MED-Midwest Medical Edition-September/October 2012

Vol. 3 Issue 6

2012 September October

Bright Future

South Dakota and the Upper Midwest’s Magazine for Physicians and Healthcare Professionals

Vote YES on IM #15 to ensure access to health care and education for South Dakotans!

Following substantial budget cuts over the past few years, a grassroots coalition of organizations and individuals that support education and healthcare in South Dakota are supporting a ballot measure to more adequately fund two critical state programs. Initiated Measure 15 (IM #15) will add one penny to the state sales tax, raising approximately $175 to $180 million annually, split evenly between K-12 public education and Medicaid.

Inadequate Funding for our Children’s Education At current funding levels, South Dakota school districts cannot continue to provide students with a quality education. As a result of recent funding cuts, many schools have already had to increase class sizes, eliminate or limit student opportunities and cut classroom staff. And the cuts aren’t over – many districts are relying on short-term solutions, including additional property tax revenue, to stall more dramatic cuts.

Medicaid Cuts Threaten Patients’ Access Recent funding cuts could have a devastating impact on patients as physicians and nursing homes may be forced to limit the number of, or stop accepting, Medicaid patients all together. Approximately one out of every seven South Dakotans receives their basic health care through Medicaid. Roughly half of all children born in our state qualify for Medicaid. When patients cannot get their needs met in a primary care/clinic setting, they seek care at an emergency room, which is more expensive and drives up health care costs for everyone.

For more information, go to www.movingsdforward.com.

Vote YES on IM#15 Paid for by the South Dakota Association of Healthcare Organizations

Contents Midwest Medical Edition

SEPTEMBER / OCTOBER 2012

Regular Features 2 | From Us to You 4 | News & Notes: Expanded! News from around the region 8 | Meet a MED Advisor – Patty Peters, MD 24 | M edicine & the Arts: Geriatrician Arthur Cowden, DO and ‘Medical Minstrel’

26 | The Nurses' Station 32 | Grape Expectations: The Chicken and the Egg

| By Heather Taylor Boysen

37 | M ED’s Annual Call for Nominations MED is committed to supporting area physicians with timey, relevant regional news. Help us pick the topics you want to read in MED’s pages in 2013

38 | Learning Opportunities:

Upcoming Symposiums, Conferences, CME Courses

In This Issue 8 | I owa Health Systems Launch Regional Alliance: Four Iowa healthcare organizations are banking on the promise of strength – and cost savings – in numbers.

12 | N ew Peds Cardiac Surgery Program to Honor VanderWoude A month after the death of respected vascular surgeon John VanderWoude, MD, Sanford announces the region’s first pediatric cardiovascular program.

20 | M edicaid ‘Health Home’ Pilot Design Progresses | By Dave Hewett 22 | R esearch Roundup

| Area scientists are seeking and finding answers to pressing medical questions.

23 | Sioux Falls Leads the Nation in Cancer Trial Enrollment 28 | T o Improve Health

| Originally formed as a way to bring low-cost sports medicine services to Siouxland, CNOS Foundation is now redefining the concept of ‘sport’ as it broadens its mission in the region.

Sponsored Feature

31 | R ural Communities Welcome Health Professions Students

| Can exposing students to small-town medicine influence their future career choices? A new program takes a ‘from-the-ground-up’ approach to addressing rural South Dakota’s provider shortage.

34 | Trust Modification

| But What if it Says Irrevocable? | By Alice Rokahr

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

A Bright Future

With 25,000 people, Aberdeen is South Dakota’s third largest city. Now that the Sanford Aberdeen Medical Center has opened, the city has another claim to fame – not one, but two full-service community hospitals. In this month’s Cover Feature, we’ll explore what the new medical center will mean for the community and for the 200,000 people in its trade territory.

page

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Cover Feature

From Us to You

Staying in Touch with MED

A

lthough the New Year is still months away, for many professionals (especially those with families), the end of the summer also marks a beginning. As the school year and colder weather set in, practices may see a rise in infectious diseases, sports physicals, and sportsrelated injuries. Schedules tighten as kids’ school, lessons and practices restart, colleagues and staff return from vacations and committees and boards reconvene. In many practical ways, September – not January or even May – is the time for new beginnings.

Which is why it seems fitting that Aberdeen’s new hospital has opened for business as the fall begins. In this month’s Cover Feature, MED takes you inside Sanford Aberdeen Medical Center to explore what the facility means for this growing community.

We were excited for the opportunity to visit with so many MED supporters and readers in August at the SDMGMA meeting and we are glad to be at this month’s SDAHO Conference.

