Prostate Brachytherapy in the Spotlight What to Consider Before Hiring a Scribe
SIOUXLAND’S INFECTIOUS DISEASE Ashlesha Kaushik, MD CRUSADER UnityPoint Health–St. Luke's THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS
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2021
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VO LU M E 12 , N O. 5 ■ J U LY / AU G U S T 2021
Inside This Issue
CONTENTS PAGE 7 | [Sponsored Content]
“We’re doing more with less, working smarter and harder . . . and we're still struggling to get ahead, stay ahead, and continuously improve.” ■ By Amini
ON THE COVER
Siouxland's Infectious Disease Crusader: Ashlesha Kaushik, MD ■
By Alex Strauss
Pediatric infectious disease specialist Ashlesha Kaushik, MD, is committed to helping parents and providers around the world protect kids against infection, now and in the future. PAGE
10
PAGE 8 | This Month Online Exclusive online articles, Upcoming events, How MED can help you keep your office cleaner, What it's like to work with an independent research firm PAGE 13 | New Specialty Hospital Will Fill a Care Gap Highlighted by COVID-19 The Rehabilitation and Critical Care Hospital of the Black Hills will offer a new way for patients to get back on their feet after serious illnesses. PAGE 14 | [Interview]
Daniel Petereit, MD: The New Approach to HDR Brachytherapy at Monument Health PAGE 16 | NEWS & NOTES PAGE 20 | Points to Consider Before
You Hire a Scribe for Your Practice ■ By Copic
Hiring a scribe might save time but it could also create some unexpected headaches. PAGE 22 | Looking for a Financial
Advisor? Here are the questions you should be asking
FROM US TO YOU
CONTACT INFORMATION
2021 ADVERTISING DEADLINES
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W
elcome to the summer edition of MED Magazine. Whether you're hard at work this month or enjoying some down time, you can count on MED to make sure you don't miss a thing. In this issue, we feature an extraordinary Siouxland doctor committed to protecting the nation's children against the threat of infectious diseases. The experts at Copic weigh in on the pros and cons of hiring a scribe for documentation assistance in the medical office. And we talk to a Black Hills physician who is bringing prostate brachytherapy back into the spotlight in South Dakota. We'll also introduce you to Amini, a new Sioux Falls company committed to helping healthcare organizations identify what's holding them back and position themselves for sustainable growth. Finally, as always, we have your roundup of the latest news and events, and a collection of articles and information you'll find only on our website. Until September, —Alex & Steff
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MED & MEDICINE EXPLORING. ADAPTING. EVOLVING. EXPANDING.
JUN E
icited How to Handle Unsol ts Test Resul ol Finding Infection Contr Knowledge Gaps Now Birth Tissue Donation a Available in South Dakot
In today’s healthcare environment, the only constant is change.
2021
Coping with Compassion Fatig ue Protecting Your Prac in the Age of Teleh tice ealth
Jacob Weasel, MD, General Surgeon
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ARE PRO FESS
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At MED, we get that. As the region’s foremost source of up-to-the-minute medical community news and information, we’re constantly growing and evolving to serve you better. Through our print and digital publications, interactive website, and curated news distribution in South Dakota, North Dakota, and (coming soon) Nebraska, we’re reaching into more regions, providing more news, to more providers than ever before.
VOL. 12 NO. 4
[ S P O NS O R E D C O N T E N T ]
We’re doing more with less. We’re working smarter and harder. . . . and we are still struggling to get ahead, stay ahead, and continuously improve. BY AMINI
“T
HESE ARE COMMON experiences for our clients”, says Carl Richardson, founder of
Amini, a company new to South
Dakota, started with the purpose of helping healthcare organizations of all sizes address factors that are limiting their growth. “Healthcare has experienced great disruption. The most visible effect has been a significant reduction in operating dollars, resulting in teams being asked to do more with less. The effects are challenging.” Richardson says stress levels are up among healthcare workers. Some feel they are losing traction, forced to
Richardson offers this example from a recent project:
operate in reactive mode, and are
agreement. The pre and post metrics from weeks of performance proved to leadership they could annually capture $2.2 million
unable to get in front of the many
A large multi-specialty clinic had been
of revenue that they were simply missing
undesirable new realities. Organiza-
open for 3.5 years and was ending every
out on. The VP of the facility stood up in
tions may be aggressively pursuing
year significantly in the red. We deployed
a leadership meeting, shared what we had
new ideas to get ahead of the situation
a team to work in operational roles that
achieved, and stated that we were the best
but, in many cases, their efforts aren’t
gave us great exposure to all influencing
thing that had happened to them since the
working.
factors. We evaluated dashboard reports,
day they opened the doors.
