MED Magazine March 2019

Page 1

Is It Time to Ditch Your Passwords? A Roundup of Spring Events

A NEW APPROACH TO OPIOID ADDICTION Regional Health’s Stephen Tamang, MD



Public Health 3.0 in Rural SD

VOL. 10 NO. 2







Regional Health Orthopedic & Specialty Hospital combines top physicians, advanced treatments and the latest technology to deliver high-quality care to our patients.

1635 Caregiver Circle | Rapid City, SD 57702 605-755-6100 160881_0219

VO LU M E 1 0, N O. 2 ■ M A R C H 2019





PAGE 6 | [INTERVIEW] Omaha Children’s CEO on the Organization’s Transformational Vision


Medication Assisted Treatment for Opioid Addiction

PAGE 12 | NEWS & NOTES New positions, promotions, awards, and more

become his passion.

PAGE 17 | Minimally Invasive Options Boost Sanford’s Colon Cancer Screening Rates

have ever run. We devote a large por-

PAGE 18 | [TECHNOLOGY] Passwords 101 Think your office or personal files are safe behind your “strong” password? Here’s why a security expert says you might be wrong.

the most comprehensive, most trusted

Regional Health’s Stephen

■ By Sandra Melstad

Tamang, MD, is helping

PAGE 22 | Beef and the Mediterranean Diet: Surprising New Research

the Black Hills kick with a powerful new approach. PAGE


Vice president Sales & Marketing STEFFANIE LISTON-HOLTROP Editor in Chief / ALEX STRAUSS Graphic Design / CORBO DESIGN Photographer / JULIE PRAIRIE PHOTOGRAPHY Web Design / LOCABLE Digital Media Director / ALYSSA MCGINNIS


ing to people struggling with opioid addiction in the Black Hills. As you will learn, this life-saving work has truly This issue also features one of the largest News & Notes segments we tion of MED to this, our most popular feature, in our continuing effort to be source for medical community news in the region. Remember, it is always free to share your news, announcements, and events with the wider community through MED. Get in touch any time at All the Best, —Steff and Alex

PAGE 23 | Upcoming Events Conferences, Symposiums and Spring events

Publisher / MED MAGAZINE, LLC Sioux Falls, South Dakota


focus on an innovative

PAGE 8 | THIS MONTH ONLINE New GERD Technology at Prairie Lakes and a roundup of exclusive content available only on the website.

PAGE 20 | Public Health 3.0: A New Opportunity to Address Health in Rural America

opioid addicted patients in

of MED, we are proud to

young doctor bringing hope and heal-

■ By Alex Strauss

■ By Alex Strauss






VP Sales & Marketing







Editor in Chief


June 10



July 10


Oct 10



Nov 10



Editorial contributions due March 1

PO Box 90646, Sioux Falls, SD 57109

Ads due March 10

DUE Dec 10 Feb 10 March 10 May 10

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Omaha Children’s

Transformational Vision


MAHA Children’s Hospital & Medical Center is advancing its mission “to improve the life of every child.” With a vision “to be a global leader for children’s health”, Children’s has entered a dramatic season of growth and

transformation, the most visible sign of which is a new 9-story Hubbard Center now underway. For a clearer picture of what’s to come, MED spoke with Children’s President & CEO, Richard Azizkhan, MD, a pediatric surgeon who took the helm three years ago. MED: What drew you to Omaha? RA: At Cincinnati Children’s Hospital, I spent about 20 percent of my effort in international health. So part of my interest in taking this CEO position was that I was going to be able to continue and expand that work. The other thing that attracted me was that the geographic reach was quite substantial - we are the only freestanding children’s hospital for 250 miles - but I could see that we had an opportunity to meet the needs of the broader Midwest. There were many disciplines that were understaffed or just didn’t exist, such as pediatric neuro-oncology. MED: How are you addressing those gaps?

RA: We are doing a lot of recruiting. When I came, we had 130 specialists. Today, we have 230. We are on track to go up to about 400 in the next 5 years. We will also bring on 6o to 70 new scientists. We are looking for people who are game-changers in their field as part of a child health research institute in conjunction with UNMC. MED: How does the new Hubbard Center fit into the overall expansion plan? RA: We are adding 450,000 square feet of new space and are literally doubling in size from 145 beds to 260 beds. We are expanding our ICU capabilities and we are developing a complete set of cardiac services. Our NICU is expanding from 40 to 60 beds and we will have the first NICU-embedded Neonatal MRI. The OR is expanding from 7 to 16 rooms and will include hybrid ORs with interventional radiology embedded. That building will also house a hematology/oncology unit and some shelled space for future expansion. These are the kinds of things we are designing in our tower. MED: How do these changes reflect the changing mission of Children’s? RA: Our original mission, that all children would have a chance to survive, was based on the polio epidemic. Today, it is more about improving the lives of children in our six surrounding states and around the world with exceptional clinical care, research, education, and advocacy.


