Interacting with Law Enforcement: What You Need to Know How (and Why) to Pitch a News Story
NEW DECADE, NEW NAME
REBRAND REFLECTS MONUMENTAL CHANGES AT REGIONAL HEALTH THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS
Yankton Respiratory Therapist’s eCig Ed Campaign
VOL. 11 NO. 1
When one number connects you to the region’s best neonatal and pediatric transport team, Anything can be. 1.855.850.KIDS (5437) is your 24-hour link to pediatric specialists for physician-to-physician consults, referrals, admissions and transport.
Jan. Jan. 17, 17, 2020 2020
Monument Health and Mayo Clinic. Working Working together. together. Working Working for for you. you.
Regional RegionalHealth Healthisisbecoming becomingMonument MonumentHealth HealthJan. Jan.17, 17,2020. 2020.
For more information regarding this relationship, visit regionalhealth.org/announcement. For more information regarding this relationship, visit regionalhealth.org/announcement.
VO LU M E 1 1 , N O. 1
■ JA N UA RY / F E B R UA RY 2020
Inside This Issue
CONTENTS PAGE 6 | Interaction with Law
Enforcement: Considerations for Healthcare Providers ■ By Jean Martin PAGE 8 | THIS MONTH ONLINE 5 Reasons to be a MED VIP, The Patient Experience and Your Bottom Line PAGE 13 | How (and Why) to
ON THE COVER
NEW DECADE, NEW NAME
We are kicking off
the new decade (and our second decade) with a Cover Feature on Monument Health, the Black Hills' newly-rebranded health system. Find out why Regional Health decided
It is an unfortunate fact that many healthcare providers will find themselves having to deal with law enforcement at some point. In this issue, we bring you expert tips on privacy law in those situations. Plus, what providers should know about e-cigarettes, a first-in-thenation achievement for a local heart doctor, advanced orthopedics in Spearfish and a new birth tissue donation program in South Dakota. To stay up-to-date between
PAGE 17 | Reverse Shoulder
Replacement Now Offered in Spearfish PAGE 18 | Yankton Respiratory
Therapist Battling eCigarette Use with Education PAGE 20 | Sioux Falls Heart
Doctor First in the Nation to Use Newly-Approved Occlusion Device Designed to Grow Awareness and Empathy USD simulates the
all of us here at MED!
PAGE 14 | NEWS & NOTES
APPY NEW YEAR from
now was the perfect time to make
PAGE 22 | Aging “Escape Room”
at Regional Health.
Pitch a Story to the Media or Your PR Department
■ By Alex Strauss
FROM US TO YOU
challenges of aging patients for Health Services Administration students. PAGE 23 | Upcoming Events Conferences, Symposiums and CME Opportunities
some monumental changes.
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Cover photo: Paulette Davidson, President and Chief Executive Officer of the new Monument Health, signs the document marking the health system’s membership in the Mayo Clinic Care Network. Looking on is Brad Archer, MD, Monument Health Chief Medical Officer. Photo courtesy Regional Health.
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INTERACTING WITH LAW ENFORCEMENT Considerations for Healthcare Providers BY JEAN MARTIN
The default position under HIPAA is that PHI cannot be disclosed without the patient’s authorization, but there are some exceptions relevant to law enforcement, including where reporting is required by state law.
KEY CONSIDERATIONS FOR ANY LAW ENFORCEMENT INTERACTION • Don’t be afraid to ask for identification. If the law enforcement official is not known to the
EALTHCARE PROVIDERS may experience interactions with law
the identity and authority of the
enforcement personnel that create uncertainty around their respon-
person.3 Processes should be in
sibilities to patients, including the duty to protect patients’ privacy.
place for in-person, phone, and
Law enforcement personnel are tasked with ensuring public safety
and conducting criminal investigations. When these duties intersect as they relate to patients in the healthcare system, providers should understand how to meet their obligations while respecting the requests of law enforcement personnel. Situations that providers may encounter with law enforcement include treating a gunshot wound, reporting child abuse or neglect, possible threats to public safety, and if there is a crime on the premises of a medical facility or practice.
PROTECTED HEALTH INFORMATION UNDER HIPAA Before disclosing patient information to law enforcement, a provider should consider whether it is protected under HIPAA rules.
provider, the provider must verify
the provision of healthcare to the individual; or payment for the provision of healthcare to the individual.1
WHO IS CONSIDERED A LAW ENFORCEMENT OFFICIAL?
