MED Magazine, December 2023

Page 1

What’s New at Sanford Orthopedics & Sports Medicine? News from Around the Region

DECEMBER

Artificial Intelligence in Medicine

VOL. 14 NO. 8

2023

EIGHT HEALTHCARE LEADERS ANSWER TWO QUESTIONS: • What are you most excited about for your organization in the coming year? • What challenges might you have to overcome?

2024

LOOKING FORWARD THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS


We’re shining brightly—now as

The story of Children’s Hospital & Medical Center has always been defined by light. Since 1948, we’ve stood as a glowing ray of hope for kids and families searching for a healthier tomorrow. And so, as a new day breaks, we continue to deliver exceptional care for every child—only now, under a different name. We are Children’s Nebraska. A new name with the same purpose: supporting the light within every child. Providing everything from routine checkups to lifesaving procedures. All while advancing the art and science of pediatric care. Today, tomorrow and far into the future. See the whole story at ChildrensNebraska.org/Shine


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2024 LOOKING LOOKING

CONTENTS

VOLUME 14, NO. 8 ■ D E C E M B E R 2 02 3

ON THE COVER

We asked healthcare leaders from across the region to share what they’re looking forward to and what challenges they expect to face in 2024. We’ve included those who responded to that invitation in this month’s final cover feature.

FORWARD FORWARD 8 REGIONAL HEALTHCARE LEADERS SHARE THEIR HOPES FOR THE YEAR AHEAD

PAGE

■ By Alex Strauss

FROM US TO YOU PAGE 6 | This Month Online

Exclusive articles from our website, upcoming virtual events, and three easy ways to share YOUR news, events, and announcements through MED

PAGE 14 | LOOKING BACK An abbreviated version of our annual ‘Year in Review’. See what stories graced our cover in 2023. Did you miss any of these?

PAGE 16 | ARTIFICIAL INTELLIGENCE IN MEDICINE ■ By Alan Lembitz, MD, and Michael Victoroff, MD AI is rapidly changing the face of medicine. Here’s why the experts at COPIC say the technology could carry enormous benefits, risks, and unforeseen consequences.

PAGE 17 | USD School of Health Sciences Success Spotlight: Keeley Pollman, PA PAGE 18 | [Sponsored] What’s New at Sanford Orthopedics and Sports Medicine?

Cutting edge treatments and technologies now available at Sanford through its 60 orthopedic providers.

PAGE 20 | NEWS & NOTES National recognition for area healthcare institutions, local leaders speak on national stages, new physicians at Sanford, Huron Regional, and Prairie Lakes, and more.

n a break with our tradition of reviewing the past year, we at MED decided to dedicate this final issue of 2023 to some forward thinking. We hope you’ll enjoy reading what top level executives at large and small hospitals and health systems across the region are most excited about for the coming year. Get ready to be inspired! Also in this issue, the experts at COPIC take on the complex but timely topic of artificial intelligence in medical practice. Like it or hate it, AI is a part of the new reality. We know you’ll glean some useful tips from this month’s insightful article. Of course, it wouldn’t be an and-of-the-year issue without at least a brief look back at the people and programs that graced our pages in 2023, so we have that for you, too. And just a reminder that you can do your own ‘look back’ any time by claiming your free subscription at MidwestMedicalEdition.com. MED VIPs get instant and ongoing access to every past issue of the magazine — and get each new one delivered right to their Inbox! Have a safe and Happy New Year,

I

—Alex & Steff

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Working Hand in Hand: The Value of Community Health Workers (CHWs)

Earn 2 FREE CMEs Access the free, self-paced South Dakota Community Health Worker (CHW) Planning and Sustainability Toolkit to learn more! Upon completion of the toolkit, you will receive 2 FREE CMEs*.

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The South Dakota Community Health Worker (CHW) Planning and Sustainability Toolkit provides information, resources, and frameworks to help you work effectively with CHWs. For more information about CHWs in SD and to learn more about the Community Health Worker Collaborative of South Dakota (CHWSD), visit www.chwsd.org.

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*In support of improving patient care, this activity has been planned and implemented by Avera, Community Health Worker Collaborative of South Dakota, Sage Project Consultants, LLC. Avera is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

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Website Exclusives Developing Pricing for Your Operating Room

PhD in Health Sciences Program Sees Record Number of Students

A

s health systems increasingly utilize more and more data, the demand for leaders with research backgrounds also surges. The University of South Dakota’s PhD in Health Sciences program is designed exactly for this — practicing healthcare professionals ready to take on shaping the healthcare industry, improve patient outcomes or teach the next generation of practitioners. From 2020 to 2023, the program’s first-year cohort grew by nine students —more than doubling— from eight to 17 enrolled, its largest cohort to date. Currently, 52 students are enrolled in the program in various phases of study, with 14 of those in the candidacy phase, working on their dissertations. Twenty-eight students have graduated from the program since 2016. The doctoral program is designed for the working health professional to achieve a PhD without having to leave a current job as an academic in health sciences, in public health or within a healthcare organization. The curriculum can be tailored to meet individual career aspirations and research interests through elective coursework, projects completed within courses and Dissertation. READ THE FULL ARTICLE and learn more about the PhD program on our website.

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Managed Service Providers: What Are They and What Do They Do?

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LOOK FORW Regional Healthcare Their Hopes for the

F

or more than a decade, MED has used this space in our December issue to revisit some of the top healthcare stories and headlines from the past year. But, given the stress and challenges of the last few chaotic years in medicine, we decided to focus this year's cover feature, instead, on hope and anticipation.