MED is committed to keeping its finger on the pulse of what impacts your medical practice and we welcome your feedback and suggestions. Contact us any time at Steff@MidwestMedicalEdition.com or Alex@MidwestMedicalEdition.com.

—Alex and Steff

Publisher

Steffanie Liston-Holtrop

Contributing Writers

Staff Writers

Steffanie Liston-Holtrop Alex Strauss Corbo Design Darrel Fickbohm Kristi Shanks 5j Design Darrel Fickbohm Hannah Weise

Heather Boysen Dave Hewett Alice Rokahr Liz Boyd Caroline Chenault John Knies

Contact Information Alex Strauss

Steffanie Liston-Holtrop, VP Sales & Marketing 605-366-1479 Steff@MidwestMedicalEdition.com Alex Strauss, Editor in Chief 605-759-3295 Alex@MidwestMedicalEdition.com Fax 605-271-5486 Mailing Address PO Box 90646 Sioux Falls, SD 57109 Website MidwestMedicalEdition.com

2012 Advertising / Editorial Deadlines Jan/Feb Issue December 5

June Issue May 5

November Issue October 5

March Issue February 5

July/August Issue June 5

December Issue November 5

April/May Issue March 5

Sep/Oct Issue August 5

Reproduction or use of the contents of this magazine is prohibited.

Awards

e Woruits! t

t ccep We aader re s i o n is subm

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Announcing The Meddy This is an award given by the Publishers, Editorial Staff, and/or Board of Advisors of Midwest Medical Edition (MED Magazine) to recognize a subject of outstanding interest or contribution that has appeared in the magazine. Recipients will receive a framed, personalized edition of the issue in which they are featured as well as an announcement in a future issue. Watch for an announcement of our first Meddy Award recipients in the November issue of MED.

VP Sales & Marketing Editor in Chief Design/Art Direction Cover Design Photographer Web Design Contributing Editor Copy Editor

MED Magazine, LLC Sioux Falls, South Dakota

©2011 Midwest Medical Edition, LLC Midwest Medical Edition (MED Magazine) is committed to bringing our readership of 3500 South Dakota area physicians and healthcare professionals the very latest in regional medical news and information to enhance their lives and practices. MED is published 8 times a year by MED Magazine, LLC and strives to publish only accurate information, however Midwest Medical Edition, LLC cannot be held responsible for consequences resulting from errors or omissions. All material in this magazine is the property of MED Magazine, LLC and cannot be reproduced without permission of the publisher. We welcome article proposals, story suggestions and unsolicited articles and will consider all submissions for publication. Please send your thoughts, ideas and submissions to alex@midwestmedicaledition.com.

Magazine feedback and advertising and marketing inquiries, subscription requests and address changes can be sent to steff@midwestmedicaledition.com.

MED is produced eight times a year by MED Magazine, LLC which owns the rights to all content.

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Happenings around the region

South Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska

News & Notes Avera Tricia Merrigan, MD, has joined Avera Medical Group Comprehensive Breast Care in Sioux Falls. Dr. Merrigan recently

completed fellowship in breast surgical oncology at Akron General Medical Center in Akron, Ohio. She is an MD graduate of USDSM and did her residency at Iowa Methodist Medical Center in Des Moines.

She joins breast surgeons Dr. Julie Reiland and Dr. Wade Dosch in the practice, which is soley dedicated to breast surgery.

Sioux Center Community Hospital & Health Center Avera broke ground on its new hospital and clinic in July. The

ceremony took place on the 40-acre development site located on B-40 and 13th Avenue in Sioux Center.

The new 123,500 sq. ft. facility will replace the current hospital built in 1951 located on Highway 75. The new floor plan allows for additional space in the outpatient services area which accommodates the growing trend of same-day surgeries and specialty care. It is expected to be completed in the fall of 2013.

Rochelle Reider, Vice President of Patient Services at Avera Queen of Peace, recently became a Fellow of the American College of Healthcare Executives, the nation’s leading professional society for health care leaders.

Reider has worked at Avera Queen of Peace Hospital for 14 years. The new certification means that Reider is now Board Certified in Health Care Management.

Matthew Kammer is the new Director of Chaplaincy Services at Avera Queen of Peace Hospital. Kammer

received his Bachelor's Degree in Criminal Justice/Religious Studies and his Masters Degree in Pastoral Ministries from Mount Marty College in Yankton. He has extensive experience in pastoral care, having served as a hospital chaplain in Nebraska and a pastoral care director in Washington.

Kammer is Board Certified by the National Association of Catholic Chaplains.

Russ Diedrichsen, President of Midwest Bank, Creighton, Neb., and Michael Peterson, MD, Avera Medical Group Radiation Oncology Yankton have joined the Avera Sacred Heart Hospital Board of Directors.

