midwest Regional Pediatric Conference

Location: Prairie Center, Sr. Colman Room Information: mckeducation@avera.org Registration: 322-8950, www.Avera.org/conferences

October 5 8:00 am – 3:00 pm Sanford Cardiovascular Symposium

Location: Marina Inn Conference Center, South Sioux City, NE Information and Registration: www.umrpconference.com

Location: Sanford Center Information: www.sanfordhealth.org, keyword: cardiovascular symposium

September 27 Palliative Care Conference Location: UnityPoint Health – St. Luke’s, Sioux City, IA Information and Registration: www.unitypoint.org/ professional-education

October 11 8:00 am – 4:30 pm 2nd Annual Sanford Genomic Medicine Symposium: Bringing Genomic Medicine into Clinical Practice

September 27 - 28 8:00 am – 4:30 pm, 8:00 am – 12:30 pm Avera Cancer Institute 14th Annual Oncology Symposium

Location: Sanford Center, Dakota Room Information: cath.roling@sanfordhealth.org Registration: 605-312-6094, www.sanfordhealth.org

Location: Prairie Center Information: mckeducation@avera.org Registration: 322-8950, www.Avera.org/conferences

October 25 Perinatal Clinical Update

October 3 5:30 pm – 7:00 pm Medical Provider’s Role in the Identification of Human Trafficking Victims Location: Sanford Medical Center, Board of Governors Room Information: connie.k.schmidt@sanfordhelath.org Registration: 605-333-2200

Location: Sanford USD Medical Center, Schroeder Auditorium Information: Priscilla.jurkovich@sanfordhealth.org, 605-328-6349

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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.

Sanford Center for Digestive Health

The largest most experienced team in the region.

We offer a full-scope of gastroenterology care and services.

Our 9 fellowship-trained, board-certified gastroenterologists and 5 APPs specialize in the prevention, diagnosis and treatment of disorders of the pancreas, gallbladder, esophagus, liver, stomach, small intestine and colon.

• Colorectal Cancer Screening • Celiac Disease • Inflammatory Bowel Disease • Digestive Disorders • Liver and Pancreas Disorders • Reflux Disease • Chronic Diarrhea and Constipation Turn to Sanford Center for Digestive Health for a level of specialty services unmatched in this region.

Choose Expert Care. Call (605) 328-8500 to refer a patient. sanfordhealth.org 500-54200-0147 8/13

Left to Right: Troy Schmidt, MD, Khalouck Abdrabbo, MD, Philip Tanner, MD, Heather McDougall, MD, Jorge Gilbert, MD, Muslim Atiq, MD, Brett Baloun, MD, Lee Austin, MD, Jeffrey Murray, MD.

Sanford Center for Digestive Health 1205 S. Grange Avenue Suite 104 Sioux Falls, SD 57105 Monday–Friday 8 a.m. – 5 p.m.