In that spirit, we invited CEOs of some of the region’s leading hospitals

and health systems, both small and large, to share some of the things they are looking forward to at their respective organizations in 2024. To avoid painting an unrealistic picture, we also asked each respondent to anticipate some of the challenges they are likely to face along the way. Below are their unedited responses. We hope they will inspire you, too, to dream big in 2024.

Happy New Year!

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KING WARD Leaders Share Year Ahead

BY ALEX STRAUSS

John Allen, President and CEO at Prairie Lakes Healthcare System, Watertown, South Dakota

1

WHAT ARE YOU MOST EXCITED/HOPEFUL ABOUT FOR YOUR ORGANIZATION IN THE COMING YEAR?

We have an amazing opportunity to design healthcare

delivery specifically for our region. As a rural regional health system, we know our communities, our current capabilities, as well as opportunities to close gaps and integrate care across the continuum. Laying out the “how” and “when” to execute on a future state design is incredibly exciting. It’s the opportunity to do nothing less than positively benefit the health of our region for the next generation.

2

WHAT (IF ANY) CHALLENGES MIGHT THE ORGANIZATION HAVE TO OVERCOME TO ACCOMPLISH THIS? One word: People. The systemic shortages of healthcare workers across multiple disciplines

have dramatically impacted the cost of care and the ability to focus beyond the next work shift. Acting on opportunities to highlight why we are a great career destination, while embracing technology and process redesign is crucial to what we must do to sustain care capabilities.

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LOOKING FORWARD TO 2024

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Bill Gassen, President & CEO of Sanford Health, Sioux Falls, South Dakota

1

WHAT ARE YOU MOST EXCITED/HOPEFUL ABOUT FOR YOUR ORGANIZATION IN THE COMING YEAR? Our landmark $350 million virtual care initiative will help to fill gaps in provider

shortage areas and expand access to care across our vast rural geographic footprint. We will provide the most advanced technology close to home, allowing patients to immediately access care, monitor their health and connect with a trusted provider from home or a nearby satellite clinic. A new Virtual Care Center, currently under construction in Sioux Falls and set to be fully operational by late 2024, will serve as the hub for this work, featuring dedicated clinician workspaces equipped with the latest telemedicine technology to offer on-demand urgent care, behavioral health care and primary care. As part of the virtual care initiative, we will also establish a new Education Institute, which will serve as the premier training ground to attract, retain, and prepare medical students, residents and nurses for this next generation of care delivery.

2

WHAT (IF ANY) CHALLENGES MIGHT THE ORGANIZATION HAVE TO OVERCOME TO ACCOMPLISH THIS? We are focused on investing in our workforce and building a strong culture. Our people are

our greatest strength. Our more than 2,800 physicians and advanced practice providers allow us to deliver on our promise of providing world-class care across the upper Midwest. Our biggest opportunity is to retain the people we have here. We are building a pipeline of the next generation of physicians and nurses through partnerships with medical and nursing schools in our region to strengthen the rural health care workforce of the future. We’ve made an unprecedented $300 million expansion in our GME programs. Sanford Health will fully fund 15 additional residency and fellowship programs, which will train more than 300 residents and fellows a year. Expanding the number of medical residency training programs in rural areas is key to filling gaps in care because many doctors — including more than half of family medicine physicians — stay within 100 miles of where they train. At Sanford Health, up to 40% of the physicians who train with us stay and practice with Sanford, and 70% choose to practice in the upper rural Midwest.

Brenda Tiefenthaler, President and CEO at Spencer Hospital, Spencer, Iowa

1

WHAT ARE YOU MOST EXCITED/ HOPEFUL ABOUT FOR YOUR ORGANIZATION IN THE COMING YEAR? Spencer Hospital is looking forward to focusing

on not only meeting the needs of patients experiencing health concerns, but also focusing on helping our community members reach and maintain their optimal health, and focus on the well-being of our healthcare team. During the COVID-19 pandemic, our focus shifted to the urgent, day-to-day needs of our patients and organization. Since then we’ve been able to reassess priorities to focus on our patients’ needs and what’s best for our team. For our professionals, our goal is to provide a supportive working environment to assist them in their personal and professional development goals. We strive to provide a culture that encourages growth, input and collaboration.

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We are also excited to have our emergency department construction project underway, which is better designed to meet the urgent medical needs of the communities served by Spencer Hospital. Construction started during fall of 2022, and completion is anticipated in early 2025.

2

WHAT (IF ANY) CHALLENGES MIGHT THE ORGANIZATION HAVE TO OVERCOME TO ACCOMPLISH THIS? Nationally, hospitals are facing tighter operations budgets due to reimbursement challenges

and expenses created by a shortage of healthcare professionals and inconsistencies in the supply chain. We are starting to see improvements in staffing and supplies, yet must remain diligent in our cost containment efforts in order to have ample resources to invest in our people and healthcare services.

Paulette Davidson, President and CEO at Monument Health, Rapid City, South Dakota

1

WHAT ARE YOU MOST EXCITED/HOPEFUL ABOUT FOR YOUR ORGANIZATION IN THE COMING YEAR?

I am excited to kick off 2024 with the new and updated

Monument Health five-year Strategic Plan. This set of goals and priorities will guide Monument Health through 2029, and provide a roadmap for our Physicians, Caregivers and Governing Board to keep us all moving forward with the shared mission to Make a Difference, every day. The Strategic Plan focuses on five priority areas: Deliver high-quality care; Provide a caring experience; Be a great place to work; Impact our communities; and Be here for generations to come. Our Physicians and Caregivers play a critical role in carrying out our strategic plan. We are all equally invested because we each had a hand in building the goals that steer our future and empower us to do the right thing. Each new year brings new ways for us to innovate and collaborate, and with the rollout of new strategic goals I am very excited for the new year at Monument Health.