MED: How is the project being paid for and how long will it take? RA: This is a $430 million project with the parking garage and we have a 10-year capital plan. We are almost finished with the $50 million for the bricks and mortar portion and The Hubbard Center will be completed in the first quarter of 2021. We have another $10 million for research infrastructure and we have $20 million segregated into endowment for a research institute. $100 million will be financed and the rest is coming from our resources. We want to show the community that we can reinvent ourselves. MED: Why is it important to make these changes now? RA: How we care for patients will continue to evolve. Because of the moves we’re making now, our successors will have the flexibility to make the right decisions for the community in the future. �



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March 2019

Neurology Neurosurgery Orthopaedics Podiatry Rheumatology Spine




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Exclusive articles: An Interview with Good Sam’s New President By Alex Strauss Sanford’s former chief administration officer Randy Bury is now the President of the Good Samaritan Society since the two organizations joined forces early this year. We talk to Bury about his long tenure with Sanford and the joys and challenges of the transition.

Squaring Success: Unlocking The Powerful Math Of Cultural Transformation By Nathan Harrup Last year, one of Kansas’ better known healthcare providers launched a major initiative to transform its outpatient culture. In this guest article, see why their experience offers valuable lessons for healthcare professionals everywhere.

No More “M-Word”: Why Healthcare Marketing Can No Longer Be Evil By H2M Marketing (MED Digital Sponsor) On the surface, it sounds altruistic to focus on serving rather than selling in healthcare. In this article, read why the experts at H2M marketing say this attitude has led to setbacks that have caused healthcare to fall behind.

“ What are you most looking forward to in healthcare in 2019?”


“I would have to say

I am the most excited about changes in homecare. Many medical professionals are now beginning to view the home as the best place to recover and also to age. In addition, some private insurances are adding non-skilled homecare as a benefit.” —Travis Remmis, Owner, Visiting Angels of Sioux Falls.


“We are most looking forward to the advancement in technology as it relates to communication. A number of the people we serve have been able to utilize retinal recognition and other devices to communicate in instances where it was difficult before due to various disabilities.” —Steve Watkins, CEO, LifeScape

Evolving communication tools like live video, email automation, and interactive website features, have allowed us to bring medical news and information to our market in new ways. I'm looking forward to seeing how our readers will use these same tools to connect with each other and with patients both in and outside the office this year. —Alex Strauss, MED Magazine

Digital Partners Prairie Lakes’ New Acid Reflux Center Offers the Latest in GERD Treatment WITH THE OPENING OF ITS NEW

Nissen fundoplication still has a role,

Acid Reflux Center, Prairie Lakes Health-

Dr. Schaeffer, says the new system has

care System in Watertown began offering

some distinct advantages.

the LINX System for patients with chronic

“For one, patients don’t have to alter

acid reflux. LINX is a small, flexible ring

their diet at all. In addition, the lifespan

of magnetic beads placed around a

of the device is indefinite since the beads

patient’s weak esophageal sphincter.

don’t lose their magnetism. And finally,

The beads pull together to strengthen the esophageal sphincter and restore the

the device can easily be removed if, for some reason, it doesn’t work,” he says.

body’s natural reflux barrier. For eating,

Laparoscopic placement of the LINX

swallowing, belching, or vomiting, the

device is relatively simple and recovery is

beads expand and separate to allow

usually quick —especially when patients

passage. Reflux specialists Dr. Greg

follow the recommended swallowing

Gerrish and Dr. Jacob Schaeffer have been

protocol to prevent dysphagia.

using the system since November.

Complications, such as erosion into

“About 60 percent of Americans have

the esophagus, occur in less than one

some degree of reflux,” Dr. Gerrish told

percent of cases. Dr. Schaeffer says people

MED. In severe cases, the problem can

with weak peristalsis do not make good

raise the risk of serious problems like

candidates. Otherwise, LINX is an option

Barrett’s esophagus, erosive esophagitis,

for most adults with GERD who want to

and even esophageal cancer. “The point

finally get off medication.

of the reflux center is that more can be done for these people,” says Gerrish. Long-term use of antacids has been linked with kidney disease, dementia, osteoporosis, and C. diff infections. While both doctors acknowledge that traditional

“We are really trying to find people with life-limiting problems and steer them toward the best option,” says Dr. Gerrish. Fewer than five percent of LINX patients go back on antacids within five years. ❖

hat is your ? “ W favorite way to

The Question

prepare for Spring?” Send your short answer to We'll feature your answers online and in an upcoming issue.

January / February 2019


MEDICATION ASSISTED TREATMENT Black Hills Doctor Helps Patients Reclaim Lives After Opioid Addiction



HERE IS NO LONGER any debate about the fact that America is in the midst of an opioid crisis. There are now more Americans addicted to these potent drugs - both nationally and in our own region - than at any time in history. But exactly how to address the crisis is still a topic of considerable debate.