Diedrichsen, a Creighton native, has been president of Midwest Bank in Creighton for seven years and has served on the Avera Creighton Hospital Advisory Board and Creighton Area Health Services Board of Directors. Dr. Peterson has practiced radiation oncology at Avera Sacred Heart Cancer Center for 12 years.

Avera McKennan Hospital & University Health Center has been ranked the number one hospital in South Dakota by U.S. News and World Report.

Rankings are based in part on patient safety, reputation and advanced technologies. This

year’s Best Hospitals, the 23rd annual edition, showcases more than 720 of the nation’s roughly 5,000 hospitals. Avera McKennan was also nationally ranked No. 38 in gynecology.

Dr. Tommy Reynolds and Dr. Michael Bacharach of North Central Heart Institute, place a carotid stent in the cardiac catheterization lab at the Avera Heart Hospital.

Avera Heart Hospital in Sioux Falls has been granted a threeyear term of accreditation in Carotid Stenting by the Intersocietal Accreditation Commission (IAC). Avera Heart

Hospital is the fifth facility in the nation to receive this designation.

The IAC grants accreditation to facilities that have processes in place to ensure quality patient care in compliance with national standards.

Avera McKennan Hospital & University Health Center has been designated a Community Value Five-Star Provider by Columbus, Ohio-based Cleverley & Associates. The Five-Star

recognition goes to hospitals that achieve a Community Value Index score in the top 20 percent of all hospitals in their group. Avera McKennan was one of only three hospitals recognized in South Dakota, and the only one in the Sioux Falls region. This is the fourth time Avera McKennan has received this award since 2008.

The new Digital Art Show is now open in the lobby of the Avera Prairie Center in Sioux Falls. The current

display, which runs through October 6, features the work of Native American artists. The digital exhibition is held in conjunction with the annual Northern Plains Indian Art Market. Also on display in the Digital Gallery through October are the winning entries in Avera’s system-wide art contest for staff and their families.

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Midwest Medical Edition

Western South Dakota Several new physicians have joined Regional Medical Clinic: Pulmonologist Anne Bagley, DO,

and completed her residency in Internal Medicine at Maine Medical Center in Portland, Maine, and her fellowship in Pulmonology at Lahey Clinic in Burlington, Massachusetts.

Neurosurgeon Mark Monasky, MD, completed

his residency in Neurosurgery at the University of Maryland & Stock Trauma Unit in Baltimore and finished a fellowship in Pediatric Neurosurgery at the Children’s Medical Center & Humana Hospital in Dallas.

A native of Rapid City, General Surgeon William Stone, MD, received his MD from Sanford USD School of Medicine and

completed his residency in General Surgery at Synergy Medical Education Alliance in Saginaw, Michigan. Drs. Bagley, Monasky and Stone will practice in the Western Hills Professional Building in Rapid City.

September / October 2012

Nephrologist, Mazen Nemeh, MD completed his

residency in internal medicine at the University of South Dakota (USD) School of Medicine in Sioux Falls. He completed his fellowship in Nephrology at the University of California in Los Angeles and the University of Utah in Salt Lake City. He is a former Chief of Nephrology at the USD School of Medicine and has been a private practice physician in Sioux Falls for the past 10 years

The Black Hills community has raised $95,000 for the Children’s Miracle Network (CMN). Eighteen thousand ducks

were sponsored in this year’s 23rd annual Great Black Hills Duck Race on Sunday, July 29. Funds will be used to provide services and equipment for ill and injured children in the Black Hills area served by Rapid City Regional Hospital.

Infectious Disease Specialist Mahendra Poudel, MD, completed his

residency in Internal Medical at Danbury Hospital, an affiliate of the Yale University School of Medicine. He also recently finished a fellowship in Infectious Disease from Ochsner Clinic Foundation in New Orleans.

Dr. Poudel will hold an Infectious Diseases/HIV clinic at the Family Medicine Residency Clinic in Rapid City. He and Dr. Nemeh will practice in the Aspen Centre at 640 Flormann Street in Rapid City.

Regional Medical Clinic Aspen Centre specialists Keith Bryson, MD, Urology; Gary Carlson, MD, ENT; and Louise French, MA, CCC-A, Audiology have relocated to Regional Medical Clinic – Western Hills Professional Building. Western

Black Hills Urgent Care (BHUC), a division of the physicianowned Black Hills Surgical Hospital, opened in July with five practioners: Board certified Family Practice physicians Kari Lund, MD and Rolf Norlin, MD, and Physician Assistants Andrea Hansen, PA-C, Mari Daly, PA-C, and Eric Ottenbacher, PA-C.