2

WHAT (IF ANY) CHALLENGES MIGHT THE ORGANIZATION HAVE TO OVERCOME TO ACCOMPLISH THIS? It’s no secret that the healthcare industry, like many others,

is facing uncertain times. At Monument Health, we anticipate there will be challenges and unexpected obstacles in the next five years. Many of the hurdles that we have worked to overcome may be challenges we face again, and no doubt new opportunities will emerge as well. Despite this, our commitment to the communities we serve remains unwavering, and I have confidence in the people who work for our organization. Our strategic plan will require leadership focus, agility and strong engagement from our teams. As a healthcare system, Monument Health made significant progress executing the 2018-2023 five-year strategic plan. That plan established a strong foundation for the coming five years. On a daily basis, we rely heavily on the voice of our physicians and caregivers, as they provide valuable insight based on best practices. We have built an atmosphere of Just Culture, encouraging everyone to report areas for improvement and provide feedback in daily tiered safety huddles. We’ve taken great strides to create a culture of excellence through a triadic leadership model enabling shared decision-making. Together, as a team, we will continue to care for our communities and provide comprehensive healthcare, close to home, for our patients throughout the region.

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LOOKING FORWARD TO 2024

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Nolan Lubarski, CEO at CNOS, Dakota Dunes, South Dakota

1

WHAT ARE YOU MOST EXCITED/HOPEFUL ABOUT FOR YOUR ORGANIZATION IN THE COMING YEAR? “I am excited about the future of CNOS! There are many actions we are planning

to implement to fulfill our mission of “Improving Health”. I am most excited about our high-quality specialty provider’s ongoing efforts to expand our reach and meet patients where they are- providing their care, close to home, not only in our base market of Sioux City, Iowa/Dakota Dunes, South Dakota, but in 26 rural communities in our tri-state service area. There is no better way to improve health than to commit to providing access to specialty care both in-person and virtually!

2

WHAT (IF ANY) CHALLENGES MIGHT THE ORGANIZATION HAVE TO OVERCOME TO ACCOMPLISH THIS? Our opportunities will be to maintain our strong, collab-

orative relations with rural community partners and ensure coordination of clinic space and staffing as the demand for our specialty services continues to grow. It has been very energizing to know patients are receiving care closer to their home and engaging with their local healthcare facilities more frequently for their needs!

Chanda Chacón, President and CEO at Children’s Nebraska, Omaha, Nebraska

1

WHAT ARE YOU MOST EXCITED/HOPEFUL ABOUT FOR YOUR ORGANIZATION IN THE COMING YEAR? I am most hopeful about the work we are doing around innovation, both

in care delivery models and in our day-to-day work. We have amazing momentum and the best team members who are leading these efforts to ensure we can provide care in new ways to children and families across our region.

2

WHAT (IF ANY) CHALLENGES MIGHT THE ORGANIZATION HAVE TO OVERCOME TO ACCOMPLISH THIS? Our work in health-

care is always challenging because we serve people in their most vulnerable times; however, supporting and empowering our team to think creatively and innovatively about how we make an impact creates a positive energy for the future.

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Jim Dover, President and CEO at Avera Health, Sioux Falls, South Dakota

1

WHAT ARE YOU MOST EXCITED/HOPEFUL ABOUT FOR YOUR ORGANIZATION IN THE COMING YEAR? Avera is well positioned in terms of size, scale and essentiality. We are

big enough to scale up for growth initiatives and small enough to react nimbly to needs in our market. And, Avera is essential in our market because of our broad and varied access points across our region. Healthcare is a basic human need and a sought-after service for improved quality of life. Avera is exceptionally positioned to serve a better tomorrow through preventive care today. We are excited about our future because we will use these three factors and have a meaningful impact.

2

WHAT (IF ANY) CHALLENGES MIGHT THE ORGANIZATION HAVE TO OVERCOME TO ACCOMPLISH THIS? Becker’s Hospital Review reports that more than 600 rural hospitals are at risk of closure. Yet

at a time when other systems are closing their rural hospitals and long-term care centers, Avera is growing, expanding and replacing aging facilities. We can’t do this without the support of our state legislature and Congress. Appropriate financing through Medicare and Medicaid reimbursement that keeps up with the cost of services makes or breaks nonprofit healthcare facilities. Additionally important is post-acute availability for people who need an appropriate care setting after a hospital stay, like long-term care or transitional care. But, staffing mandates have the potential to create insurmountable hurdles that could close facilities in rural America. Another critical challenge is workforce, especially for healthcare because we’re a people-centered industry and cannot deliver our services without competent, welltrained staff. We continue to deploy a number of key strategies including targeted recruiting efforts, enhanced pay and benefits, and partnerships with numerous universities and tech schools across our footprint. These partnerships vary greatly from supporting four-year nursing education to specific training programs such as radiology techs, to scholarships and sponsorships for students that grow our talent right here in South Dakota and our wider region.

Erick Larson, resident and CEO, Huron Regional Medical P Center, Huron, South Dakota

1

WHAT ARE YOU MOST EXCITED/HOPEFUL ABOUT FOR YOUR ORGANIZATION IN THE COMING YEAR? First, I couldn’t be prouder of the work we’re doing here at Huron Regional

Medical Center. We have made huge strides in many of our initiatives to improve the care we provide to our patients. We’ve been diligent in our attention to patient safety and clinical quality while at the same time working hard to meet our diverse community members where they’re at through our Community Liaison program—and then there’s everything in between we’re elevating each day!

Midwest Medical Edition

LOOKING FORWARD TO 2024

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LOOKING

20 2023 was a year of creativity in regional healthcare, as hospitals and health systems searched for ways to support clinicians, improve patient care, and maximize efficiency in the wake of the pandemic. From harnessing new technology to forming new alliances and launching new programs, here’s a quick look at our top stories.