Despite research suggesting that one in ten people will relapse after a combination of

detoxification and psychosocial treatment, therapy and abstinence-based programs are still the most common approaches. But one treatment protocol is emerging as the gold standard for lasting freedom from opioid addiction: medication assisted treatment or MAT. “MAT is basically utilizing FDA approved medications to allow a patient to not have the physical symptoms of their addiction while they go through counseling,” explains Regional Health family medicine physician Stephen Tamang, MD. Multiple studies of MAT have found that over 80 percent of patients maintain sobriety as long as they are on their medication. Inspired by these success stories, and with Regional’s support, Tamang underwent the DEA-mandated training to become certified to prescribe Suboxone (buprenorphine and naloxone), the most common drug used for MAT, to his opioid-addicted patients at Regional Health Medical Clinic. [See Sidebar]

MEETING THE (UNEXPECTED) NEED MAT is highly regulated and MAT patients require significant time and resources, which is why, Tamang suspects, no one else in his region had ever tried to offer it. “I have had colleagues say they would love to offer this but they are already booked out three months,” says Tamang. “And these patients require a lot of care. Many don’t have health insurance and federal guidelines mandate how often they should be seen, dosing, frequency of drug screens, handling comorbidities, etc. It’s not complicated, it’s just arduous.” Under federal guidelines, a MAT provider can treat only 30 patients in the first year. That number jumps to 100 after a year. Physicians who have prescribed buprenorphine to 100 patients for at least one year can apply to increase their patient limit to 275. This month, one year after Tamang treated his first opioid dependent patient, the MAT


“ This takes people who are lying, stealing, or buying drugs and makes them functional again. I can’t tell you how many people have told me they got their kids back, got their job back, or saved their marriages.”

The Project Recovery team includes (l to r) Nicole Hulsing, RN, Stephen Tamang, MD, Heather Chastein, LPN, Shelli Brandli, RN, Kim Hayden, PA, Tim Aylward, PA, David Christensen, admin, Shelbi Thompson, BSW, Ashleigh Lecy, RN,Trevor Cook, Laboratory Scientist, Troy Thompson, PA

program at Regional Health has become so large that it requires five providers (each of whom will be able to treat 100 patients after a year), four nurses, a social worker, an administrator, and a lab tech to run it. “When I started, it was primarily to help people get off of opioids. I was woefully ignorant of the number of functional heroin users in our area, many of whom had tried multiple times to quit,” says Tamang. Today, these street drug users make up about half of Tamang’s MAT practice while the other half are people addicted to prescription painkillers. “These people are not criminals, but they can also be very protective, just like street drug users, because they know what happens to them when they go off their medication,” Tamang observes. “I had an older man tell me, ‘These drugs have made me steal and lie to my wife’.”

A FAST GROWING PROGRAM At first, Dr. Tamang offered MAT only at Regional Health Medical Clinic. “As I started doing MAT here, it became obvious that one of the resistance points for patients was that they don’t want to do all the counseling,” he says. “But this is an integral part. So we realized that we needed to partner with counselors.” With Regional’s blessing, a partnership was formed with Addiction Recov-

WHAT IS SUBOXONE? Suboxone is the brand name for a combination of buprenorphine and naloxone. Administered as a sublingual film, it is the most common drug used for MAT.

ery Center of the Black Hills, a program with 16 drug addiction counselors. That partnership led to a two-tiered system called Project Recovery which offers MAT at both Regional Health Medical Clinic and the ARC. As the program grew, its evidence-based approach caught the attention of the South Dakota State Department of Social Services Division of Behavioral Health, which has offered support, in the form of both funding and consulting. Meanwhile, Tamang and his colleagues are working to get the word out about MAT. They have formed an alliance with social workers in Rapid City’s

Buprenorphine is a long-acting, high-affinity partial agonist at the mu-opioid receptor. It prevents withdrawal and cravings and blocks other opioids from binding, preventing abuse.

longstanding Cornerstone Rescue Mission to help identify addicted individuals who want treatment. Patients receive free transportation to and from treatment. The next goal is to get the work into the prison. “This is the most fulfilling, rewarding work I’ve ever done,” says Tamang. “This takes people who are lying, stealing, or buying drugs and makes them functional again. I can’t tell you how many people have told me they got their

There is a low risk of overdose with buprenorphine and it does not produce a high in the opioid dependent.

kids back, got their job back, or saved their marriages.” MAT patients are also screened for infectious diseases (Dr. Tamang has identified 5 cases of Hepatitis C) and are helped to get on Medicaid, if they qualify, for more consistent healthcare. “The bottom line is that MAT works and it works best with a systems approach,” says Dr. Tamang. “I can tell you from personal experience that it is way harder to do this work on your own. You need some infrastructure behind you. But when you have great partners backing you, like Regional Health, Cornerstone, the ARC, and the state of South Dakota, you are able to make great strides.” “It takes some efforts to get it set up, but once you do, it is a beautiful

Combining it with naloxone (as in Suboxone) blocks the intranasal or intravenous abuse of buprenorphine. Buprenorphine is the only opioid authorized under the Drug Addiction Treatment Act of 2000 for the treatment of opioid use disorder.

thing.” ❖


Read More

❱ Read recent research and watch a video explaining more about MAT on our website.

March 2019


Happenings around the region

News & Notes

South Dakota | Southwest Minnesota | Northwest Iowa | Northeast Nebraska

AVERA Avera and Avera Behavioral Health have started a new Farmers’ Stress Hotline. The free service is available 24/7 for farmers & ranchers and their families. Operators take inventory of callers’ needs and direct them to local care. “Stress, fear, anxiety, frustration and depression are all words I’ve heard to describe the ag climate,” observes Karl Oehlke, ABIM, PA-C, of Avera Medical Group University Psychiatry. The number is 1-800-691-4336 Yankton podiatrist Scott Shindler, DPM, of Shindler Foot Clinic, retired in December and moved to Arizona, 70 years after his father, Edward, founded the clinic. Avera Medical Group Podiatry has purchased the electronic medical record for the practice so patients are encouraged to go to Dr. Terence Pedersen and Christy Wiarda at the AMG Podiatry Clinic.