BHUC offers care for common illnesses and injuries, women’s health/pap smear, lab services, vaccinations/immunizations, travel medicine, basic and sports physicals, DOT drug screens and physicals, and occupational medicine

David Evans, MD, an internist at Regional Medical Clinic – Aspen Centre in Rapid City, recently received the “Golden Apple Award” from the Sanford School of Medicine Department of Internal Medicine. Medical

students in the third- and fourthyear classes nominate the faculty members for the awards, which have been given since 1990. The faculty members are from health care facilities in Yankton, Sioux Falls, Fort Meade, and Rapid City.

Juli Bovard, Rapid City Regional Hospital (RCRH) Clinical Document Specialist, recently received certification as a Certified Clinical Documentation Specialist (CCDS). Bovard is only

the second person in South Dakota to earn this certification.

Hills recently underwent a major expansion and renovation, which offers additional space and resources for Urology, ENT, and Audiology patients.

MidwestMedicalEdition.com

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South Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska

News & Notes Sanford Sanford has hired pediatric cardiac surgeon Brett Mettler, MD, to develop a child heart surgery program at Sanford Children’s Hospital. A Nebraska

native, Dr. Mettler graduated from USDSM and is a pediatric surgical director at Vanderbilt University Medical Center where he will continue to also practice. Sanford has reportedly been negotiating with Dr. Mettler since 2011. Until it is decided whether he will move to Sioux Falls full time, Sanford Health staffers will train at Vanderbilt.

Sanford Health broke ground this summer on the largest private construction project in the history of the Dakotas, the new

Sanford Fargo Medical Center. Set to open in 2016, the medical center is a $541 million project, one of the largest in the nation to break ground this year. After continued evaluation of local market needs, the project’s size has grown since its initial announcement in 2010.

In 2011 alone, Sanford Fargo saw a nine percent increase in hospital admissions and an eight percent rise in emergency visits.

Bismark-based Medcenter One and Sanford Health have

completed their merger. As part of the agreement, Sanford Health will invest $200 million over the next 10 years in Bismarck-Mandan and western North Dakota, including a new super clinic in Dickinson. The clinic will feature all the current services provided in Dickinson along with space for additional physicians, a walk-in clinic, an ambulatory surgery center and diagnostic services. Medcenter One will operate under the Sanford Health name.

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South Dakota’s first cardiovascular fellowship program welcomed its first fellows at the Sanford Heart Hospital this summer. The

new USDSM program is one of 187 cardiovascular fellowships approved for development in the U.S. The three-year program will train two fellows per year and include rotations in areas such as cardiac catheterization, coronary critical care, electrophysiology, non-invasive cardiac evaluations, cardiac research and others.

Rotations will occur primarily at Sanford Heart Hospital, with some rotations at the Sioux Falls VA Hospital.

Sanford Cancer in Sioux Falls will continue to participate in the National Cancer Institute’s NCI Community Cancer Centers Program (NCCCC). Sanford has

been a member of the NCCCP since its inception in 2007 and has been awarded $939,590 to fund participation in the network for the next two years. Sanford was one of 21 awarded funds for a program extension.

Olympic Medalist Gary Hall Jr., a member of Sanford Children’s International Advisory Board, was inducted into the U.S. Olympic Hall of Fame in July. In

addition to his role with Sanford’s International Advisory Board, Hall recently became a spokesperson for the Edith Sanford Breast Cancer Foundation’s “Suit Up to Stop Breast Cancer” grassroots water-based challenge. “Suit Up to Stop Breast Cancer” encourages consumers to create a swimming, water-walking or water aerobics challenge and obtain sponsors for the challenge.

continued

Sanford USD Medical Center is one of the nation’s most improved users of health information technology, according to the results of the 2012 Most Wired Survey published in the July issue of Hospitals & Health Networks magazine. Sanford enhanced

its EMR system in the last year by implementing computerized provider order management (CPOM). Sanford Health as a system has implemented CPOM in 20+ hospitals throughout South Dakota, North Dakota, Minnesota and Iowa. Respondents to the Most Wired survey completed 662 surveys, representing 1,570 hospitals, or roughly 27 percent of all U.S. hospitals.

Siouxland Physiatrist Chad Stadsvold, DO, of St. Luke’s Physical Medicine and Rehabilitation Clinic has earned board certification from the American Board of Physical Medicine and Rehabilitation. A native of

Spencer, Iowa, Stadsvold received a BS in Exercise Science from the University of Iowa and a DO from Des Moines University— Osteopathic Medical Center. He completed his residency in Physical Medicine and Rehabilitation at the University of Wisconsin, Madison where he also served as chief resident. Stadsvold in licensed in Iowa and South Dakota.