Expansion at The Lodge at Deadwood

CHWs Advancing Health Initiatives in Brookings

As with many healthcare institutions this past year, our post pandemic recovery has had its ups and downs. We are greeting this next year with great optimism as we see our outpatient service lines grow and bring much needed services to our community—including expanded orthopedic surgery, podiatry, and pediatrics. It’s exciting to see the countenance of community members light

JANUARY FEBRUARY

Get to Know Dakota Vascular

VOL. 14 NO. 1

2023

Fostering a Culture of Wellbeing

Dr. Heather Spies Physician Director, Clinician Experience and Wellbeing at Sanford Health

JANUARY/FEBRUARY

THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

MED_Jan 2023_ƒ .indd 1

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up when we talk about the infusion of new practitioners to our organization and local options this

Community Health Workers in SD Remarkable Recovery at Sanford Children’s

MARCH

Medical Documention: What Really Matters?

gives them.

VOL. 14 NO. 2

2023

2

WHAT (IF ANY) CHALLENGES MIGHT THE ORGANIZATION HAVE TO OVERCOME TO ACCOMPLISH THIS?

Ultimately, we need to continue to tweak on

putting the patient experience at the forefront of what we do. There is a lot that goes into what shapes and influences the patient experience. We realize patients can choose where to get their care — and

PUTTING TELEMEDICINE IN MOTION FIRST-OF-ITS-KIND PROGRAM KEEPS EMS CONNECTED IN THE FIELD MARCH

THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

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can often be influenced by things we can’t control, Tackling Geographic Disparities in Heart Health Informed Refusal for Patient Safety & Risk Management

our sphere of influence to the benefit of the patients in our community. One hot topic in our area is the influx of non-local insurance companies working to influ-

Feature: Physician Bank Serves Unique Physician Needs

APRIL MAY

but our challenge is to master those things within

VOL. 14 NO. 3

2023

The Pain Science Center at Prairie Lakes A New Approach to an Old Problem

ence care decisions of our communities — which is unfortunate. There’s little we can do to affect those efforts directly. But, what we can do is help educate our community on what insurance plans may mean to them — thereby raising awareness to the cause and effect of what may seem to some

Eric Fjeldheim, DPT, Pain Specialist Dot McAreavey, PT, Director of Rehabilitation Services

APRIL/MAY

THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

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JANUARY/FEBRUARY

In the year’s first issue, MED delved into the problem of clinician stress and burnout with Heather Spies, MD, the Ob/Gyn who directs Sanford’s Clinician Experience and Wellbeing program. “As of 2020, it became clear that it is literally impossible to keep up with everything in medicine,” Spies told MED. “There are simply not enough hours in a typical day.” Sanford is combating the issue, in part, by fostering a “culture of well-being”.

MARCH Telemedicine has been an increasingly important part of healthcare delivery in recent years, especially in rural areas. But the pandemic catapulted the technology to new heights. In our March issue, we explored South Dakota’s new ‘Telemedicine in Motion’ program outfitting rural ambulances with telehealth equipment to keep them connected to specialized care, even on the road.

APRIL/MAY In April, we focused on the new Pain Science Center at Prairie Lakes Specialty Clinic in Watertown, the brainchild of fellowship-trained pain specialist and physical therapist Eric Fjeldheim, DPT. “The pain science comes in when everything checks out and the pain doesn’t make sense from a physiological standpoint,” said Dot McAreavey, Director of Rehabilitation Services and Wound Care.

as a trivial matter until they seek local care. As a critical access hospital, we recognize we can’t be all things to all people but, we have the responsibility to be the conduit of care for every

SUBCRIBE ON OUR WEBSITE TO READ THE DIGITAL VERSION OF EVERY PAST ISSUE OF MED.

member of our community. ❖

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G BACK

023 Spring DAISIES and Other Healthcare Winners

JUNE

Meet SD's Only Female Vascular Surgeon

Need a Break? Consider This 'Hidden Treasure' Near Sioux Falls

VOL. 14 NO. 4

2023

LIFE in the FAST

LANE Dr. Stephen Dick, Emergency Physician Monument Health Rapid City Hospital

JUNE

THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

Complying with the CURES Act: What to Avoid

Spencer Hospital

PROFILE OF A TOP 100 RURAL HOSPITAL

JULY AUGUST

Protecting Your Practice from Cyberattacks

USD's $3 Million Plan to Address Nursing Shortage

VOL. 14 NO. 5

2023

Bill Bumgarner, President Brenda Tiefenthaler, Senior VP of Patient Care and Operations

JULY/AUGUST

THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

Sanford Advances Care in the NICU National Recognition for Area Hospitals

SEPTEMBER OCTOBER

South Dakota Named 9th Best State for Healthcare

VOL. 14 NO. 6

2023

50 YEARS of

TREATING PATIENTS, TRAINING DOCTORS The Center for Family Medicine and the Sioux Falls Family Medicine Residency

Dr. Brad Kamstra, Program Director Dr. Mary Watson, Dr. Mark Huntington

SEPTEMBER / OCTOBER

THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

News & Events from Around the Region

NOVEMBER

Are In-Person Conferences Still Relevant? Screening Surgery Patients for Cannabis Use

VOL. 14 NO. 7

2023

Supporting Survivors at Sanford Oncologist Shelby Terstriep, MD

NOVEMBER

THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

Midwest Medical Edition

DECEMBER

YOUR TEAM | OUR COMMUNITY

JUNE

This summer marked the end of an era at Level 2 Trauma Center at Monument Health Rapid City Hospital, the largest and busiest ER in the tri-state area. In April, we spoke with Dr. Stephen Dick, a 30-year veteran of the emergency department and its former director, about his long career, the last few volatile years, and the joys and challenges of emergency medicine in the Black Hills.