email interactions. • Share your side of the situation. Explain your understanding of the situation and the laws (HIPAA, etc.) that govern your actions. • W hen trying to decide which federal or state law applies, the more restrictive one will likely apply. In general, if there is a state or federal law that is more restrictive than HIPAA, providers are required to comply with the more restrictive law. • Document the details. Obtain any documentation or statements from
Protected health information
As outlined in the HIPAA Privacy
the person requesting protected
(PHI) includes individually identifiable
Rule, a law enforcement official
health information (PHI) when
health information transmitted or
means an officer or employee of
these documents or statements
maintained in electronic media or any
any agency or authority within the
are relied upon to make the
other form or medium.1 Individually
US, who is empowered by law to:
identifiable health information is
(1) Investigate or conduct an official
information created or received by a
• Respect law enforcement and the
inquiry into a potential violation of
healthcare provider that identifies the
challenges they are dealing with.
law; or (2) Prosecute or otherwise
Do not physically interfere with
individual and relates to the past,
conduct a criminal, civil, or admin-
law enforcement officials or
present, or future physical/mental
istrative proceeding arising from an
provide them false or misleading
health or condition of an individual;
alleged violation of law.2
• Don’t provide more information than necessary. Unless disclosures made to law enforcement are required by law, they should be held to the “minimum necessary” standard. The HIPAA-covered entity or provider must make reasonable efforts to limit PHI to the minimum necessary to accomplish the purpose of the use, disclosure, or request.5 ❖ 45 C.F.R. § 160.103 45 C.F.R. § 164.103 45 C.F.R. § 164.514(h)(1)(i) 4 45 C.F.R. § 164.514(h)(1)(ii) 5 45 C.F.R. § 164.502(b) 1
Jean Martin, MD, JD, is a member of COPIC’s Legal Department.
❱ Find a link to more details on disclosures for law enforcement under HIPAA in the online version of this article.
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January / February 2020
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Exclusive online articles Is Your Business Ready for 2020? By Eide Bailly The year has ended but there is still time to optimize your 2019 taxes and kick off 2020 on a high note. From tax reform implications, to technology and cybersecurity review, to retirement planning, succession considerations, and financial management, the experts at Eide Bailly have a Top 10 list to get your business ready for the year ahead.
Exam Room Manners and Your Bottom Line Patients who feel heard and respected not only heal faster, but also leave better reviews, tell their friends, and pay their bills. In this article, you’ll find five expert tips for ensuring praiseworthy rapport in the exam room–no matter how crazy your day is.
Robotic Whipple Surgery and Other Advanced Procedures at Surgical Institute of SD Surgeon Mike Person discusses some of the most advanced procedures available for treating conditions of the foregut, stomach, esophagus, and pancreas. including the complex robotic Whipple procedure. “We have been treating these things for a decade but in the last three to four years, we have been able to shorten recovery times, minimize pain, and shorten hospitalizations, even with some big operations," says Dr. Person
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[ INTERVIEW ]
The Patient Experience and Your Bottom Line More and more healthcare providers are realizing that today’s patients expect more than just good medical care–they expect a positive overall experience. In fact, research shows that experience is closely linked to a practice’s bottom line. MED Digital Partner PatientX specializes in helping providers create an experience that will not only serve patients–but will also get the provider paid promptly. PatientX CEO Michael Winkleman explained in an exclusive interview with MED. MED: Why is the ‘patient experience’ such an important part of healthcare today? MW: On patient satisfaction surveys, one of the top areas where we see negativity is about the billing process. When patients do not understand what to expect, where their bill will come from, who they are paying and how much they’ll owe, it impacts their whole interaction with that process.
from the anesthesiology or radiology group. They get a second or third bill they aren’t expecting and they think, ‘What is this?’ MED: Do you think this is a bigger problem now than it was in the past? MW: Yes. People are more aware than ever of scams and fraudulent practices. A lot of times, this third party billing looks like a scam to them so they don’t pay it. If you don’t tell your patients and they don’t know, it is hard for the facility themselves to track how many
MED: Can you give an example of a billing practice that some patients might find confusing?
times they have asked the patient for
MW: Patients expect their bill to come
be very frustrated by this process.
payment. What can happen is they get sent straight to collections. Patients can
from the provider themselves or the place where they had the procedure
Fortunately, there are things a practice
done. Often, they don’t realize that they
can do to ensure a positive patient billing
may have three different bills associ-
experience. To read the full interview, click
ated with one procedure–one from the
here in your digital issue or on the PatientX
doctor, one from the lab, maybe one
logo on any page of MED’s website.