Mercy Medical Center has been awarded the Environmental Excellence Award from Sterilmed Inc., a Minnesota-based health care cost containment company and leading reprocessor of single-use medical devices.

Mercy Medical Center has been recognized as a Best Practice facility for its superior accomplishments in reducing environmental impact and improving overall health care sustainability through medical device recycling.

Siouxland cardiologist Dr. Jerome Pierson has been named the new Chief Medical Officer for Mercy Medical Center.

Dr. Pierson succeeds Dr. Larry Sellers in the role after Dr. Sellers returned to private practice with Mercy Internal Medicine. Dr. Pierson has been a part of the Siouxland medical community since 1992 when he joined Cardiovascular Associates, P.C. (CVA).

Interventional cardiologist Rauf Subla, MD, has joined Mercy Cardiology.

Dr. Subla earned his MD from the Government Medical College in India and completed fellowships in Interventional Cardiology at Duke University Medical Center and in Cardiovascular Diseases at Mayo Clinic, where he most recently worked. Dr. Subla is a Diplomat of the American Board of Critical Care Medicine and the American Board of Internal Medicine.

Midwest Medical Edition

Happenings around the region

Mercy Medical Center’s Department of Laboratory Services has been nominated for Best of 2012 Clinical Lab Facilities sponsored by CLP

(Clinical Lab Products) Magazine.

Medical laboratories are nominated by their peers, and selected by a panel of industry experts. Selection for this honor is based on how well the lab redefines the industry’s best practices to provide the best quality service to clinicians and patients.

Dr. Bertha Ayi, medical director of the Infectious Disease Clinic at Mercy Medical Center is opening an additional office in Sioux City as the operator of Global Infectious Disease Services (GIDS), PC. Dr. Ayi will

continue to have an office at Mercy Medical Center and will serve as the Medical Director of Hospital Epidemiology and the Chairperson of the Infection Control committee.

Dr. Ayi is well-known in the Siouxland area. She has organized an annual Infectious Disease Symposium that has grown in popularity among Siouxland area healthcare providers. In 2008, Dr. Ayi authored the book, MRSA – Killer Bug: What You Need to Know to Protect Yourself.

For the second consecutive year, St. Luke’s Regional Medical Center ranks among the nation’s top hospitals for the value it brings to the local community according to a new study. In its

ninth annual Community Value Index® (CVI) study, Cleverley + Associates named St. Luke’s one of the top hospitals nationwide.

St. Luke’s is the only Siouxland area hospital included on the list of “Community Value Five-Star” facilities.

September / October 2012

Other Ophthalmologist Karen E. Dickes, DO, of Wilcockson Eye Associates has received her Board Certification in Ophthalmology. Dr. Dickes

joined the Willcockson Eye Associates in August 2011 and sees patients in both Yankton, SD and Norfolk, NE. Dr. Dickes’ practice involves general ophthalmology, cataract and implant surgery, laser surgery, glaucoma and diabetes eye management, and eyelid surgery.

Prairie Lakes Healthcare System in Watertown, SD has promoted Mary Petersen, RN, to the position of Vice President. Petersen will

oversee surgical services and the cath lab and will provide leadership for the development of hospital-based services. Petersen has worked at Prairie Lakes for 7 years and holds an associate of applied nursing degree from the University of South Dakota and BA in interdisciplinary studies (business and nursing) from Mount Marty College.

Medical Oncologist/ Hematologist Homam Alkaied, MD, has joined Prairie Lakes Healthcare System. Dr. Alkaied

is board certified in Internal and Geriatric Medicine and board eligible in Medical Oncology and Hematology. He completed his residency and fellowships in Hematology/Oncology and Geriatric Medicine at Staten Island University Hospital in New York.

The South Dakota Breastfeeding Coalition will hold the first Regional Breastfeeding Summit on Monday, Oct. 8 from 8 a.m. to 5 p.m. at the Swiftel Center in Brookings, S.D. The event will be hosted by

Brookings Health System. Keynote presenters include Linda J. Smith, an internationally known lactation consultant and author, and Dr. Raylene Phillips, a neonatologist at the Department of Pediatrics at Loma Linda University Children’s Hospital, Loma Linda, California.

Board Certified Internal medicine physician Timothy L. Irwin, MD,

is a graduate of the University of Iowa Carver College of medicine in Iowa City. He completed his Internal Medicine residency at the University of Iowa and his cardiovascular medicine fellowship at the University of Michigan.

Dr. Irwin is also certified in Advanced Cardiac life Support and Advanced Trauma Life Support.