KIM JENSEN Kim Jensen became Chief Human Resources Officer for the Avera Health system in December after serving in an interim role since June. Jensen joined Avera in 1997, serving as VP for Human Resources at Avera Sacred Heart Hospital in Yankton. Since 2012, Jensen has served as VP of Talent Management. She holds a BS in HR Management from University of Minnesota and is a nationally certified HR professional. Carris Health Marshall Clinic on Carlson Street in Marshall, Minnesota is now an Avera Medical Group location. The former Carris surgery center will become Avera Surgery Center and the 150 Carris Health employees now work for Avera. Avera Medical Group now employs more than 100 physicians and advanced practice providers in the Marshall region.

Avera Health and Children’s Home Society (CHS) of South Dakota have published a children’s book. “A New Norm” expresses the confusing and stormy feelings that can overwhelm young people. By identifying negative thoughts and emotions that are potentially harmful, the book encourages young people to have conversations with people they trust. It is designed for used by families as well as in youth groups and in classrooms.

BLACK HILLS Regional Health’s Rehabilitation Institute building at Fifth Street and Fairmont Boulevard was demolished in January as the next phase of hospital construction began. Before demolition, the Rapid City Fire Department conducted a series of training exercises in the vacant building. Next steps are to complete the steel framing on the new five-story hospital clinic addition and build the second parking garage west of the existing garage. A number of Regional departments and services have relocated to the new Regional Health Orthopedic & Specialty Hospital at Caregiver Circle in Rapid City, which opened in early January. Services at the new location include physiatry, podiatry, neurosurgery, orthopedics, sports medicine, weight management, wound care, neurophysiology and outpatient rehabilitation services such as massage therapy, physical therapy, occupational therapy and speech therapy. The Pain Management Clinic has moved to the Regional Health Medical Clinic on 5th Street and the Neuropsychology Clinic has moved to the Medical Office Building on Cathedral Drive.

LISA BROWN Dr. Lisa Brown, a family medicine doctor at Regional Health Custer Hospital and Clinic, was elected president of the SD Academy of Family Physicians at the group’s December meeting in Deadwood. The statewide organization is a chapter of the AAFP and has more than 500 members. It is focused on education for physician, medical resident and medical student members. The chapter is also involved in advocacy at both the state and national levels.



JESSICAL ALUISE Several Regional Health nurses won DAISY awards in the last few months. RN Todd Anderson in the Orthopedic-Neurology-Surgery Department at Rapid City Hospital was nominated by a grieving patient who said he helped facilitate her quick discharge. Jessica Aluise, RN, in the medical/ surgical unit at Sturgis Hospital, was nominated by a patient’s family who cited

March 2019

her concern and compassion when their mother was in hospice. And Rapid CIty Hospital Labor and Delivery RN Jenny Wills was nominated for her support of a patient during an emergency C-section.

SANFORD Early results from a clinical trial of adiposederived regenerative cells to treat rotator cuff injuries indicate that the treatment is safe and well-tolerated. Top line results were reported earlier this year by the study sponsor, InGeneron Inc. The FDA-approved trial, which enrolled participants at Sanford Health, was the first of its kind in the United States, launching in 2016. Sanford Health has broken ground for a new clinic on Sanford Sports Complex grounds in northwest Sioux Falls. The 8,000 square foot facility will house a Sanford Acute Care and Orthopedic Fast Track Clinic and the headquarters for The Summit League. The clinic will offer onsite laboratory and imaging services plus immediate access for athletes utilizing the Sanford Sports Complex. It will also offer more convenient care for residents in that expanding part of Sioux Falls.

Sanford Health has pledged $300,000 per year in scholarship funds for medical students at The University of South Dakota Sanford School of Medicine. That amount will be matched annually by USD’s foundation. Starting in 2019-2020, ten medical students from each class will be selected to receive a $7,500 scholarship annually. The scholarship program will be the largest single source of scholarship money for USD med school students.

TINA GEARY Two Sanford nurses have been recognized with DAISY awards recently. RN Sarah Stoebner of Aberdeen Oncology Clinic was nominated by patients who appreciated that she recognized and spoke to them outside of the clinic. RN Tina Geary of The Birth Place in Sioux Falls was described as encouraging, calming and compassionate.

The Evangelical Lutheran Good Samaritan Society and Sanford Health have officially combined. As a combined organization, Sanford Health now employs nearly 50,000 people, offering health services spanning the continuum of life, including clinics, hospitals, health insurance and senior care services, in 26 states. David Horazdovsky remains CEO of The Society and Randy Bury is its president.


• Happenings around the region

News & Notes

Happenings around the region


Hawarden Regional Healthcare is now providing Urgent Care services. According to Hospital Administrator, Jayson Pullman, “When talking with the public, we found there was a need for after hour services in the area. The community is receiving these additional medical services with open arms.” Hawarden Regional Healthcare is managed by Mercy Medical Center-Sioux City.