New Decade, New Name
REBRAND REFLECTS ‘MONUMENTAL’ CHANGES AT REGIONAL HEALTH
BY ALEX STRAUSS
HIS MONTH, RAPID CITY-BASED REGIONAL HEALTH WILL officially become Monument Health. The new name comes with a new logo and millions of dollars of new signage for its five hospitals, eight specialty and surgical centers, and 40+ clinics and service
centers. It also coincides with a new affiliation with the Mayo Clinic Care Network. But the changes at Regional Health did not start with the Monument name. Although the rebranding brings a fresh new look to the organization, Regional’s leaders say it symbolizes an evolution that has been in the works in the healthcare system for several years. MED spoke with Monument Health CEO Paulette Davidson, who took the helm in 2018, and Robin Zebroski, Vice President of Strategic Marketing and Communication for some perspective on what the shift means for Black Hills patients and for the system’s 4,500 physicians and caregivers. PD: The refreshing of our brand is something our governing board has been considering for some time. They brought the idea to us about a year ago and we have spent the past year conducting a thorough and very collaborative assessment of the idea. We brought in physicians, caregivers, and residents from all across the Black Hills Regional Health acquired the named rights to the Rushmore Plaza Civic Center will be renamed “The Monument” after expansion construction is completed in the fall of 2021.
to ask them questions about what they thought of our current brand and to get feedback. There was a unanimous feeling that it was the right time to move forward with the new brand.
People want permanence, credibility, and a name they can trust," says Monument Health CEO Paulette Davidson.
Regional Health acquired the named rights to the Rushmore Plaza Civic Center will be renamed “The Monument” after expansion construction is completed in the fall of 2021.
MED: What is significant about this time in the organization’s history? PD: We are different than we were even three years ago. We have recruited more than 200 physicians in the last few years. We have also transitioned to an EMR system, which is changing the way we communicate and the way we do things. We are making significant investments in all of our campuses, including a $270 million dollar project here in Rapid City that is just finishing up. The message that we want to send within our organizations that we’re different and we’re changing. RZ: We have approached this thoughtfully because we want to be fiscally responsible. One of the largest expenses in a rebrand like this is physical signage throughout the organization. So the timing of our construction aligns very well. Our largest campus is where we have major construction going on. So the money for new signs on the south side of that campus was already in the budget. It will take some time to update the brand throughout the system. We will approach it as our budget allows. MED: Why “Monument Health”? Where did the name come from? PD: That is a direct result of the feedback we got over the past year. People want permanence, credibility, and a name they can trust. We also wanted a brand that was going to resonate with our workforce. Like other organizations, workforce is going to be a major challenge for us in the future. We are recruiting talented people, not just regionally, but nationally. When they Google ‘Regional Health’, the lack of
About the Logo The M-shaped, five-diamond logo represents Monument Health’s five priorities: • Deliver high-quality care • Provide a caring experience • Be a great place to work • Impact our communities • Be here for generations to come The five diamonds are in the shape of an “M” for Monument. The three filled-in center diamonds represent Monument Health’s vision: It starts with heart. Diamonds signify transformation.
identity was a problem. Monument Health is a nod to the beautiful Black Hills and history and legacy. But it is also about the future; monuments stand firm regardless of the weather or the challenges. MED: How did the affiliation with the Mayo Clinic Care Network come about? Is it significant that it is happening at the same time as the rebranding?
January / February 2020
PD: All the feedback we got led us to say, while we are becoming Monument Health, what are the areas that we need to look at to ensure that we have high performance? We could see there are many people in South Dakota who leave home and go to Mayo Clinic for care. We decided that we could make it easier for people by bringing that expertise here. Hopefully, this gives them peace of mind without the burden of travelling to Rochester. MED: What did the process of joining the Network involve? PD: First, we went there and met with them. Then they came here. It was clear that, before we started any in-depth conversation, that we needed our physicians here to be in support of this. So Mayo met with our physician leaders and our leaders recommended we move forward with the discussion. Joining the Network was a complex process during which they assessed everything about our organization–our culture, patient outcomes, financial viability, etc. It was really the high performance Staff from the Regional Health Orthopedic & Specialty Hospital pose in T-shirts that bear the new Monument Health logo. (l to r) LPN Autumn Shoemaker, Dr. Christopher Huot, RN Loretta Gunderson, Dr. Joshua Sole and RN Kim Einerwold. Kneeling is RN Kari Bolt.
and high quality of our current teams that led the Mayo Clinic board to unanimously approve this relationship. MED: How will this clinical collaboration work, on a practical level? RZ: As part of the Epic implementation, the protocols that Mayo Clinic physicians follow will be available to our providers right inside the electronic medical record system. If they want to know how a Mayo doctor would approach these same symptoms, they can use a ‘What Would Mayo Do?’ tool within Epic. It is a great backbone for our physicians to be able to use these high quality resources. Monument Health doctors can also consult directly with Mayo specialists on their patients’ behalf whenever they feel it will benefit their care. PD: Monument Health is located in Western South Dakota and we serve Nebraska, Wyoming and North Dakota. We are not in Chicago or New York or a large academic health science center. But we have physicians who have trained in those kinds of places. For them to have that worldrenowned clinical knowledge and expertise available when they are talking to patients or recommending diagnostic or treatment plans not only improves their ability to care for people but will improve our ability to retain well-trained physicians. MED: And how has the reaction been among providers to all these changes?