JULY/AUGUST

In the summer, we turned our attention to a much smaller but equally dynamic rural hospital in Iowa. The 64-bed Spencer Hospital has served its community in some form for more than 100 years. “We are a traditional community hospital where it’s not unusual to see your friends and neighbors,” then President Bill Bumgarner told MED. “But on another level, we are also a regional medical center for about nine counties in Iowa.”

SEPTEMBER/OCTOBER In October, the long-standing Center for Family Medicine and the Sioux Falls Family Medicine Residency marked 50 years of treating patients and training physicians in South Dakota. Our September/October issue took a long look back at the history of this pivotal practice and program (with plenty of historical photos) and imagined what the next 50 years might bring.

Quentin Durward, MD, FAANS Neurosurgeon | Proud Grandpa

Specializing in surgeries and time with family. Being connected to our community is just one way we care. That’s why you’ll see us in the office and around town making a difference — in many different ways.

REFER TO 605-217-2667, OPTION 2.

NOVEMBER With more patients living longer after a cancer diagnosis, support programs for survivors — from palliation and stress management to preserving fertility — are more important than ever. In November, we met oncologist Shelby Terstriep, MD, the Fargo-based oncologist who started Sanford’s sweeping Survivorship Program. “I became passionate about, if we can save their life, how do we impact the rest of it?,” she told MED.

CNOS.NET NEUROLOGY • NEUROSURGERY • ORTHOPAEDICS PODIATRY • SPINE • RHEUMATOLOGY • DERMATOLOGY GENERAL SURGERY • GASTROENTEROLOGY OCCUPATIONAL MEDICINE • IMAGING CENTER

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Artificial Intelligence in Medicine BY ALAN LEMBITZ, MD, AND MICHAEL VICTOROFF, MD

T

HE USE OF ARTIFICIAL INTELLIGENCE (AI) applications is the most important new information technology in decades that will change healthcare. This creates an ongoing necessity for healthcare systems to regularly assess the impact and risks of AI as its development and deployment is outpacing legal, medical, or business changes. The implications

carry enormous benefits, risks, and unforeseen consequences.

AI APPLICATION FOR MEDICAL PROVIDERS Providers are already using AI and adoption/experimentation is accelerating. AI will be able to assist with just about every cognitive task a healthcare provider performs. Their interactive dialog capabilities can be used for patient interactions such as inbox management, scheduling, history taking, surveys, prescription management, translation services, recall and follow-up, answering medical questions, diagnosing conditions, performing risk assessments, triage, and referrals. Some patients will be more comfortable interacting with AI than humans with respect to sensitive issues. Many are likely to have already interacted with a diagnostic AI tool online prior to seeing a healthcare professional. Providers might use AI to help them in the informed consent process, disclosures of outcomes and results, adverse event reporting, apology and resolution discussions, and explaining medical information. AI can also be used for generating notes, reports, and correspondence, summarizing records and incoming reports, reviewing results, and creating task lists and reminders. Additional areas for AI applications include performance management, planning, procurement, research, literature review, and employee supervision.

The following highlights three potential uses of AI, their likelihood of adoption, benefits and risks, and some strategies to address those risks.

1

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VIRTUAL SCRIBING AND CLINICAL DOC-

and what is going in their permanent medical

UMENTATION—The benefits of using a tool

record.

to quickly and accurately generate a record

The need to provide the processes required

of clinical interactions are obvious. Patients

by the Cures Act will be even more important.

will need to be aware of and consent to the use

One can also predict that patients’ awareness

of the recording devices in place to generate

of the record and their requests to edit, amend,

the records. Providers will need to learn to

or delete materials in it will increase and the

“narrate their examinations” to populate the

provider or their staff will need to be cognizant

record. A policy to erase the work product of

of the necessary HIPAA processes and

the recording at regular, short intervals, as well

documentation.

as open access to the final record generated

Finally, and most importantly, given how

from that work product will help allay patients’

AI works and its inherent ability to produce

fears about how their information was captured

fluent but possibly inaccurate, misleading, or

MidwestMedicalEdition.com


even harmful output, the provider will absolutely need to read and verify the content of the notes generated by AI. The option of “dictated but not read,” in this case becomes “AI generated but not read” and will not be an accepted practice.

2

OFFICE ADMINISTRATION TASKS— Much of office administration will have AI tools adaptable to everyday practice

in the near future. The need to accurately assign a visit, schedule its length, collect the necessary pre-visit information, obtain authorizations, etc. will be adopted quickly by short-staffed practices and systems. The interactions with third party payors are likely to be highly automated on their end, which will necessitate efficient and accurate automation on the provider side. Generating requests for authorization can be done effectively by AI as it becomes more adept at extracting from EHRs.