JESICA HANSON Jesica Hanson became Vice President of Finance at Mercy Medical Center-Sioux City in January. Hanson has more than 20 years of experience in business plan development, revenue cycle analytics, operating and capital budgeting processes, and long range financial planning. She holds a BS in Business and Economics from George Fox University and is a Certified Public Accountant.

Mercy Medical CenterSioux City has earned the American Heart Association Gold Plus Heart Failure recognition and Silver Plus Stroke recognition. Mercy is the only hospital in Iowa to secure a spot as a Target: Stroke Honor Roll Elite Plus award winner. In addition, Mercy has earned Gold honors for Mission: Lifeline, which aims to reduce the amount of time from arrival to treatment of acute heart attack.

Chad Markham is the new COO of UnityPoint Health–Sioux City. He succeeds Leah Glasgo, who was named president and CEO at UnityPoint Health–Fort Dodge in November. Markham has served as the Senior VP for Clinics and Network Development at UnityPoint Health–Sioux City since he joined the organization in November 2009. He previously served as CEO of the Hawarden Community Hospital. He holds an MBA from St. Cloud State University in Minnesota. Mercy Medical Center has opened a Clinical Decision Unit (CDU) in the ED. In this unit, patients are treated and observed following their emergency room visit while Mercy physicians and staff continue to evaluate whether or not the the patient should be admitted to the hospital. The CDU allows patients to have thorough treatment, often without having to be admitted.

UnityPoint Health is among 12 health systems representing approximately 250 US hospitals that have joined Civica Rx as founding members. Civica Rx members drive drug selection decisions to ensure Civica Rx manufactures medications most essential to patient care. Civica Rx expects to bring over 14 hospitaladministered generic drugs to hospitals and healthcare systems in 2019. The company is working towards becoming an FDA approved manufacturer.

TAMMY DEROCHER Tammy DeRocher, BSN, RN, CDE, is now the Diabetes Nurse Educator-Clinical Coordinator at UnityPoint Health–St. Luke’s. DeRocher has worked as an RN at St. Luke’s in Employee Health and Wellness, Occupational Medicine, and the Diabetes Center. She has more than 28 years of nursing experience and completed the Iowa Hospital Association Leadership Series in 2017. DeRocher completed her associate degree in nursing at St. Luke’s School of Nursing and earned her bachelor’s degree in nursing through Briar Cliff University.

Staff work in the CDU in Sioux City.



Save the Date

LORNELL HANSEN Dr. Lornell Hansen, Owner and Medical Director of Physicians Vein Clinics in Sioux Falls, recently received credentials as a Registered Phlebology Sonographer (RPhS). The Registered Phlebology Sonographer (RPhS) examination is for professionals working in the area of venous/ phlebology ultrasound. Dr. Hansen practices in Sioux Falls, Sioux Center, Sioux City and Watertown.

Orthopedic Institute and CORE Orthopedics in Sioux Falls announced a partnership in January. Both independent orthopedic clinics have a long history of orthopedic care in the area. In addition to the diagnosis and treatment of orthopedic conditions, the new integrated practice will provide the entire spectrum of musculoskeletal care including orthopedic urgent care, physical and hand therapy, orthotics, advanced imaging, sports performance and injury prevention, and non-opioid, comprehensive pain management.

The VA Black Hills Health Care System and the Sioux Falls VA Medical Center were among five VA Midwest Healthcare network facilities to receive national recognition last month at the VA Patient Experience Symposium in Crystal City, Virginia. Twelve VA facilities in three categories of complexity were nominated to receive Patient Experience awards. Sioux Falls was recognized as the top performer in the Level 2 category.

24th Annual North Central Heart Vascular Symposium

24th Annual

Friday, May 10, 2019 8 a.m. – 4:30 p.m.

Vascular Symposium

Sioux Falls Convention Center 1201 N. West Ave. Sioux Falls, S.D. Hear from vascular experts around the country as they discuss the latest technology and treatment for vascular disease.

Learn more at

March 2019


Retired plastic surgeon Dr. Vaughn Meyer and his wife JoAnn (Kruse) Meyer were remembered in a December funeral service at Our Redeemer Lutheran Church in Sioux Falls. The couple were heading toward the Sioux Falls Regional Airport when their 1980 twin-engine, six-seat Beechcraft Baron crashed on Christmas day. The Meyers were 68. Dr. Meyer had been a pilot since medical school. JoAnn Meyer was a former speech pathologist.


• Happenings around the region

News & Notes

Happenings around the region


Visions Eye Care & Vision Therapy Center has moved to 6201 South Minnesota Avenue in Sioux Falls. The new clinic features more than 3,000 additional square feet and will be comprised of Visions Eye Care and Visions Therapy Center, which includes specialized vision, occupational, and sports vision therapy services. Other upgrades include computerized exam equipment that integrates with patient records along with a larger selection frames.