Regional Health is about to conclude a $270 million dollar expansion and renovation project on its Rapid City campus.
RZ: We have a caregiver going around doing forums with our other caregivers, just to answer questions and get feedback. One of the doctors attending a forum said “Let me get this straight...We have Mayo Clinic’s stamp of approval but we are strong enough to be an independent health system so we can make decisions that are in the best interests of our local area?” That pretty much sums it up. PD: At the end of the day, peace of mind for our families and people in communities around the Black Hills is a tremendous asset. Monument Health is independent, private, and not-for-profit. We make our decisions here. Our governing board understands the needs of this community and this keeps them open-minded. I don’t think that will ever change. ❖
How (and Why) to Pitch a New Story to the Media or Your PR Department BY ALEX STRAUSS
O MATTER WHO YOU ARE or how great you believe your “pitch” to be, approaching a member of the media (or, in some cases, your own PR department) with a medical story idea can be intimidating. For one thing, you risk the very real possibility that the person to whom you are explaining your great idea will not “get it” or find it valuable enough to want to share with the public. There is also the natural
aversion to making oneself vulnerable to scrutiny or criticism. Most people with potentially valuable information to share – including health professionals – conclude that the risks and hassle are not worth the effort. But the fact is that the media and the public they serve need what you know – now, more than ever. The advantages of timely, relevant health news for consumers are obvious, but this is about more than public service. By way of encouraging more engagement with your local news providers and/or your communication department, here are a few things I believe are “in it” for you, the health professional.
the media responds in kind by
Although no news report could ever
presenting you as an expert source.
By establishing good relations with
match the value of personalized, one-
Fortunately, even if you have never
your local health news providers,
to-one human interaction, when you
been asked to speak to the press
you are opening what can be an ines-
put a health scare into perspective,
before, it only takes one good inter-
timably valuable channel of commu-
recommend a healthy course of
view (during which you offer clear,
nication between the medical world
action, or explain a new treatment
concise information) or one news-
and the “real” world. Like doctors,
option through the media, you are
worthy article suggestion to put you
journalists want to uncover truth and
being a provider on a level that is
on their radar.
serve their audiences.
standing between patients and
simply not possible within the walls of the office or hospital.
At a time when the gulf of under-
And unlike the words you say
Appearing in a news segment, being
providers seems to be widening, in a
during an office visit, which research
quoted in the newspaper or online, or
very real sense, by accepting and
suggests are often misunderstood
being interviewed for a magazine
working with the media, you can help
or forgotten within minutes of the
article or podcast are ideal ways to
close it. That is the power of physi-
appointment1, words that are captured
help promote your practice and your
cians and the press, together. ❖
in a news article may be broadcast
services, provided that you do not
multiple times, repeated, copied, dis-
take it too far by being blatantly
seminated online, and even referenced
again in future stories.
In an increasingly competitive healthcare environment, the authority you can establish and the respect
Speaking through the news media
you can earn through unpaid media
gives you the opportunity to position
interactions can give you and your
yourself as an authority, bolstering
practice a competitive edge that
trust and credibility among your own
simply cannot be achieved through
patients, as well as among those who
advertising —or your own social
may become patients in the future.
media channels— alone.
When you demonstrate that you are willing to provide your expertise,  O’Hanluain, Daithi, “Patients forget about two-thirds of doctors’ treatment instructions, says neuropsychologist”, European Society of Cataract and Refractive Surgeons, July 2003
January / February 2020
Happenings around the region
News & Notes
South Dakota | Southwest Minnesota | Northwest Iowa | Northeast Nebraska
AVERA KAMI WOLDT
CRYSTAL NELSON Avera McKennan recently awarded its first three DAISY Awards for outstanding nurses. The three inaugural recipients were: Kami Woldt, RN, BSN, who works in the pre/post area at the Avera Surgery Center, Cassie Olson, RN, BSN, SCRN, a nurse in the Avera McKennan Brain & Spine Institute, and Crystal Nelson, RN, a NICU nurse. Going forward, the hospital plans to recognize three new DAISY winners each quarter.
BLACK HILLS Regional Health, in partnership with the National Heart Health Program, has launched a new screening program to detect and measure calcium-containing plaque/blockages in coronary arteries. Measuring calcified plaque with a heart scan may identify disease before symptoms arise. The scan is recommended for people over 40 with high blood pressure, high cholesterol, a family history of heart disease, diabetes, obesity, or a history of tobacco use. The $75 calcium scoring screening is a 10-minute CT scan that requires no needles, prep or recovery time.
MANDY VERMEER Mandy VerMeer, RN, a nurse with Sheldon Medical Center, which is part of the Sanford Health Network, was recognized with her hospitalâ€™s third quarter DAISY Award.