3

OFFICE TRIAGE AND AI TELEMEDICINE CLINICAL ASSESSMENT—Phone triage and pre-visit clinical assessment has

the ability to become very automated. This will be more sophisticated than the current algorithmically generated barrage of questions and will be able to process open-ended speech and generate interactions that will look surprisingly human. Awareness that this is being done via AI will be necessary for the patient, and the option to reach a human should be made available. Plus, the documentation from that interaction will need to be audited to ensure that the system is performing as expected. Ultimately the machine-generated clinical assessment will be the work product of licensed providers, and the responsibility and liability will likely rest with them, however, issues of product liability will arise and create new concerns around responsibility for errors. ❖

Keeley Pollman, PA Degree: Bachelor of Science in Physician Assistant Studies Current Position: Physician Assistant at Surgical Institute of South Dakota For 16 years, Keeley Pollman has worked daily with advanced practice providers, physicians, nurses and therapists as a Physician Assistant at Surgical Institute of South Dakota. She works primarily in general surgery and trauma and says the physician assistant program at the USD School of Health Sciences was excellent preparation for the collaborative work she does now. “We had a lot of our classes with physical therapy, occupational therapy, and medical students,” says the Wakonda native. “I had the same gross anatomy classes as the medical students. In healthcare, we work together everyday anyway, so that was a perfect entry into the profession.” Pollman’s draw toward medicine and toward USD is not surprising given that her mother is a nurse who taught at the University. Although she considered going to medical school, Pollman says she settled on the PA program, which has since become a master's program, because of the career flexibility it would give her. “I appreciated that I could change my specialty without having to go back and do a residency,” she says. Pollman spent five years working in a plastic surgery practice before joining Surgical Institute, where she had done a five-week rotation. “I definitely picked the right career path and I appreciate where it has led me,” she says. Today, Pollman helps select the USD PA students who will also rotate through Surgical Institute. “I really appreciate and strongly encourage people to go to USD, to the point that I actually sit on the admissions committee and help do interviews every year,” she says. “I like to be a part of that because we will be working with those PA students for weeks.” And potentially even longer; Pollman says three out of the four PAs at Surgical Institutes are graduates of the USD School of Health Sciences PA program.

This SUCCESS SPOTLIGHT brought to you by

Alan Lembitz, MD, and Michael Victoroff, MD are with the COPIC Department of Patient Safety and Risk Management

Midwest Medical Edition

DECEMBER

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[ S P O NS O R E D ]

What’s New at Sanford Orthopedics and Sports Medicine?

S

ANFORD ORTHOPEDICS & SPORTS MEDICINE in Sioux Falls, South Dakota, delivers comprehensive and compassionate musculoskeletal care with a team approach. Our team is the largest in South Dakota with 60 orthopedic providers that include surgeons, physicians, nurse practitioners and physician assistants. Our providers are national leaders in orthopedic care who use cutting-edge technologies and treatments.

These technologies and treatments cannot be found anywhere else in the region:

Joshua Johnson, MD

• O rthopedic oncology — highly specialized care for the diagnosis and treatment of benign and malignant bone and soft tissue neoplasia • W ide-awake hand surgery with an immersive virtual reality experience that helps lower patient anxiety • C ustomizable 3D-printed surgical guides that improve precision during complex procedures Our surgeons collaborate with the University of South Dakota and multiple national research grants. They also support health policy issues in South Dakota and the nation to help patients seeking musculoskeletal care.

Mark Heidenreich, MD

ORTHOPEDIC ONCOLOGY Orthopedic oncology is highly specialized with only a few hundred practitioners in the country. Sanford Health has the only orthopedic oncology program in the state, with two orthopedic surgeons who are fellowship-trained in oncology. Joshua Johnson, MD, and Mark Heidenreich, MD, provide diagnosis, treatment and management of tumors or cancers that start in, spread to, or affect bones and soft tissues, including cartilage, fibrous tissues, muscles, nerves and vessels. If patients report bone pain, especially if it occurs primarily at night or they have constitutional symptoms such as fatigue, weight loss, fever and chills, they should see their provider for imaging. Scans may reveal a tumor or other lesion, which should be further examined by a specialist like Dr. Johnson or Dr. Heidenreich.

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“Anytime a provider discovers a concerning bone or soft tissue lesion, I’m happy to see their patient,” said Dr. Johnson. “Any soft tissue mass larger than a golf ball should be evaluated with advanced imaging prior to resection.” Since orthopedic oncologists are so rare, most patients with bone or soft tissue cancers need to travel to get the care they need. Dr. Johnson and Dr. Heidenreich the sounds and sights on the screen.

Our team of experts helps patients

In addition to VR, they can watch

explore their orthopedic options,

television, listen to music or talk with

using the latest in treatments and

INCORPORATING VIRTUAL REALITY

the staff during the procedure.

technology. Put your patients in our

Wide-awake surgery is a safe and

patients who has had wide-awake

convenient treatment option for a vari-

hand surgery.

are grateful to be able to provide this treatment locally.

Barb Halstenson is one of many

ety of hand injuries and conditions.

Using a local anesthetic, Dr. Van

“The biggest selling point is

Demark took about 15 minutes to

patient convenience,” said Robert

operate on Halstenson’s carpal tunnel.

Van Demark, Jr., MD. “People can keep

She was awake the whole time and

their clothes on, they can eat break-

experienced a pleasantly uneventful

fast and they can drive home after

procedure.

surgery.”

“I definitely would recommend if

Since 2015, our providers have

you have hand surgery to do it the

done over 2,000 procedures in our

way I did it,” Halstenson said. “And I

office procedure rooms.

might be a little biased, but I think

“The in-office procedures are safe

capable hands. ❖

Alan Yan, MD

Dr. Van Demark is the best.”

with high patient satisfaction scores. 99% of patients felt that their procegoing to the dentist,” Dr. Van Demark,

3D TECHNOLOGY FOR FOOT AND ANKLE PROGRAM

stated. “The ability to do a majority

The 3D-printing lab at Sanford has

of our hand procedures here in the

allowed for more advances in foot and

office has been a game changer for

ankle care. Alan Yan, MD, is an ortho-

our practice and our patients.”

pedic surgeon specializing in treating

dure room experience was better than

Many patients have used virtual

foot and ankle conditions.

reality during the procedure to help

He is one of the providers who

decrease their anxiety. A virtual

uses 3D-printed models for surgical

reality (VR) headset immerses them

planning and 3D-printed implants for

in a computer-generated environment

total ankle replacement and total

where they can fully experience

talus replacement.