“This is the big problem we focus
metrics, workflows, team dynamics,
on solving,” says Richardson. “Most
patient experience and much more, from
“Factors that limit growth are
people and organizations seek
start to finish. We discovered the real prob-
prevalent and the nature of organi-
improvement through new ideas.
lem-drivers were out of view, measurable
zations and people is to tolerate
Very few take the time needed to
data was not being captured on these
them,” says Richardson. “If you don’t
identify and correct what’s holding
drivers, and consequently, dashboard
address these factors, your organi-
them back. Limiting factors tend to
reports were not facilitating impactful
zation can slowly choke. But if you
accumulate and entrench. Removing
decisions.
do address them, you can unleash
them can be difficult but can have
Our team addressed every component
huge return on investment. This is
of this problem all the way through to
Initial assessments with Amini are
our specialty and we have been doing
execution of reengineered processes. For
free. Learn more at www.amini.co or
it successfully in Twin Cities health-
the first time, the client operational team
by contacting Carl Richardson at carl.
care for twenty-three years.”
met and exceeded their service level
richardson@amini.co. ❖
July / August
growth. That’s where we come in.”
7
THIS MONTH ONLINE Highlighting content and opportunities available exclusively at MidwestMedicalEdition.com
Upcoming
EVENTS July 21 2021 Mayo Clinic Quality Conference: Ensuring Quality, Safety & Equity in a Virtual Era LIVESTREAM Information: ce.mayo.edu
July–October
A Variety of Mayo Clinic virtual CME events. Check the MED website for times and topics
August 27 8:00 am–4:30 pm Sanford Diabetes Care Conference Location: Sanford Center, Sioux Falls Information: SanfordHealth.csod.com
September 22–24 8:00 am–5:00 pm SDAHO Annual Convention Location: Sioux Falls Convention Center
Website Exclusive: BACK TO BASICS: Yankton Medical Clinic Doctor Helps Research New Drugs for Omaha Company When patients visit Dr. Charles Harper at Yankton Medical Clinic’s (YMC) Norfolk office, most have no idea he helped test many of the medicines they rely on, including the COVID-19 vaccines from Pfizer, Novavax, and Moderna. In addition to being an internal medicine specialist with YMC, the Nebraska native is an independent contractor with Omaha-based Meridian Clinical Research. Meridian partners with pharmaceutical and biotechnology companies to research new drugs, medical devices, and diagnostics. Founded in 1999 by CEO Nicole Osborn, Meridian has become a trusted name in clinical research. Dr. Harper was a principal investigator for Pfizer and Novavax coronavirus vaccine studies in Norfolk, and a sub-investigator for
Information: SDAHO.org/convention
the Moderna clinical trials. He said that during his five years with
October 12
equally vital — medications.
7:30 am–5:00 pm Monument Health 23rd Annual Cardiovascular Disease and Wellness Symposium Location: The Monument, Rapid City Information & Registration: monument. health/cardiovascularsymposium
Meridian he has also studied a number of more ordinary — but “It’s a lot of fun and has been great for me, professionally,” says Harper. “I’ve learned so much about research. A drug representative will visit YMC and start telling me about a new drug and sometimes I’ll be able to tell them even more about that medication because I did the study!” In addition to the COVID-19 vaccine research, Dr. Harper recently wrapped up a diabetes drug study. He is currently involved in the study of a new Holter monitor for atrial fibrillation and will begin researching a new treatment for
For a list of upcoming live and virtual events in the region, check out MED’s online calendar at MidwestMedicalEdition. com/calendar You can also add your own events for free!
8
migraines. He also expects to start another vaccine study soon.
Read more about how Dr. Harper balances his busy practice with his work at Meridian in the full version of this article on our website.
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January / February 2019
9
SIOUXLAND’S INFECTIOUS DISEASE
CRUSADER ASHLESHA KAUSHIK, MD
F
EW PHYSICIANS IN THE COUNTRY KNOW MORE about COVID-19 infection in children and teenagers than UnityPoint Health-St. Luke’s Pediatric Infectious Disease specialist Ashlesha Kaushik, MBBS, MD, FAAP.
Last summer, while the rest of the world was still trying to wrap its head around
the scope of the pandemic and ICUs across the country were filling up with sick patients, Kaushik was already publishing papers on multisystem inflammatory syndrome (MIS-C), one of the most serious illnesses caused by SARS-CoV-2 infection in young patients. Kaushik, winner of the CDC 2019 Childhood Immunization Champion Award, also serves as the hospital’s Director of Antimicrobial Stewardship. In the past year, she has published 13 papers and abstracts, including a report on UnityPoint
BY ALEX STRAUSS
10
Health’s impressively low COVID-19 mortality rate and a systematic review of MIS-C in the Pediatric Infectious Disease Journal, which has become one of the most
MidwestMedicalEdition.com
referenced articles on the
20 media interviews with news
mitigating staff shortages, risk
subject.
outlets around the world.
assessment, and infection con-
When she is not working on
She’s also spreading the word
trol principles. Participants have
her own research, she is often
as one of ten national faculty
the chance to share and discuss
reading the research of others as
members for the CDC Project
cases and get answers to their
a peer reviewer for 35+ medical
Firstline/AAP Infection Preven-
questions.
journals and the Pediatric Aca-
tion and Control Extension for
“I have really loved my roles
demic Society’s annual meeting.