JILL TICE Jill Tice has been promoted to Vice President of Quality, Patient Safety and Risk Management at Regional Health. Tice started her career as a CNA in 1999. She later served the Orthopedics/Neuro/Surgical departments as a Health Unit Clerk, RN and Clinical Resource Nurse. She was named Director of Quality, Safety and Risk Management in 2009. Tice earned her nursing degree at SDSU and holds an MA and an MBA from the University of Phoenix. She recently completed the Institute for Healthcare Improvement (IHI) Chief Quality Officer Certification course.
SANFORD ALEX KALSBECK Certified Nurse Practitioner Alex Kalsbeck has joined Pioneer Memorial Hospital & Health Services in Viborg, South Dakota. Kalsbeck earned his BS in Nursing and his Master of Science in Nursing, Family Nurse Practitioner, at SDSU. He is board certified with the American Academy of Nurse Practitioners. Kalsbeck grew up in the Brookings area and currently lives in Sioux Falls. He has been an RN at Sanford Health in the Pulmonary Department since 2012. Kalsbeck is certified in Pediatric Advanced Life Support (PALS), Basic Life Support (BLS), and Advanced Cardiovascular Life Support (ACLS).
JESSICA C. MAESCHEN Sanford USD Medical Center in Sioux Falls recognized three DAISY award winners this Fall. They were cardiology nurse Andrew McCann, RN, Lauren Peiffer, RN, of the Central Resource Pool, and Jessica C. Maeschen, RN, who works in The Birth Place.
INDEPENDENTS & OTHERS AMANDA SEDLACEK Amanda Sedlacek, DO, has joined the internal medicine team at Yankton Medical Clinic, PC. Sedlacek earned her Master’s degree in anatomy and her DO at Des Moines University of Osteopathic Medicine. She completed a residency in internal medicine at St. Joseph Warren Hospital in Warren, Ohio followed by a palliative and hospice medicine fellowship at Summa Health System in Akron, Ohio. She is board certified by the American Osteopathic Association.
MEGAN BLOCK Prairie Lakes Healthcare System welcomes Clinical DIetitian Megan Block to Prairie Lakes Nutritional Services and Sodexo team. Block will assess and work with patients in the hospital and can also accept appointments for one-to-one or group sessions. Block earned a BS in Education and Human Sciences and an MS in Nutrition and Exercise Sciences at SDSU. Individuals may receive counseling from Block during their stay at the hospital or by appointment on a variety of topics; including, weight management and diets for health conditions like cancer, diabetes, and heart disease.
Madonna Rehabilitation Hospitals recently announced a $57 million dollar 3-story patient wing and renovation of the Lincoln, Nebraska Campus. The expansion will encompass 112,000 square feet and will create a new entrance facade, update the parking and renovate the outpatient registration area Fifty-nine of the current 120 rooms will be replaced and equipped with new rehabilitation technology. Groundbreaking is anticipated this Spring with an estimated completion in January 2023. As part of National Rural Health Day, Prairie Lakes Healthcare System was recently recognized by The Chartis Center of Rural Health and the National Organization of State Offices of Rural Health (NOSORH) for overall excellence in quality healthcare performance. This recognition is based on the results of the Hospital Strength INDEX from iVantage Health Analytics; the Performance Leadership Awards reflect top quartile performance among all rural hospitals in the United States.
SHAWN MARTIN Shawn Martin is the new executive director of Huron Regional Medical Center. Martin earned a BA in business administration at USD and graduated from the University of Sioux Falls with a Bachelor of Arts in business administration. Martin has worked at Performance Radio in Huron for the last 15 years, most recently serving as general manager. He has lived in Huron for more than 20 years.
Enjoy Lean Beef in a Heart-Healthy Lifestyle • The American Heart Association recommends eating a variety of nutritious foods from all food groups for a heart-healthy diet.1 • Go lean when adding nutrient-rich beef to heart-healthy diets. • Consider variety and portion size when balancing lean protein on a hearthealthy plate. 1
The American Heart Association’s Diet and Lifestyle Recommendations. (n.d.). Retrieved October 03, 2016, from http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/ Nutrition/ The-American-Heart-Associations-Diet-and-Lifestyle-Recommendations.
January / February 2020
11/6/2019 2:33:40 PM
Happenings around the region
The Helmsley Charitable Trust has awarded a grant of $3.6 million to equip law enforcement agencies and South Dakota State Park facilities with the next generation of Automated External Defibrillators (AEDs). The grant, facilitated through the South Dakota Department of Health, will place 1,200 devices in law enforcement vehicles, with conservation officers, and at critical state park locations. The new devices will be placed, and training conducted, by the end of December. AEDs previously used by some agencies will be relocated throughout communities increasing the number of AEDs accessible to the public.
Brooke Sydow, HRMC project manager, with DLR Secretary Marcia Hultman, and John R. Bolger, State Director of U.S. DOL, Office of Apprenticeship.