LAUREN WOOD THUM Dr. Lauren Wood Thum, a fellowship-trained pelvic medicine specialist and reconstructive surgeon with Urology Specialists in SIoux Falls, has added a leading edge treatment to her practice to resolve urologic and gynecologic health issues often caused by menopause. MonaLisa Touch, which was FDA cleared in 2014, delivers fractional CO2 laser energy to the vaginal wall to induce collagen production. Patients undergo three five-minute treatments spaced six weeks apart. Recent studies show that patients experienced statistically significant improvement in the vaginal tissue after the first treatment.


LifeScape is adding a new clinic at 41st Street in Sioux Falls. The Autism & Child Development Center will be the new home of expanded Applied Behavioral Analysis therapy for autism. OT, PT, Speech Therapy, and Psychology Services will also be expanded. The new location opens in mid-March. The Specialty Clinic at Prairie Lakes has opened an Acid Reflux Center. Reflux specialists Dr. Greg Gerrish and Dr. Jacob Schaeffer offer advanced diagnostic and treatment tools including the Bravo Reflux Testing System, ManoScan ESO high-resolution manometry system, and the LINX procedure for GERD. [Read more on page 9]

Prairie Lakes Healthcare System (PLHS) has named several new directors:

JENNIFER BRIGGS Jennifer Briggs is now the new Director of Medical/ Surgical/Pediatrics. Briggs holds a Bachelor’s Degree in Nursing and has worked at PLHS for 31 years, with 29 of those years as a registered nurse.

New Laboratory Director Jennifer Sieck has 10 years of experience in the clinical laboratory and holds a Bachelor’s degree in Microbiology.

KARNA STROSCHEIN Karna Stroschein, the new Director of Coding, holds a Bachelor’s degree in Health Information Administration and a Masters degree in Health Informatics. Prior to her new role, Stroschein was the Director of the Business Office at PLHS and has thirty years of healthcare experience.

AMANDA JOHANNSEN JENNA HULSCHER Jenna Hulscher, Director of Radiology, has more than 13 years of experience. She holds an Associate’s degree from Mitchell Technical Institute and advanced certifications in Radiologic Technology, Magnetic Resonance Imaging and Certified Radiology Administration.

Stroschein’s previous role as Director of the Business Office was filled by Amanda Johannsen who has worked for Prairie Lakes since 1999 and holds a Bachelor’s degree in Business Administration.

Minimally Invasive Options Boost Sanford’s Colon Cancer Screening Rates BY ALEX STRAUSS



Vice President for Sanford

patients. Another effort,

is the second leading

Health Network. “We know

called FluFIT, involved

cause of cancer death in

that we have saved some

offering FIT tests to eligi-

the US after lung cancer.

individual lives through

ble patients who came for

this effort.”

flu shots. Sanford employ-

Unlike lung cancer, effective screening tools exist for colorectal cancer.

The life-saving initia-

ees in Bismarck and Sioux

The challenge is to get more Ameri-

tive has been a major

Falls were also offered

cans to utilize them.

undertaking for Sanford,

one of these screening

Sanford Health took up that

which required the entire

options, or help schedul-

challenge in recent years, joining a

organization to expand its

national effort by the American

view of what constitutes

Cancer Society to get 80 percent of

effective screening and come

Americans screened by the end of

up with creative ways to promote it.


ing a colonoscopy, at their Dan Heinemann

flu shot visits. Because about 15 percent

of these non-invasive tests require a

“Unfortunately, we know that 30

follow-up colonoscopy, Heinemann

When Sanford joined the effort,

to 35 percent of people offered colo-

says the initiative required Sanford to

their own patient screen rates stood

noscopy, which lasts for 10 years, just

step up efforts to ensure clear com-

at 68.7 percent. By the end of last year,

say no. They don’t like the prep, they

munication between primary care,

the number had risen to 77 percent

have heard bad things about it, what-

GI, and surgeons.

across the footprint of the organiza-

ever,” says Dr. Heinemann.

tion. As of this writing, a 22nd Sanford

“It has been great to see how indi-

So Sanford began also offering two

vidual practices have implemented

non-invasive tests – fecal immu-

it,” says Dr. Heinemann. “We are proud

nochemical testing (FIT), which is an

of the progress we have made but we

“We have seen an increase of about

annual test, and Cologuard, which can

know that we cannot rest when 20

20 thousand patients screened over

be done every three years. In some

percent of our patients haven’t been

three years,” says Dr. Dan Heinemann,

cases, FIT tests were mailed to

screened.” ❖

practice better for the info. had reached the 80 percent mark. Some are even at 90 percent.

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March 2019


Passwords 101

Think your office or personal files are safe behind your “strong” password? Here’s why a security expert says you might be wrong. BY ALEX STRAUSS


OST OF US THINK we know what makes a

those kinds of traditional password rules on users,

strong password, even if we don’t always

people tend to create passwords that are pretty

follow that wisdom. To protect themselves,

easy to guess like ‘Winter2019!’, especially if you


require them to change the password every 90




password requirements for employees. These are things

days, which falls into a seasonal rotation.”

like the password must have 8 characters, upper and lowerHow can a busy medical practice help ensure

case, at least one number and one special character. But James Maguire, Senior Security Engineer with High

that its data is protected? Maguire offers the

Point Networks, says passwords like that are no longer good

following suggestions:

enough to keep the bad guys out. Maguire does penetration


testing — ethical hacking — to expose organizational vulnerabilities. He says passwords are often one of the weakest points. “We now have much more powerful hardware to crack passwords like that,” says Maguire. “Also, when you enforce

REPLACE PASSWORDS WITH PASSPHRASES — Maguire says passphrases are usually preferable to passwords. That

is because a phrase longer than 16 characters can still be easy to remember but much, much harder to crack. “My dog’s name is Frank. So I might use a phrase like ‘Walk Frank twice a day!’ in which case the spaces count as special characters,” says Maguire. Maguire says a passphrase that strong does not have to be changed every 90 days, which is also easier on users.