Community Healthcare Out-
of educating not just my imme-
Dr. Kaushik’s work earned
comes (AAP IPC ECHO) program.
diate patients and family, but
her nominations to the presti-
The program aims to provide
also all of those providers nation-
gious New York Academy of
pediatricians and pediatric pro-
ally and parents all around the
Medicine and the Midwest Soci-
viders with the most up-to-date
world,” she says. “It has been an
ety for Pediatric Research and
information on infection preven-
amazing journey.”
an elected position as an over-
tion and COVID-19 control.
seas fellow of the Royal Society of Medicine, UK.
appreciative and enthusiastic
FOR THE LOVE OF MEDICINE
“Providers have been so
“Research and publication are
about this,” says Dr. Kaushik.
That journey started early for
my personal passions,” says Dr.
“This is really needed education.
Dr. Kaushik who grew up in an
Kaushik. “Clinical investigation
It is still a very new pandemic for
“intellectually stimulating” home
is what I usually do.”
all of us and we are trying to
in India. Her parents, both pub-
make sure that we are following
lished authors themselves, tell
the latest CDC guidance and
her she was “examining” her
doing evidence-backed things.”
stuffed animals at three years
SPREADING THE WORD ABOUT SPREADING INFECTIONS
In a series of live webinars,
old, recruiting friends to be her “nurses”.
In fact, Dr. Kaushik has a lot of
Kaushik and her fellow faculty
personal passions. Almost all of
members share the latest on PPE
“I was always the doctor,” she
them revolve around fighting the
use, preventing transmission,
recalls. “That’s all I wanted to be.”
bugs that threaten human health. “Antimicrobial stewardship is really the need of the hour,” says Kaushik. “Antibiotic-resistant microbes are becoming a bigger threat globally because of overuse. We have to continue to share the basics of infection control and the principle of using the most narrow antibiotic possible for the problem.” The message has hit home for UnityPoint Health-St. Luke’s, which has reduced its own antibiotic use by 50 percent in the last three years. Now, Kaushik has committed herself to sharing the message in an even bigger way. A member of the Board of Directors of Iowa’s Chapter of the American Academy of Pediatrics (AAP), she was appointed last year as a national spokesperson for the AAP. Since then, Dr. Kaushik has conducted more than
July / August
11
“All of the strides that we have made in fighting infectious diseases is because of belief in science.” Dr. Kaushik developed a passion for pediatric infectious disease during
Leadership from Harvard Medical
this and any future pandemics. Her
School.
message to her medical colleagues
her medical training at Sawai Man
Dr. Kaushik says she was attracted
locally and around the world is
Singh Medical College and Hospital
to Siouxland for the opportunity to
twofold: limit antibiotic use and
in India, where she regularly saw
not only bring pediatric infectious
advocate for vaccines.
patients with vaccine-preventable
disease expertise to the area, but also
“Antibiotic use is a lot more judi-
illnesses like measles. After gradu-
the chance to support antimicrobial
cious now than it used to be and that
ation, she completed her residency
stewardship at UnityPoint Health and
is commendable,” acknowledges
at New York’s St. Joseph’s Regional
to take part in medical education. She
Kaushik. But she warns physicians
Medical Center and went on to a
is now a Clinical Assistant Professor
not to let their guard down. “We need
pediatric infectious disease fellow-
of Pediatrics at the University of Iowa
to continue to be mindful of using
ship program at the University of
Carver College of Medicine and is a
the right antibiotic for the right bug.
Texas Southwestern Medical Center
resident preceptor at the Siouxland
If you have to start with a broad-spec-
in Dallas.