Huron Regional Medical Center recently received a grant award to develop an apprenticeship in respiratory therapy. The $10,000 grant was a part of the $370,000 in incentive funding awarded last month by the Department of Labor and Regulation (DLR) to help businesses expand the number of Registered Apprenticeships in South Dakota. HRMC was one of 20 recipients awarded funds in this latest grant cycle.
SIOUXLAND KELLI ENGEL Kelli Engel, MSN, RN, has been appointed the Director of Cardiology Services/Cath Lab at UnityPoint Health–St. Luke’s in Sioux City. Engel began her nursing career in the ED at UnityPoint Health–St. Luke’s and has worked in nursing for almost 25 years. Engel holds a Master’s degree in Nursing from Nebraska Methodist and spent 15 years as a nursing instructor at Western Iowa Tech Community College before joining St. Luke’s as a nurse in the Cardiac Cath Lab.
❱ Intrigued by something you’ve read here in News & Notes? Want to know more? You can always read the full versions of these and other recent news items on our website. New articles are added every week!
The Milford Family Care staff (l to r): Marlene Kass, Advanced Nurse Practitioner Jamie Billings, Monica Edwards, and Nichole White.
Two local healthcare clinics have been named 2019 Guardian of Excellence Award winners by Press Ganey, a national company which monitors patient satisfaction. The winners, Milford Family Care and Sioux Rapids Family Care, are both operated by Spencer Hospital in collaboration with Avera Medical Group Spencer. The award recognizes Press Ganey clients that have consistently achieved the 95th percentile or above in the patient experience rankings. Nurse practitioner Jamie Billings is the primary care provider at Milford Family Care and nurse practitioner Sue Terrell sees patients at Sioux Rapids Family Care.
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11/5/2019 1:22:11 PM
Reverse Shoulder Replacement Now Offered in Spearfish BY ALEX STRAUSS
EOPLE IN THE Spearfish, South Dakota area with shoulder problems now have a new option for relief thanks to orthopedic surgeon Ray Jensen, DO. Dr. Jensen is the first in the area to offer reverse shoulder replacement at the Regional
Health Hospital in Spearfish. The reverse operation, which was FDA-approved in 2003, switches
the ball and socket of the shoulder joint, affixing a metal ball to the socket and a plastic cup to the upper end of the humerus. Although the operation
“OF ALL THE SURGERIES I DO, THIS IS MY FAVORITE ONE.”
itself is more technically complex, it is a promising alternative for people who are not candidates for standard shoulder replacement because of rotator cuff injuries, complex fractures, severe arthritis or glenoid bone stock problems. “Rotator cuff tears are really what this procedure was designed for,” says Jensen. “If you have a rotator cuff tear, you are not a candidate for standard replacement because the joint is not going to be stable.”. Instead of relying on the rotator cuff to hold the joint in place, the reverse operation uses the larger deltoid muscle to lift the arm. Patients sacrifice some range of motion, especially in forward elevation, but they end up with more strength in the shoulder. “We see a lot of ranchers who do a lot of overhead activities and wear out their joints,” says Jensen. “These are tough people out here. If they do get a rotator cuff tear, they might not see anyone for it until it gets really bad. This is a very effective treatment for them.” Jensen mastered the reverse shoulder procedure during his sports medicine fellowship at the University of New Mexico. He now uses this approach more often than not. “In my practice, I tend to do reverses greater than 50 percent of the time,” says Dr. Jensen. “Most surgeons tend to do the traditional shoulder procedure, but I just find that I have better results with reverses. Also, if you go the traditional route and your rotator cuff tears later on, you end up having to have an additional surgery.” Jensen uses new augmented base plates to help spare the bone where the implant will attach without compromising fixation. Advanced options for customization, moulded implants, and 3D modeling have helped to make this complex operation both faster and more effective for a wider range of patients. “Of all the surgeries I do, this is my favorite one,” says Dr. Jensen. “People go to the gym and cross country ski and don’t even take pain pills.” ❖
January / February 2020
Yankton Respiratory Therapist Battling eCigarette Use with Education
S A REGISTERED RESPIRATORY
giving them the
therapist at Yankton Medical Clinic,
facts and we just
education has always been a part of
want them to be
Linda Reese’s job. But since becoming
able to make good
a Certified Asthma Educator last February,
dec i sions
she has taken it to a whole new level.