Midwest Medical Edition

DECEMBER

Robert Van Demark, Jr , MD

MAKING A REFERRAL IS EASY. Contact us at (605) 328-2663

19


NEWS & NOTES

Happenings around the region

News & Notes South Dakota | Southwest Minnesota | Northwest Iowa | Northeast Nebraska

AVERA

SANFORD

For the fifth consecutive year, Avera Foundation was recognized by the Association of Healthcare Philanthropy (AHP) with the High Performer distinction for 2023. Avera Foundation was recognized in each of the three categories for data based on fiscal year 2022: Overall Revenue, Overall Productivity, and Health System. Thanks to more than 18,900 benefactors, the Avera Foundation reported giving of more than $46.6 million during the benchmarking timeframe.

John Snyder, president and chief executive officer of Sanford Health Plan, Emily Griese, PhD, chief operating and population health officer, and Brian Maude, chief financial officer, were featured panelists at the annual Becker’s CEO + CFO Roundtable in Chicago in early November. Snyder was part of a semi-keynote panel entitled, Cultural Makeover: How the Best CEOs Make a Big Difference. Griese’s panel was entitled, Can Health Systems Have Value and Volume? and Maude took part in a panel entitled, CFO Spotlight: Balancing Defensive and Offensive Strategy to Win.

RACHAEL SHERARD Rachael Sherard, Senior Vice President of Rural Health for Avera Health, has been selected for the new class of Rural Health Fellows by the National Rural Health Association. After a competitive review process, 17 fellows were selected to participate in this year-long, intensive program aimed at developing leaders who can articulate a clear and compelling vision for rural America.

CHARISSA RAYMOND Charissa Raymond, DO, recently joined Sanford Health Pierre Clinic as a family medicine physician. Raymond graduated from Oklahoma State University from the College of Osteopathic Medicine in Tulsa, Oklahoma. Raymond is a familiar face to the Sanford Health Pierre Clinic as she served as a resident to the location during her time in the Sioux Falls Family Residency Program.

LORA BLACK

MONUMENT Monument Health earned two Level 7 achievements for the Acute and Ambulatory survey selections of the College of Healthcare Information Management Executives ‘Most Wired’ survey for 2023. Among the more than 55,000 facilities represented, Monument Health ranked above peers in categories like analytics and data management, population health, infrastructure, and patient engagement.

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Lora Black, executive director of clinical research at Sanford Research, was recently one of the featured speakers at the 2023 Milken Institute Future of Health Summit in Washington DC. The summit included more than 200 speakers over three days. Black joined an invitation-only roundtable discussion on the Community-Based Research Collaboratory.

The American Cancer Society recently awarded a $60,000 lodging grant to Sanford Health. The grant is one of 91 lodging grants totaling $2.5 million awarded to health systems nationwide to provide eligible patients an estimated 32,000 nights of free lodging during treatment. Proximity to treatment prevents many people living with cancer from getting high-quality care which worsens cancer outcomes.

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Augustana University President Stephanie Herseth Sandlin and former Veterans Affairs Secretary, The Honorable David J. Shulkin, MD, have been elected to serve on the 11-member Sanford Health Board of Trustees. Herseth Sandlin and Sec. Shulkin will begin their terms in January. Sanford Health trustees are elected by the full Board and currently serve up to three three-year terms.

MARCUS IBRAHIM Marcus Ibrahim, MD, recently joined Sanford Health Aberdeen Clinic as a family medicine physician. Ibrahim received his medical degree from Avalon University School of Medicine in Curacao and completed his family medicine residency in Jacksonville, Florida. For the fifth year in a row, Sanford Health has been recognized by Military Times as one of the best healthcare employers for veterans. The 2023 Best for Vets: Employers List highlights 175 employers, and Sanford Health landed at No. 1 in the healthcare category. Winning employers were identified in an independent survey from a sample of nearly 8,500 US veterans working for US companies with at least 1,000 employees.

Sanford Health Plan’s Medicare Advantage plan, Align powered by Sanford Health Plan, received a 4.5-star rating from the Centers for Medicare and Medicaid Services (CMS) for the 2024 plan year for its plans available in North Dakota, South Dakota and Iowa, placing them among the highest-rated in the region as well as the nation. Enrollment is open for Align powered by Sanford Health Plan through December 7th.

SIOUXLAND GEORGE MAKHOUL George Makhoul, MD, has joined UnityPoint Health–St. Luke’s Regional Medical Center for a two-year term as President of the Medical Staff. In a press release, St. Luke’s also thanked Sandeep Gupta, MD, for his years of service as President.

INDEPENDENTS Sheila Renner, MT, laboratory supervisor, was recently recognized as Huron Regional Medical Center’s first Innovator of the Quarter. Renner, who has worked at HRMC for more than 32 years, submitted a suggestion to redesign employee name badges to ensure the name and department of each individual is consistently visible to patients, visitors and other staff members. Renner’s suggestion was selected as the winning idea for the Innovator of the Quarter challenge, a new award at HRMC.

C O N F I D E N C E

Sanford Health orthopedic hand surgeon, Hao Li, MD, along with a team of advanced practice providers, nurses and additional volunteers, spent their time and talents on Saturday, October 21, to perform nine free procedures to four uninsured patients. The procedures included carpal tunnel and trigger finger surgeries. Patients will also receive follow-up care free of charge. This was the first time a Hand Day event has been held in South Dakota. Due to its success, it is anticipated Sanford Health will continue to hold this event on an annual basis.