Medical Education Foundation.
trum, if you don’t grow anything on
“I was so fortunate to be selected
tious diseases,” she says. “It was an
PHYSICIANS AS THE FRONT LINE OF DEFENSE
incredible opportunity.”
for a fellowship with some of the founding fathers of pediatric infec-
the cultures then always narrow down.” While not every infection is preventable, Kaushik says primary care
Dr. Kaushik lives her belief that edu-
doctors should not underestimate
The final piece of her education
cation —of providers, patients, and
their role in driving vaccinations for
was a certification in Pediatrics
parents— is the way forward through
those that are, including COVID-19. “A strong word from the pediatrician has been shown to be a powerful tool for countering misinformation,” says Dr. Kaushik. “Patients trust their doctors and look to them for advice. So give them facts and details. Say ‘I advise this vaccine’ rather than saying ‘Would you like to get this vaccine today?’ Advise them up front. Then, if they have questions, you can counsel them.” And to fellow healthcare providers who have worked so hard during this difficult year and are alarmed and frustrated
by
what
Kaushik
calls a “second pandemic” of misinformation, she has these words of encouragement: “We need to remember that all of the strides that we have made in fighting infectious diseases is because of belief in science. That’s what we have to focus on.” ❖
12
MidwestMedicalEdition.com
New Specialty Hospital Will Fill a Care Gap Highlighted by COVID-19
B
LACK HILLS area patients
Director. “We haven’t really had a
16 to 36 beds. The new facility will
who are ready to transition
great way to help patients get back on
include perks like a therapy garden,
out of the ICU but are not
their feet.”
more space for gym equipment,
quite strong enough for
When the hospital is no longer
kitchen and laundry facilities, and
rehabilitation will soon have a new
the best place for them, many of
more places for patients to safely
option in Rapid City. Monument
these patients have had to travel to
practice everyday tasks like navigat-
Health has announced that it will
long-term acute care facilities in Bill-
ing stairs and uneven surfaces.
partner with national company
ings, Bismarck, Lincoln, Sioux Falls,
Vibra Healthcare to build the area’s
or Denver.
While Monument Health is experienced at offering rehabilitation
first long-term acute care hospital
“That just breaks your heart to
services, their LTACH knowledge was
(LTACH) and expanded rehabilita-
see,” says Dr. Stacy. “Having an
limited. Longacre says partnering
tion facility.
LTACH here means that these
with Vibra Healthcare will not only
After the initial acute phase of
patients can get the higher level of
shorten the learning curve, but may
their recovery, patients who have
care they need and we don’t have to
also make it easier to staff the new
suffered from things like stroke,
send them away where there is no
facility.
heart attack, brain and spinal cord
family support.”
“We are going to need more phy-
injuries, and neurological diseases
“This was a need before the pan-
sicians and care staff and we don’t
often move on to intensive (at least
demic but the pandemic definitely
have staff that is skilled on the LTACH
three hours a day) acute medical
amplified it,” says Mark Longacre, Vice
side,” says Longacre. “Vibra’s national
rehabilitation.
President of Operations for Monument
presence means they have a better
But for people who are not healthy
Health in Rapid City. “We serve
reach in terms of attracting caregiv-
enough to tolerate that level of reha-
patients in about a 300 mile radius
ers. There may be people who want
bilitation, such as patients who have
and we hear a lot of stories about the
to transfer from other places to work
been on a ventilator in the ICU for
stress on families when they have to
in the Black Hills. Having a national
weeks, there has been no appropriate
travel. We realized that this was an
partner will help us find them.”
intermediate option locally.
important service that could be a huge
“As providers we have really
benefit to our community.”
Construction on the 55,000-square foot Rehabilitation and Critical Care
struggled with this,” says primary
In addition to 18 LTACH beds, the
Hospital of the Black Hills is expected
care physician Kelly Stacy, MD, Mon-
new facility will also expand Monu-
to begin this fall with a goal of open-
ument Health Executive Medical
ment’s rehabilitation capacity from
ing in 2023. ❖
July / August
13
[ INTERVIEW ]
Daniel Petereit, MD THE NEW APPROACH TO HDR BRACHYTHERAPY AT MONUMENT HEALTH
R
ADIATION ONCOLOGIST DANIEL PETEREIT, MD, and his team recently performed South Dakota’s first high-dose-rate (HDR) prostate brachytherapy treatments using real-time, ultrasound-based planning. The Monument Health Cancer Care
Institute is currently the only site in South Dakota offering this type of comprehensive prostate brachytherapy, both HDR and low-doserate (LDR), for men with various stages of prostate cancer. We spoke with Dr. Petereit about his decision to begin offering HDR prostate brachytherapy again after a 15 year hiatus.
MED: How does the new HDR brachytherapy system differ from what you were doing before?
to speed so they can do more brachytherapy, not only for prostate cancer but for gynecological cancer, too. I think another problem is that too many patients do
Photo courtesy Monument Health.
not have the opportunity to con-
Dr. Daniel Petereit and Physicist James McKee with the new Oncentra Planning System for prostate brachytherapy.