“At about the same time that I got my
One fact that
certification, we started getting questions
many kids, par-
about vaping,” Reese told MED. “The high
ents, and even
school was seeing a lot of it and we were
ers may not know
Vaping is the blanket term for smoking
is that almost all
e-cigarettes, including the Juulpods, that have
become so popular among teens and young
tain nicotine. And
adults. E-cigarettes heat nicotine, flavorings,
with vaping, it is possible to inhale significantly
and other chemicals to create a water vapor
more nicotine than with traditional cigarettes
that can be inhaled. Though they were origi-
thanks to extra strength cartridges and the
nally billed as a cessation aid for adults, an
ability to modify the e-cigarette’s voltage.
estimated 5.3 million middle and high schoolers have used them in the last 30 days. Vaping is generally thought to be safer than smoking traditional cigarettes, but it is
Additionally, the US does not regulate the nicotine content of e-cigarettes. A single Juulpod contains the same amount of nicotine as a pack of cigarettes.
not without risk. As of November 2019, the
“A lot of kids, and even parents, think it’s
CDC confirmed 47 deaths in patients with
just flavored water,” says Reese. “What’s scary
e-cigarette, or vaping, product use associated
is that it is so much more addictive for adoles-
lung injury (EVALI).
cents because their brains are not fully
When one of Yankton’s pulmonologists
approached Reese for her insight on the prob-
Beyond the risk of lung injury from
lem, Reese committed to learning all she
e-cigarettes, their nicotine can affect behav-
could about vaping. Last May, she presented
ior, decision making, impulse control and the
her findings to Yankton 8th graders. It was to
ability to learn. It can also make kids more
be the first of many presentations for area
susceptible to depression and anxiety. Reese
parents, students, and healthcare providers
says healthcare providers need to know
on the facts about e-cigarettes.
vaping terminology in order to ask the right
“These kids are being bombarded by
questions of their young patients.
marketing,” says Reese. “We aren’t wagging
“If you ask a kid if they smoke and they
our fingers at them. We are just bringing
vape, they’ll say no,” says Reese. “If they use
them facts. E-cigarette companies are not
Juulpods, they will say they don’t vape. You
have to say something like ‘Have you been inhaling anything other
Honey Balsamic-Glazed Ham
than air?’” Reese has now done multiple presentations on vaping for parents, teachers, and students at both public and private middle and high schools in her area. She has presented to her clinic’s physicians and staff and will soon speak to the respiratory department at Yankton’s Avera Sacred Heart Hospital. “Parents and teachers tend to be shocked, but they are grateful for the information,” says Reese. “And I am grateful to the clinic for giving me the chance to share this. We are a pretty small community, so the people you are dealing with are your friends’ kids, your co-workers’ kids, etc. We have a lot
Let’s make this. Let’s make it happen – simply and deliciously. Get the recipe at pork.org/cooking ©2018 National Pork Board, Des Moines, IA USA. This message funded by America’s Pork Producers and the Pork Checkoff.
of skin in this game.” ❖
I wish to go deep sea fishing in Hawaii Kaiser, 16
January / February 2020
Sioux Falls Heart Doctor First in the Nation to Use Newly-Approved Occlusion Device
“THERE WILL STILL BE SOME WHO REQUIRE SURGICAL INTERVENTION, BUT IT WILL BE MUCH LESS.”
I C H A E L B AC H A R AC H , M D , a
migrations and erosions with that device.”
vascular medicine specialist with
The new Gore device is predominantly fabric
Avera Heart Hospital in Sioux
with much less metallic framework. Its conical
Falls, recently became the first
shape allows for a wider range of sizes. Eventu-
doctor in the country to use a new minimally
ally, it becomes incorporated into the heart wall.
invasive device for large atrial septal defects commercially.
“It basically allows you to occlude the hole without having a huge rim on each side,” says
“An ASD is a hole between the right and left
Bacharach. “There will still be some who require
atriums of the heart,” explains Bacharach. “What
surgical intervention, but it will be much less.”
happens is the blood goes from left to right. Over
Dr. Bacharach has used a similar device to
time it causes the right ventricle to become
close patent foramen ovales, a smaller type of
dilated and raises the risk for right-sided heart
congenital hole in the heart that can raise the
failure. It is one of the more common congenital
risk for stroke. “We have never had an erosion
with the Gore device that we’ve used for PFOs,”
The Gore Cardioform ASD occluder is an
implantable fabric-based device for trancatheter
Implantation of the Cardioform ASD occluder
closure of ostium secundum ASDs. These larger
takes about an hour and patients go home the
ASDs typically carry a greater risk for complica-
next day. The first two patients treated with the
tions like pulmonary hypertension, right heart
new device were not good candidates for the
enlargement, or atrial fibrillation. For years,
Amplatzer device. In one case, the only alterna-
ostium secundum ASDs were only treatable with
tive would have been a much riskier open
open surgery. Then came the Jude Amplatzer
Atrial Septal Occluder.
“The new device worked very well and it was
“It is essentially a metal screen with big discs
nice to have the opportunity to do it endovascu-
on either side,” says Bacharach. “Sometimes,
larly rather than surgically,” says Dr. Bacharach.
when you sized it, the wings took up too much
“Both operations went smoothly and both
space in the atrium. There were also some
patients went home the following day.” ❖
❱ Check our website for a video of the new occlusion device being deployed.