Jennifer McGinnis, CNP, MSN, is a

Yankton Medical Clinic, PC, has added a number of new providers : Rheumatologist Leann Maska, MD is a USDSM graduate

who completed her Internal medicine residency at Sanford and her Rheumatology Fellowship at the University of Nebraska Medical Center. She is board certified in Internal medicine and board eligible in Rheumatology.

graduate of the Family Nurse Practioner Graduate Program at Briar Cliff University in Sioux City. She earned her Bachelor of Science in Nursing from Mount Marty College.

McGinnis will collaborate with YMC physician Dr. Scott Weber and will assist the clinic’s family medicine physicians in providing comprehensive primary care.

General Surgeon Ryan J. Garry, MD, is a graduate of USDSM who

completed his general surgery residency at Exempla St. Joseph in Denver and Iowa Methodist Medical Center in Des Moines.

MidwestMedicalEdition.com

7

A talk with MED Advisor

Patty Peters, MD Family Practice Physician

Q: You have become interested in the concept of functional medicine in recent years. How do you define it?

A: Functional medicine is about trying to help patients deal with chronic conditions and diseases by getting to the basis of why they are sick. It is all about trying to get to the bottom of it. I like to use the image of a tree. The branches and limbs are the disease we can see.

Functional medicine focuses more on the roots.

Q: Does a shift toward ‘functional medicine’ require a new set of skills for physicians?

A: Not really. It gets back to biochemistry and cell biology. As physicians, we learn the basic sciences but sometimes, when we get into treating diseases, we forget the things we learned in our basic science classes. A functional medicine approach requires you to get back to the basics of how the body actually functions. For instance, we now understand that inflammation, which can be caused by a wide variety of things, is at the root of a lot of disease. If we can address the source of the inflammation, many times the condition will improve on its own.

Q: How do you treat something as nebulous as inflammation? After all, there is no drug for that, is there?

A: A lot of what we do, from a functional medicine standpoint, is related to diet and exercise, relaxation, mind-body-spirit kinds of things. It may include dietary supplements, when we have science to back them up. The Institute for Functional Medicine has been around for 20 years, so this is not really new.

But it is becoming more mainstream.

Q: What kinds of practitioners are using functional medicine?

A: A growing number of primary care physicians are applying these principles, dieticians, naturopaths, chiropractors. Really anyone involved in the care of patients can look at functional medicine as a way to do it.

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Iowa Health Systems Launch Regional Alliance

Four of Iowa’s premier healthcare organizations united this summer to create a single healthcare alliance in Iowa and contiguous areas. The announcement was made in a multi-city press conference in June.

The new University of Iowa Health Alliance (UIHA) includes Mercy Health Network, Genesis Health System, Mercy-Cedar Rapids, and Iowa City-based University of Iowa Health Care and is comprised of over 50 hospitals and more than 160 clinics.

UIHA will create a platform for sharing expertise, selected support services and information technologies needed to succeed in the emerging “accountable care” systems and payment programs. Members describe the arrangement as the “best of both worlds,” allowing each organization to maintain its legacy and independence, while promoting clinical integration and care coordination. It does not involve a merger of assets or changes in ownership or control. The structure is designed to sustain and honor the members’ local missions and governance authorities, while participating in a larger effort to lead needed changes in the health care system. The alliance also is designed to encourage additional health care providers in Iowa and contiguous states to join and participate in these important initiatives.

Examples of specific UIHA efforts will include: v S trengthening primary care to ensure Iowans have access to a “medical home” v A ssisting members in developing performance metrics and comparative reporting to support improvement efforts, i.e. using comparative data to identify and share best practices and reduce the variations in care, which will improve quality and lower costs v D eveloping programs to determine and address the health status of communities served v D eveloping educational programs for health care providers, patients and consumers v D eveloping techniques and systems for improving patients’ engagement in managing their health. v S haring the high costs of the information systems and experts needed to analyze clinical data and convert it into information that can be used by physicians and others to improve care and better manage populations of patients with chronic diseases v Sharing expertise and operational costs associated with development of “accountable care” initiatives, enabling the members to evaluate and participate in new payment programs offered by governmental and commercial insurance programs

Collaborating in research initiatives “We believe by working together we can achieve the necessary expertise and size – the skill and scale – to be successful into the future and to bring real value to our patients and communities,” said Dave Vellinga, president and CEO of Mercy Health Network (MHN).

MHN was established in the mid-1990s as a similar model of both owned and contracted health care organizations working collaboratively in Iowa. Executives from all four of the organizations forming UIHA noted they have longstanding relationships and a history of working together on selected projects.