MED: You have continued to offer LDR (low dose rate) permanent seed implants for men with less aggressive prostate cancer, but why did you stop offering HDR brachytherapy? DP: Fifteen years ago, we had to admit the patients to the hospital for one or two nights. They would have an epidural. Then they would have to have three or four separate
DP: The technology is such that
sult with a radiation oncologist
we don’t need to admit them or get
before they make a treatment
a CT scan on them or even move
decision.
them out of position to do both the planning and the treatment. With the patient asleep, we place the catheter into the prostate. We use a very sophisticated ultrasound-based planning system that
DP: We have very solid evidence
generates an immediate radiation
to suggest that one of the treat-
plan so that we can optimize dose
ments with a high chance for
distribution. We treat them and
cure is a combination of daily radi-
take everything out and they go
ation therapy with a brachytherapy
home. This treatment offers high
boost. When men don’t have
chances for a cure with less risk
access to quality brachytherapy
for both short and long term uri-
they lose one of the most effective
nary side effects.
treatment options. They also lose
MED: You are a recent past president of the American Brachytherapy Society. Why do you think more sites are not offering prostate brachytherapy?
treatments. It just got to be too
14
MED: Why do you think it is important that men in our region have this as an option?
one of the most convenient and cost-effective treatment options. NOTE: The HDR brachytherapy approach being offered at Monument Health is for patients with curable, but more advanced prostate cancer.
labor intensive. The reason we
DP: The biggest problem is that
Patients undergo four to five weeks
have gone back to this is that now
residents are not seeing enough
of daily radiation before they receive
we have the technology and equip-
volume to get sufficient experience
an HDR implant. This is also used as
ment and up to ten years of data
doing this. We launched a national
a treatment for patients who recur
that we can do it all in three hours
initiative about two years ago
after external beam radiation. ❖
and with fewer side effects.
designed to help get residents up
MidwestMedicalEdition.com
July / August
15
Happenings around the region
News & Notes
South Dakota | Southwest Minnesota | Northwest Iowa | Northeast Nebraska
AVERA Avera broke ground on Kirby Place at the Walsh Family Village in Sioux Falls in May. The Avera Foundation raised over $3.3 million to expand and renovate patient and family lodging adjacent to the Avera McKennan Hospital & University Health Center campus. Kirby Place will include 14 new guest rooms, more than doubling the current lodging. In addition to adding 6,500 square feet, this project will connect two of the three existing buildings at Walsh Family Village. When completed, there will be two facilities: Kirby Place and Ronald McDonald House Charities. The expanded and renovated facility will open in spring 2022. Avera has expanded the scope of its free Health Care Workers Stress Hotline to include any healthcare professional in South Dakota who might need someone to talk to about stress, anxiety, depression or other impacts caused by COVID-19 and other life events. Avera previously launched a free 24/7 Health Care Workers Stress Hotline for its own employees. It was modeled on a hotline developed to aid agricultural workers when flooding and other conditions led to difficult times in that industry. Calls are answered by a behavioral health counselor, and the hotline can be reached at 1-833-653-0515.
16
MONUMENT
SANFORD
Monument Health has expanded its Intensive Care Unit capacity, completing construction of six new ICU rooms at its Rapid City Hospital. The new rooms are a response to expanding demand for medical and surgical services, especially cardiothoracic surgery. The rooms are on the fifth floor of Rapid City Hospital in a newly remodeled and refitted patient care area. To accommodate more equipment, monitors and medical staff, the rooms are two to three times the size of a standard hospital room. In addition, the new rooms have extra oxygen lines and other infrastructure to allow for a higher level of care.
The Sanford Sports Complex has broken ground on 18 new outdoor turf fields south of Benson Road adjacent to Great Shots. The fields, which will all have lights, will host baseball, softball, soccer, lacrosse and other activities starting in 2022. Mammoth Sports Construction will be spearheading the 173-acre expansion that includes nearly 1.7 million square-feet of turf, making it the biggest turf field project in the United States. Sanford Health expects approximately a million visitors over five years to participate in tournaments, sports training programs and youth and adult league games.
Monument Health Custer Hospital is among the nation’s top 20 Critical Access Hospitals for patient satisfaction according to the National Rural Health Association. The association bases its top 20 Critical Access Hospital lists on a quality index, a patient perspective index, and an overall hospital strength index. Custer Hospital was named to the list of Top 20 hospitals based on its patient perspective index. The only other South Dakota hospital to make the patient satisfaction index was Avera Hand County Memorial Hospital in Miller.
Buck Sampson
Joann Leber
Mike Tirrel
Kim Kaufman
Pioneer Memorial Hospital & Health Services presented Employee Service Awards during Health Care Appreciation Week May 10th-14th. Maintenance Assistant Darrell (Buck) Sampson was the longest-serving employee at 40 years. Fifteen other employees including Housekeeper Joann Leber (35 years) and Director of Maintenance Mike Tirrel (30 years) also received awards. Activities Director Kim Kaufman, who has been with the organization since 2015, was recognized as 2021 Employee of the Year.