January / February 2020
Aging “Escape Room” Designed to Grow Awareness and Empathy
ITH HEALTHIER HABITS AND BETTER healthcare, many people now live well into their 80s and 90s. In fact, the percentage of people over 60 is expected to grow to 32% in the most developed
nations by 2050. (Up from 2006 numbers of 17% in North America and 23% in Western Europe). But our fast-paced, high-energy, youth-oriented culture doesn’t give much consideration to aging citizens. “We all journey through the aging experience, yet there is a societal lack of understanding and empathy towards those of us who are farther along the journey,” said Jeremy Coss, 2019 graduate of the Health Services Administration program at the University of South Dakota. “This lack of understanding and empathy leads to belittling, mistreating, segregating, and in extreme cases, dehumanizing the aging population that has so much to offer.” These challenges inspired Carole South-Winter, EdD, assistant professor of Health Services Administration (HSAD) at the USD Beacom School of Business, to find a creative solution to help healthcare organizations better prepare their workforce to care for their current and future patients. South-Winter’s idea for an empathetic aging “escape room” experience began to take form at a holiday party in 2018. After receiving positive feedback from her peers, South-Winter began working with Coss, her graduate assistant, to start bringing the idea to life. Together with members of their HSAD Student Organization HEAL (Healthcare Executives Advancing in Leadership), Coss and South-Winter began creating an aging experience that allows individuals to have a firsthand perspective of difficulties the elderly community face every day, such as cataracts, arthritis and hearing loss. They simulate this through specialized equipment including modified goggles, shoes and headphones. “We can bridge this gap of understanding and empathy best through experience, open-mindedness, and honest communication,” said Coss. “The program is designed to develop experience and encourage critical thought and honest dialogue with the aging population and this unique opportunity will absolutely change the way our society approaches the aged life.” “We hope to pave the way for a more understanding, supportive and mutually beneficial approach to caring for an aging adult,” said South-Winter. ❖
❱G o online to read graduate students’ reactions to the aging escape room experience.
January, February, March, April
UPCOMING EVENTS FEBRUARY 3
10:00 am – 12:00 pm
8:00 am – 4:30 pm
Sanford Aromatherapy Workshop Location: Center for Health and Well-Being, Sioux Falls
13th Annual Avera Brain & Spine Institute Conference
Location: Hilton Garden Inn Downtown, Sioux Falls Information: avera.cloud.cme.com
FEBRUARY 29 6:00 pm
Regional Health 23rd Annual Hospice Ball
7:30 am – 4:30 pm
Information and Reservations:
29th Annual Sanford Perinatal Neonatal Women’s Conference
regionalhealth.org/foundation or call 605-755-9193
Location: Sanford USD Medical Center, Sioux Falls
Location: Spearfish Holiday Inn & Convention Center
FEBRUARY 29 9:00 am – 1:30 pm
11th Annual Trends in Spine Care Symposium
7:30 am – 5:00 pm
Location: Schroeder Auditorium,
Location: Moquist Hall at Sanford Center, Sioux Falls
Sanford Medical Center
Information: Stefanie Hoffman, 605-328-0829
Pediatric Trauma Symposium
MARCH 10 – APRIL 18 2:00 pm – 4:30 pm Mindfulness: Stress Reduction–8-week course Location: Sanford Center for Learning, Sioux Falls
APRIL 30 9:00 am – 6:30 pm Sanford Kidney Symposium Location: Schroeder Auditorium, Sanford Medical Center Information: Catrina Hruby, 605-328-9290 Registration: Sanfordhealth.org/classes-and-events
Information: Ellie.email@example.com Registration: Sanfordhealth.org/classes-and-events
SAVE THE DATE MAY 1
vera 7th Annual Difficult A Airway Course, Sioux Falls
VISIT THE ONLINE CALENDAR at MidwestMedicalEdition.com to find more information on these and other upcoming events between issues. You can also add your own event to the calendar for free.
CARE THAT FITS THEIR LIVES Here in Sioux Falls As a woman, your patient’s health needs change throughout her life. At Sanford Health in Sioux Falls, we offer specialty care for women of all ages. We have providers that specialize in: • Bone health • Fertility and reproductive medicine • Female pelvic medicine • PCOS • Gynecologic oncology • Hormone therapy • Overactive bladder • Pelvic pain • Sexual health and intimacy
Call (605) 328-7700 to refer a patient today. 015002-00345 11/19
HAPPY New Year from all of us here at MED! We are kicking off the new decade (and our second decade) with a Cover Feature on Monument Health...
Published on Jan 2, 2020
HAPPY New Year from all of us here at MED! We are kicking off the new decade (and our second decade) with a Cover Feature on Monument Health...