USE MFA OR MULTIFACTOR AUTHENTICATION. — MFA refers to a second layer of security such as a PIN delivered by

text message, or a a cell phone app which sends a push notification when you try to log in. MFA means that, even if a hacker can get at the username and password, they cannot access files without jumping through that second hoop. Maguire suggests always using MFA for banking and shopping sites and for personal email.


Read More

❱F ind a list of some common password managers and websites that support MFA.


❱D iscover more strategies for protecting your office from a cyber-attack.

When you enforce traditional password rules on users, people tend to create passwords that are pretty easy to guess.



— Using an online password manager can help solve the problem of having to

create and remember multiple passwords by storing them for you. While Maguire says this is better than using predictable passwords or using the same password everywhere, it still means you are putting a lot of trust in a single system. If you go this route, Maguire recom-

mends a system that supports MFA and allows you to use a passphrase to access it.


CHECK FOR BREACHES — Finally, If you are concerned that your password (or those of others in

your organization) may have been breached somewhere along the line, a website that collects and aggregates data breaches may be able to tell you. At ‘’, it is possible to search for compromised

EXPERIENCED IN HEALTH CARE LAW Boyce Law Firm has decades of experience in providing counsel to hospitals, health systems, health care providers, in-house counsel, and health care insurers across South Dakota. Over the years, our attorneys have been involved with shaping the health care law landscape in South Dakota. This wealth of experience helps us to provide effective and efficient legal counsel to help clients with whatever health care related issues that arise. • Malpractice Defense • Licensing, Credentialing, and Employment • HIPAA/Privacy and Security • Fraud and Abuse/Stark • Corporate Compliance

accounts by domain, showing whether anyone in your organization has been part of a breach. “I used that site to find out that I was in the LinkedIn data breach,” says Maguire who admits to having been lazy with his own passwords in the past. “That really set me off because I used the same password for

• Roger A. Sudbeck • Lisa K. Marso • Matthew D. Murphy • Tommy L. Johnson

everything. I completely changed how I was protecting myself.” ❖

(605) 336-2424 • 300 S. Main Ave, Sioux Falls, SD 57104

March 2019


Public Health 3.0: A New Opportunity to Address Health in Rural America BY SANDRA MELSTAD


NCREASING GLOBALIZATION and the growing impact of social, economic, and environmental factors on global health, calls for expansion of the scope and reach of population health approaches to improve health outcomes across rural America.

Rural-urban disparities in life expectancy and death continue to rise, with

rural life expectancy at 76.8 years compared to urban life expectancy of 78.8. With chronic disease as the leading cause of death and illness in the US, rural communities are left disproportionately affected, with four of the five leading causes of death associated with chronic disease. Many of these poor health outcomes are heightened by social, economic, and environmental factors, including poverty, access to healthcare and/or

ublic Health 3.0 “ Pemboldens communities to serve as leaders in improving population health, including generating collective impact through engagement of multi-sector partners.

healthy foods, or community infrastructure. Public Health 3.0 emboldens communities to serve as leaders in improving population health, including generating collective impact through engagement of multi-sector partners, and improving the social determinants of health (SDOH). Public Health 3.0 builds on Public Health 1.0 and 2.0. Whereas healthcare was once considered the primary approach to health, death and illness, collaboration is key to collectively address SDOH. Collective Impact is a collaborative approach that helps reduce isolated population health efforts and convenes people to achieve social change. Collective impact centers on a common agenda, shared measurement, mutu-

Sandra Melstad, MPH, is the CEO of SLM Consulting, LLC, in Sioux Falls.

ally reinforcing activities, ongoing communication, and backbone support. Considering the lack of resources in many rural communities, implementation could be a challenge. But rural communities can adopt Public Health 3.0 approaches and collective impact by capitalizing on their strengths. That means knowing what resources are available in the community (something that is often undervalued), leveraging existing relationships, utilizing available technology to communicate with partners, and otherwise getting creative. Opportunities to develop the rural public health landscape through Public Health 3.0 will require enhanced leadership to affect SDOH beyond governmental agencies or health systems. It will require community champions, a broadening of strategic partnerships across multiple sectors, utilization of technology and data that matter, using and sharing locally relevant data, and securing sustainable and flexible funding. Above all, realizing the vision for improved health in rural communities will require a breadth of thought leaders to work together on the issue. Despite the public health challenges facing rural America, it is possible through Public Health 3.0 and the collective impact of committed people. Contact SLM Consulting to take the next step to envision a health future ❖