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SIOUXLAND Lorenzo Suter, BSN, MHA, DHA, is the new regional president and CEO of UnityPoint Health–Sioux City and senior vice president for UnityPoint Health effective July 19. Suter graduated from Western Kentucky University with a bachelor’s degree in nursing. He received a master’s in healthcare administration and a doctorate in healthcare administration from Vanderbilt University and the University of Phoenix. He most recently served as the CEO of Dupont Hospital in Fort Wayne, Indiana. Suter’s other experience includes being COO at Baptist Medical Center in San Antonio, Texas and VP of Operations at MacNeal Hospital in Berwyn, Illinois. UnityPoint Health recently won six awards at the 38th Annual Healthcare Advertising Awards for their 2020 marketing campaign featuring a “kid ambassador” delivering real, critical messages to consumers during the COVID-19 pandemic. UnityPoint also received a coveted “Best of Show” award for their commercial featuring the kid ambassador giving a pep talk to his stuffed animals on fighting COVID-19.
INDEPENDENTS The first patients under 12 received their vaccines on June 7th as part of the Pfizer COVID-19 Vaccine trial in children in Omaha. The research is being led by the Child Health Research Institute, a pediatric research partnership between Children’s Hospital & Medical Center and the University of Nebraska Medical Center. The pediatric study will evaluate the vaccine’s safety and efficacy in healthy children 6 months to 11 years old. Kari Simonsen, MD, MBA, pediatrician-in-chief at Children’s and chair of the UNMC Department of Pediatrics, will serve as site primary investigator. This global study will involve around 4,600 children. The Omaha site plans to enroll around 50. Vaccines will be administered at Children’s Specialty Pediatric Center led by Children’s Pediatric Infectious Disease specialists.
ALWAYS MOVING. Always improving.
We wake up every day to serve in the towns and places you call home. We’ve expanded our innovative care, expertise and access to always keep your patients moving. Because forward is the only direction we know.
REFER TO 605-217-2667, OPTION 7. CNOS.NET
❱ I ntrigued by something you’ve read here? Want to go deeper? Read the full versions of these and other recent news items on our website.
July / August
17
• Happenings around the region
News & Notes
Happenings around the region
Shayna KruseThoene, RN, has been awarded the 2021 Award for Nursing Excellence at Yankton Medical Clinic, PC. Nominations for the award are submitted by the nursing staff and reviewed by a randomly selected award committee. Kruse-Thoene has worked at YMC as a float nurse for nearly 3 years. The annual award was created in 2016 to recognize the contributions and hard work of nurses at YMC and is presented each year during May’s National Nurses Week. Past winners include Barb Aman, Kristie Jensen, Carole Schulte, Jean Binder, and Linda Hoffman.
Physician Assistant Rachel Leiseth has joined Prairie Lakes Ear, Nose, & Throat Clinic in Watertown. Leiseth earned her BS at South Dakota State University and her Master’s degree in Physician Assistant Studies at the University of South Dakota. She served in the South Dakota Army National Guard for six years while attending school.
After 10 ½ years at Dakota State University, Kevin Atkins has accepted a position as Outreach/Recruitment Contractor with Aledade, Inc. Atkins was most recently Director of the Center for the Advancement of Health Information Technology for HealthPOINT at DSU. He is a Certified Associate in Healthcare Information and Management Systems (CAHIMS) with 14 years of healthcare-related experience. Maryland-based Aledade is a value-based care network for independent primary care practices and community health centers. Over the next few months, Atkins will help expand Aledade's mission to strengthen primary care practices into the Dakotas.
Anthony Loewen, MD, a general surgeon at Huron Regional Medical Center has achieved board certification from the American Board of Surgery. Surgeons certified by the ABS have completed at least five years of residency training following medical school, met all ABS training requirements, and successfully completed a rigorous ABS examination process. Dr. Loewen earned his medical degree at the University of South Dakota’s Sanford School of Medicine and completed his residency at St. Joseph Hospital General Surgery in Denver. He has been with HRMC since last August.