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Midwest Medical Edition

DECEMBER

21

• Happenings around the region

News & Notes


NEWS & NOTES

Happenings around the region

TERRY LARSEN Terry Larsen, DO, general surgeon, has joined the Huron Regional Medical Center medical staff. Larsen earned his Doctor of Osteopathy at the University of Health Sciences College of Osteopathic Medicine in Kansas City, Missouri. He completed post-graduate training at Baystate Medical Center in Springfield, Massachusetts and completed his residency in general surgery at the University of Nebraska Medical Center. He recently moved to Huron from Lyndonville, Vermont.

Huron Regional Medical Center dialysis director, Jennifer Jungemann, RN, has been presented the Quality Improvement Award from the Nephrology Nursing Certification Commission to include a $1000 grant. The Nephrology Nursing QI Award is to recognize an individual or organization participating in a quality improvement project which promotes optimal patient outcomes in nephrology. Jungemann applied for the NNCC grant to share the success of the development and implementation of a Hemodialysis Technician Program at HRMC.

HAMID ASSADI, MD and JOHN KINROSS-WRIGHT Hamid Assadi, MD and John Kinross-Wright, MD have joined the team of Hospitalists at Prairie Lakes Healthcare System. Dr. Assadi received his medical degree from Ross University School of Medicine in Portsmouth, Dominica and completed his family medicine residency at the University of Wisconsin Family Medicine in Wausau, Wisconsin. He most recently has been a Hospitalist and Nocturnist at Aspirus Wausau Hospital in Wisconsin while working as an Assistant Professor of Medicine at the Medical College of Wisconsin School of Medicine. Dr. Kinross-Wright was born in Montana where he completed his undergrad before going on to receive his medical degree from the University of Colorado School of Medicine in Aurora, Colorado and completed his internal medicine residency at the Sanford School of Medicine at the University of South Dakota in Sioux Falls.

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LYNN SEVERSON Lynn Severson is the new Chief Financial Officer at Prairie Lakes Healthcare System. Severson grew up in Duluth and received her accounting degree from the University of Wisconsin Superior followed later by her master’s degree in healthcare administration from Concordia University in St. Paul. She has over 20 years of experience in healthcare, most recently working at Cuyuna Regional Medical Center in Crosby, Minnesota as the Chief Operating Officer. Severson is a member of the Healthcare Financial Management Association and is active in United Way.

Brookings Hospital has made Newsweek’s list of America’s Best-In-State Hospitals 2024. Brookings Hospital was the only South Dakota hospital on the list recognized with a Patient Satisfaction Award. The award denotes hospitals with outstanding performance in patient experience including cleanliness and quietness, communication with the care team and staff responsiveness.

AMANDA SEDLACEK Yankton Medical Clinic, PC’s Dr. Amanda Sedlacek, Internal and Palliative Medicine, has been selected to present during the 2024 Annual Assembly of Hospice and Palliative Care, taking place March 20-23, 2024, in Phoenix, Arizona. Dr. Sedlacek and the research team have been asked to give a podium presentation as well as a poster presentation during the National conference.

Freeman Regional Health Services in Freeman, South Dakota has just installed a new state-of-the-art CT machine. The purchase was made possible, in part, by the Freeman Regional Health Services Foundation, which raised more than $53,000 at its 12th annual gala last February.

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OTHERS Vance Thompson Vision is expanding its surgical treatment specialties to the whole eye, with the addition of fellowship-trained retinal specialist and surgeon Jed Assam, MD. Dr. Assam earned his medical degree at the USD Sanford School of Medicine and completed a residency in ophthalmology at the University of Texas Medical Branch in Galveston where he was chief resident. He also completed an advanced fellowship in vitreoretinal surgery at the University of Texas Health Science Center in San Antonio.

Future radiologic technology students offered tours of their newly renovated, state-of-the-art laboratory classroom on November 8th at Mitchell Technical College. The renovation, including a new GE Definium Tempo fixed X-ray System made possible by Avera Health, allows instructors to work with three groups of students at a time, making it possible for students to get more hands-on experience.

The third-floor classroom utilized primarily by the physician assistant program in at the University of South Dakota’s Center for Health Education now bears the name of one of the program’s longtime supporters. The naming of the classroom is in gratitude to an endowment given to the physician assistant program from H. Bruce Vogt, MD, the program’s medical director and professor emeritus of Dr. H. Bruce Vogt and his wife, Judy the USD Sanford School of Medicine, and his wife, Judy. Dr. Vogt has been the program’s medical director since 1996.

❱ Intrigued by something you’ve read here? Want

to go deeper? Read the full versions of these and other recent news items on our website.

YOUR HEALTH : OUR MISSION We h o p e you nev er need t o f a c e c a n c e r, bu t if y o u d o , P r a i r ie La k es Ca nc er Cent er i s ri g h t h e r e t o e n s u r e y o u g e t t he c o mp rehensi v e c a re, t re at me n t , an d sup p or t t ha t k eep s ho p e a live .

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Midwest Medical Edition

DECEMBER

| pr air iel akes .c om /h ope

23

• Happenings around the region

News & Notes


Monument Health Rapid City Market Receives Magnet Recognition® for Excellence in Nursing ANCC Magnet Recognition® is the highest and most prestigious distinction that a health care organization can receive for nursing. As a Magnet-recognized organization, Monument Health achieves excellence in five key areas: SUPPORT Collaboration across teams and departments

SHARED LEARNING Evidence-based best practices and research

INNOVATION Leadership in health care processes and delivery

CONFIDENCE Nurses who are empowered to lead and work independently

PATIENT CARE High standards and quality of care, resulting in better outcomes

Magnet recognition demonstrates our commitment to improving patient care and outcomes. Visit our website at www.monument.health to learn more about how we’re continuing to lead health care delivery and patient outcomes.

Learn more about the ANCC Magnet Recognition Program® at nursingworld.org/magnet.


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