“The formation of UIHA is a significant step forward because it formalizes our relationships and creates an infrastructure to achieve real improvement and cost savings,” says Doug Cropper, president and CEO of GHS. “However, in many ways it’s just the next logical step in the collegial relationships between our organizations that we all value.” ■

Midwest Medical Edition

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1.855.850.KIDS (5437)

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your 24-hour link to pediatric specialists for physician-to-physician consults, referrals, admissions and transport service.

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Avera Releases Sioux Falls’ First Health Care App for Mobile Devices Avera Health has introduced its first mobile health care app for smart phones and mobile devices. Avera Health To Go is free and gives patients tools to manage and track their personal health information, allowing them to be “more active partners in their health care”, according to Avera.

“Health care of the future will be more preventative in nature, and will harness the latest technology. We’re proud to be taking this innovative step,” says Michelle Lavallee, Senior Vice President of Innovation and Chief Marketing Officer at Avera McKennan Hospital & University Health Center.

It’s estimated that 1.4 billion smart phones will be in use by

2015 and 500 million will have a health-related application loaded on them. Some 5 billion apps were downloaded in 2012, and that’s expected to increase to 21 billion by 2013. Lavallee says Avera wanted to offer a health app from a locally known and trusted source.

Avera Health To Go offers health trackers for health information such as blood pressure, blood sugar, cholesterol, mood, weight, pregnancy, migraines, and medications. The information stays confidential and goes no further than the phone itself, unless the phone user chooses to share it electronically.

Consumers can also use the app to: v Gain immediate first aid information v Find the nearest Avera physician in South Dakota, Iowa,

Minnesota, Nebraska and North Dakota —including more than 560 Avera Medical Group physicians and specialists with tools that include a physician finder, GPS “wayfinding” to clinics, and a click-to-call contact directory v Get the latest Avera news and health tips, including

the Avera Story Center blog v Read current health information from the Mayo Clinic v Store insurance information and a scanned image

of insurance card(s) v Check ED and urgent care wait times

Owners of mobile devices can go to the Apple or Android apps store on their device to find Avera Health To Go in the alphabetical listing. Avera partnered with Axial Exchange to create the app, which was developed with local information and expertise. For example, the app’s myMood tracker was created with insight from Avera psychiatrist Dr. Matthew Stanley. ■

MED Quotes “ Wherever the art of Medicine is loved, there is also the love of Humanity.” —Hippocrates

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Midwest Medical Edition

September / October 2012

MidwestMedicalEdition.com

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New Peds Cardiac Surgery Program

Will Honor Vanderwoude

The legacy of Sioux Falls cardiovascular surgeon John VanderWoude, who died in July at the age of 58, will continue in the form of a newly announced Sanford Pediatric Cardiovascular Surgery Program.

The health system announced in August at the annual Sanford Children’s Gala that is has hired a pediatric cardiac surgeon from Vanderbilt to help build the program. Dr. Brett Mettler is a Nebraska native and a graduate of USDSM who is expected to perform his first surgery in Sioux Falls next spring. Until his death of non-Hodgkin’s Lymphoma, Dr. VanderWoude had performed both pediatric and adult cardiovascular surgeries at Sanford and had begun to lay the groundwork for the pediatric cardiovascular surgical program.

“It is a testament to John and his family’s strength,” says Sanford internist and colleague Dr. Mike Wilde of VanderWoude’s willingness to step into this new area. “He did pediatric cardiac surgery and took that on with the same passion as anything else.

He was then challenged with seeing a very broad range of patient ages and personalities.

He was helping to improve the program recently and the work he started will benefit

children and families of this area for years to come.”

Dr. VanderWoude was a Sioux Falls native and a standout student at Washington High School, Augustana, USD School of Medicine, and Washington University in St. Louis where he did his residency. A highlyrespected fellowship-trained surgeon, VanderWoude was an early pioneer in cardiac surgery in Sioux Falls as a part of North Central Heart Institute in the early 1990’s.

He left the state to do additional training in pediatric cardiac surgery and later joined what is now Sanford USD Medical Center as Director of Cardiothoracic Surgery. Over the years, Dr. VanderWoude served on Sanford’s Board of Trustees and Board of Governors and was highly instrumental in creating the new Sanford Heart Hospital.

“Dr. John VanderWoude had a ‘can-do’ attitude, which in cardiac surgery can mean a heroic approach to care,” says Dr. Charles O’Brien, President of Sanford USD Medical Center. “John saved many a life by saying, ‘Yes, I can help you’ when others may have backed off. You have to have skills and trust in them to make that work. John’s intensity contributed to a large number of patients

and families who feel he was caring for only them. This is because he was. This attention, combined with his great skill, bettered many lives.”