I wish to have a princess tea party
Alora, 4
cancer
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MidwestMedicalEdition.com
Huron Regional Medical Center kicked off the HRMC Physicians Clinic expansion and medical imaging remodeling projects on June 14th. The event is the official start to a $9.3 million construction project which will transform the hospital’s multi-specialty clinic, located just south of the hospital, from a single-story structure to a two-level clinic and add 23,500 square feet of space to accommodate an additional 10 physicians. In July, HRMC assumes operations of Tschetter & Hohm Clinic, which has been the healthcare home for 1,000s of families in the region since it was founded after World War II. The second part of the project includes remodeling the imaging department to accommodate state-of-the-art MRI and 3D mammography. Huron Regional Medical Center has appointed Ruth Anne Brott, ASCP, certified medical laboratory scientist (MLS), as the new laboratory director. Brott has 31 years of lab experience, including managing all areas of a multispecialty clinic laboratory. She earned a BA from John Brown University in Siloam Springs, Arkansas and graduated from the Sioux Valley School of Medical Technology in Sioux Falls. Brott also holds an associate degree in Arts and Bible from Northwestern College in St. Paul, Minnesota. Prior to joining HRMC in May, Brott was the laboratory manager for the Grand Island Clinic in Grand Island, Nebraska. Board-certified family medicine physician Vincent Oyler, MD, has joined Huron Regional Medical Center. After graduating with an MD from the University of Texas (UT), Dr. Oyler completed his residency at UT Health Northeast Family Medicine in Tyler, Texas. Prior to joining HRMC, he worked at UT Health seeing patients in the hospital, emergency room and via telemedicine. Dr. Oyler is assuming the care of the patients of Dr. Mark Belyea, who is retiring after 38 years of caring for patients in the region. Destiny Finn, RN, has been promoted to quality risk management director at Huron Regional Medical Center. Finn has more than 20 years of experience working in healthcare, including patient experience coordinator in HRMC’s Birthing Center since 2019. Prior to joining HRMC, she worked in various nursing and leadership positions in the Black Hills including as a staff nurse at Sturgis Regional Hospital and acute care director at Spearfish Regional Hospital. Originally from Redfield, Finn earned her nursing degree from Huron University.
July / August
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• Happenings around the region
News & Notes
POINTS TO CONSIDER BEFORE YOU HIRE A SCRIBE FOR YOUR PRACTICE BY COPIC’S PATIENT SAFETY AND RISK MANAGEMENT DEPARTMENT
T
HE AVERAGE PHYSICIAN in an outpa-
Medical terminology
tient setting spends 1–2 hours an evening
Health Insurance Portability and
finishing their medical records.1 This has led providers to look for new ways to
decrease EHR frustration and improve patient interactions, while still maintaining personal satisfaction. Is a scribe a possible fix for documentation tasks? What should you consider before hiring a scribe? Is there a risk of introducing a scribe into the physician-patient experience?
KEY CONSIDERATIONS
Accountability Act of 1996 (HIPAA) Principles of billing, coding, and reimbursement Electronic medical record (EMR) navigation and functionality, as appropriate based on job description Computerized order entry, clinical decision support and reminders, and proper methods for pending orders for authentication and submission
The Joint Commission (TJC) released updated infor-
The amount of training will be dependent on a
mation2 in April 2020 about using scribes that identified
person’s experience and skills. TJC says that clarity
the following potential quality and safety issues:
regarding roles and responsibilities of a scribe should
Unqualified staff performing documentation
consider the following:
assistance Unclear role and responsibilities when providing documentation assistance Documentation assistants using the physician log-in rather than independently logging in to the EMR Failure of physicians or licensed independent practitioners (LIPs) to verify orders or other documentation entered during clinical encounter TJC also updated its definition of a scribe to say
• POLICIES AND PROCEDURES: Each organization should develop a policy/procedure regarding processes associated with personnel providing documentation assistance. Policies may include proper log-in procedures (such as prohibition of documentation assistants from using the physician or LIP’s log-in), the scope of documentation that may be entered, requirements for physician review of information and orders entered by the documentation assistant, and the order entry and submission process.
that “A documentation assistant or scribe may be an unlicensed, certified (MA, ophthalmic tech) or licensed person (RN, LPN, PA) who provides documentation assistance . . . consistent with the roles and responsibilities defined in the job description, and within the scope of his or her certification or licensure.” At a minimum, TJC noted that all persons performing documentation assistance have education or training on the following:
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• JOB DESCRIPTION : All organizations utilizing personnel to provide documentation assistance must have job descriptions that define the minimum qualifications to perform this function and the allowable scope of activities that can be performed. Job descriptions should also specify plans to periodically assess performance and continued competence. • ORDERS: All types of personnel performing documentation assistance may, at the direction of a physician or another LIP, enter orders into an EMR. The use of repeat-back of the order by the documentation assistant is encouraged, especially for new medication orders. Documentation
R e f r e s h i n g S u m m e r
assistants who are not authorized to submit orders should leave the order as pending for a certified or licensed personnel to activate or submit the orders after verification.