REFERENCES Collective Impact Forum. (2014). Health Resources and Services Administration. (2019, January 23). Social determinants of health for rural people. In Rural Health Information Hub. Iyer, L. (2015, November 2). How do rural communities in the U.S. implement collective impact? In FSG. Lynn, J., Stachowiak, S., Gase, L., Roos, J. Oppeneheimer, S., Dane, A….Akey, T. (2018). When collective impact has an impact, a cross-site study of 25 collective impact initiatives. ORS IMPACT and Spark Policy Institute. Moy E, Garcia MC, Bastian B, et al. Leading Causes of Death in Nonmetropolitan and Metropolitan Areas — United States, 1999–2014. MMWR Surveill Summ 2017;66(No. SS-1):1–8. Singh, G.K., Siahpush, M. 2014. Widening Rural-Urban Disparities in Life Expectancy, U.S., 1969-2009. American Journal of Preventive Medicine, 46(2), 19-29.

Read More

❱ Read more of Melstad’s insights and find the reference links on the intersection between healthcare and public health.


March 2019



Beef and the Mediterranean Diet: Surprising New Research

M 1. O ’Connor LE, Paddon-Jones D, Wright AJ, Campbell WW. A Mediterranean-style eating pattern with lean, unprocessed red meat has cardiometabolic benefits for adults who are overweight or obese in a randomized, crossover, controlled feeding trial. Am J Clin Nutr 2018, nqy075. 2. Maki KC, et al. A meta-analysis of randomized controlled trials comparing lipid effects of beef with poultry and/or fish consumption. J Clin Lipidol 2012;6:352-61. 3. Roussell MA, et al. Beef in an Optimal Lean Diet study: Effects on lipids, lipoproteins, and apolipoproteins. Am J Clin Nutr 2012;95:9-16.

ANY PEOPLE are aware that the Mediterranean diet is one of the most popular eating patterns and its popularity continues to rise alongside the increasing need for healthier eating patterns and lifestyles. The diet is often characterized by a relatively high consumption of fruits, vegetables, whole grains, nuts/seeds and olive oil, and lower in sweets, sodium and red meat. Interestingly, many Mediterranean countries eat about the same amount or more red meat as the United States, but those countries pair red meat with more fresh vegetables and fruits, whole grains and healthy oils. New scientific evidence shows that a Mediterranean-style eating pattern that includes lean, unprocessed red meat can improve cardiometabolic risk factors, such as blood pressure and total and LDL cholesterol.1 This study adds to the growing body of scientific evidence demonstrating that a healthy dietary pattern incorporating lean, unprocessed beef alongside poultry and/or fish offers the same cardiovascular health-promoting properties as a red meat restricted dietary pattern.2-3 � To learn more about this research and other studies behinds beef’s nutritional qualities visit

Compassion . Experience . Trust  � � � �  ­ 605.334.1930 6301 S. Minnesota Ave., Suite 300 22




APRIL 26 & 27


7:00 am – 4:00 pm Women’s Health 101 for Nurse Practitioners & Physician Assistants

Hilton Garden Inn, Sioux Falls

Location: Mercy Medical Center

Location: Ramkota Hotel, Sioux Falls

Information & Registration:


Information & Registration:


8:00 am – 4:00 pm 12th Annual Avera Brain and Spine Institute Conference




8:00 am – 6:00 pm 8:00 am – 4:30 pm 13th Annual Sanford Sports Medicine Symposium


7:30 am – 4:00 pm 27th Annual Avera McKennan Trauma Symposium

MAY 10


8:00 am – 5:00 pm 24th Annual North Central Heart Vascular Symposium

Location: Schroeder Auditorium,

Sioux Falls Convention Center


Sanford USD Medical Center

Information & Registration:

Sioux Falls Convention Center


Information & Registration:


8:00 am – 5:45 pm Annual Perinatal, Neonatal & Women’s Health Conference


Registration:, keyword: PNW


9:00 am – 5:30 pm 2019 Sanford Heart and Vascular Symposium

MAY 15


8:30 am – 4:00 pm Avera Caring Professionals Conference

Delta Hotel by Marriott, Fargo


Location: Viborg Community Center


Sioux Falls Convention Center

Information: 605-326-3028

Information & Registration:


Pioneer Memorial Foundation Extravaganza 6:00 pm – 9:00 pm


9:00 am – 6:00 pm Edith Sanford Breast Center Symposium


8:30 am – 4:30 pm Avera McKennan Diabetes Conference 2019


MAY 15, 16 & 17


Location: Hilton Garden Inn

Delta Hotel By Marriott, Fargo

Downtown Sioux Falls

9:00 am – 5:45 pm 2019 Sanford Integrative Health Symposium

Teleconference location:

Information & Registration:

Location: Sanford Center, Sioux Falls

Sanford Center & Edith Sanford

Information & Registration:

Breast Center, Sioux Falls


Information & Registration:

605-312-3509 605-312-6677

VISIT THE ONLINE CALENDAR at to find more information on these and other upcoming events between issues. You can also add your own event to the calendar for free.

Protecting the human behind the heart. A healthy heart supports a healthy life — which is why trusting a team with yours means so much. Sanford Health has the preventive care and advanced treatments to create a strong, custom care plan made to fit your life and face your challenges. THINKHEARTTHINKUS.COM

013000-00692 2/19

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