THE UPSIDE Data is scarce about how scribes might affect productivity. One EM study suggested that a scribe can increase productivity by 0.8 patients an hour.3 Another University of Chicago study4 found that an average of 1.3 new patient visits per day was
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required to recover the cost of a scribe at the one-
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An integral part of the provider-patient relationship is the patient interview. Certainly, a third person in the room may be perceived as threatening and might alter the course of discussions. One best practice is to introduce the scribe and ask permission for the use of a scribe. Turnover with scribes is another key issue. Premed students who might be the best place to find a scribe are clearly looking to move on so they might only be around for a year or two. Ramp-up time can also be a challenge as one study5 noted that it took four weeks for each new scribe-physician team to get up to speed and adjust to each other. ❖
1. https://pubmed.ncbi.nlm.nih.gov/27595430/v . w ww.jointcommission.org/standards/standard-faqs/ 2 nursing-carecenterrecord-of-care- treatment-and-services-rc/000002210/ 3. Acad Emerg Med. 2010;17:490-494. 4. https://pubmed.ncbi.nlm.nih.gov/33017564/ 5. Fam Pract Manag. 2016 Jul-Aug;23(4):23-27.
July / August
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21
Looking for a Financial Advisor? Here are the
questions you should be asking
F
OR PEOPLE who are
professionals are held to a very high
says Lupkes. “There are always
serious about achieving
ethical standard.”
some conflicts of interest and you
goals,
When you have chosen a few can-
need to understand what they are
there often comes a
didates, Lupkes recommends asking
so you can work together through
them the following questions:
those conflicts.”
1. Are you a fiduciary and are you willing to put that in writing?
6. What is your investment philosophy and who manages your money?
their
financial
point in their financial journey when they find they need some outside help. Brad Lupkes, Wealth Advisor in the Wealth Management and Trust Department at Frontier Bank, says the first step in choosing
“That is key, because if they are a
“Everyone should be able to
the right partner for the job is to
fiduciary, you know up front that
explain what their own personal
recognize when you need it.
they have a legal obligation to put
investment philosophy is,” says
your interest, as the client, ahead
Lupkes. “As for their money, ideally
of their own,” says Lupkes.
they should be managing it the
“In my opinion, it makes the most sense to reach out to a financial advisor when you are not comfortable doing it on your own,” says Lupkes. “For some people, that might be from Day 1, such as a teenager just getting started. Others might be comfortable managing their investments for several years or several decades.” When an investor does reach that point, Lupkes says it is critical to know where to start searching for a qualified advisor. This is not the time to Google “financial planners near me”. Instead, Lupkes recommends starting with the Certified Financial Planner Board of Standards website, LetsMakeAPlan.org, the gold standard in the financial planning industry. “CFP designation means that you
same way that they recommend
2. What are your qualifications (such as CFP), credentials, education, and level of experience? 3. How do you get paid? Does anyone else ever pay you to advise me? “You should be working with someone getting an annual or
passed a difficult exam,” says
7. Will you be the only advisor working with me? Or is my account going to get handed off to someone else in the future? “Our clients work with us one-on-one for as long as they want to,” says Lupkes.
hourly fee,” says Lupkes. “There should be no hidden charges or kickback fees.”
Lupkes recommends asking these questions of two or three candidates to get a feel of who you would most
4. What services do you offer as an advisor? (i.e., investment management, estate planning, financial planning, coordination with a CPA or attorney, etc.)
have obtained a very high level of education and experience and have
to their clients.”
5. Can you tell me about your conflicts of interest?
Lupkes, who holds the designation
“Any advisor who says they don’t
himself. “Most importantly, CFP
have any is an immediate red flag,”
like to work with, keeping in mind that the best working relationships take time to grow. “As you grow that relationship and trust that person more, you want someone willing to really understand your unique financial situation,” he says. “That can really only be built over time.” ❖
❱ Ready to create a financial plan? Visit our website for a step-by-step guide.
22
MidwestMedicalEdition.com
Let’s get to the root of the problem As providers, we know that substance misuse and
addiction are often just symptoms of more complex problems. For treatment to be effective, the whole person—their basic needs, mental health, physical conditions, and overall safety must be addressed. Talking with your patients is a great place to start—helping them find a support team is even better. The Resource Hotline can provide your patients with the services and support they need to fully recover including:
• Connecting to housing, employment, and food assistance • Help accessing treatment and recovery services • Identifying financial assistance opportunities • Parenting education • Follow up services with a personal guide for addiction recovery through the Care Coordination program
Your guidance is powerful. Patients are more likely to follow through when you recommend a course of action.
Refer your patients and their families to the
Resource Hotline 1-800-920-4343
It’s FREE, confidential, and available 24/7. Together, we can treat the whole person and set them on the path to recovery.
AvoidOpioidSD.com/find-help
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Interventional Neurologist
538-268-918 Rev. 5/21
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Interventional Neurologist