“John was always a professional physician that would really do anything for a patient,” adds Wilde. “You hear that cliché over and again, but he lived it. He was a guy who lived and acted what he said. He didn’t speak often, however when he did it was incredibly meaningful. When John spoke, it would oftentimes alter the course of the work that you were doing.

“The patients we shared had a lot of faith in him and you knew when he was seeing patients he was doing things properly and was passionate about what he was doing.

He was ubiquitously respected by all of us physicians. He was a genuinely nice guy who you could laugh with. He was humble and down to earth.”

According to Sanford, their doctors last year referred 129 pediatric heart surgery candidates to out-of-state hospitals.

Dr. VanderWoude’s family has set up an endowment with the Sanford Health Foundation to help raise funds for the new pediatric cardiovascular surgery program. ■

A progressive thinker who held an MBA, as well as an MD, Dr. VanderWoude wrote the following in a guest editorial in 2000 for the Texas Heart Institute Journal

“

12

bviously, it is easier for physicians O to acquire insights into health care business practices than for medical administrators to understand the nuances of health care delivery.

Therefore, we must have the discipline to learn the elements of health policy and business. We must train ourselves to function within integrated health organizations at all levels, from the delivery of bedside care to the resolution of payment issues and ethical dilemmas.

… Sooner or later we will all be patients. When that time comes, we will not want politicians, lay health care administrators, and lawyers to dictate our treatment. We will want to be treated by a professionally managed, physician-directed, patient-focused health care organization that delivers the best possible quality for the lowest justifiable price

”

Midwest Medical Edition

Sioux City hospitals provide millions in community benefit According to the Iowa Hospital Association, Mercy Medical Center in Sioux City provided $19.2 million in community benefit and St. Luke’s Health System another $13.9 million during 2011.

Across Iowa, the IHA report shows that the state’s hospitals provided a combined total of $1.4 billion in benefits to their communities in the form of services and programs like health screenings, support groups, immunizations, nutritional services and transportation programs.

The same report shows that St. Luke’s reported nearly $3.5 million in charity care as well as approximately $900,000 in subsidized health or community services that, while necessary to Siouxland, result in thousands of dollars in losses each year.

Mercy reported $5 million in charity care and $6.4 million in subsidized health or community services. Together, Sioux City’s two hospitals reported over $7.7 million in Medicaid losses or unreimbursed costs associated with treating Medicaid patients.

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

September / October 2012

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13

A Bright Future

Sanford’s eight LDRP rooms feature warm colors, natural light and plenty of room for family and friends.

I

Aberdeen

Welcomes its Second Hospital

t is something of a status symbol for a city the size of Aberdeen.

While South Dakota’s third largest city may never host the Olympics or be the site of a Hollywood blockbuster, with the opening of the Sanford Aberdeen Medical Center this summer, it can now boast not one but two regional hospitals.

“I step inside and wonder ‘Am I still in Aberdeen?’,” says Becky Guffin, a 20-year Aberdeen resident and Assistant Superintendent for the Aberdeen School District. “It is an amazing structure. You can tell that every last detail is so intentional, from the local artwork to the large windows to the high-end technology. It feels very comforting and welcoming.”

While Guffin also sits on the Advisory Board for the new hospital and for Sanford Health, other Aberdeen residents apparently agree with her. More than a century after the city’s first hospital (what was to become Avera St. Luke’s) began to take root in the midst of a diphtheria epidemic, its second hospital – a 48-bed, three story structure attached to the existing Sanford Clinic – opened its doors for a public open house.

“I think most people are excited,” says Steve Redmond, MD, a family physician who has practiced in Aberdeen for 20 years. In 1994, Dr. Redmond joined United Clinic, Aberdeen’s first multi-specialty group, which eventually became Sanford Health Aberdeen Clinic.

“At the open house, they were amazed by the look of the hospital,” he says. “I think they were surprised at the amount of local art used, which really connects it to community. It’s also a very patient-friendly design, with good separation between the public and private areas.

And, of course, they are excited about what it will mean for healthcare in our community.”

What it will mean, according to Dr. Redmond, is choice. And choice, he says, benefits everyone.

“Having a healthcare facility like this in our community makes everyone a little bit better. I think it makes everyone step up their game. The people in the community benefit from that, regardless of which hospital they go to.”

By Alex Strauss

September / October 2012

15

Growth Spurt

Although it did not see its first patients until this summer, Sanford’s first ‘from the ground up’ community hospital has been in the works for years, even before the health system’s expansion into North Dakota. According to Aberdeen officials, the city has been virtually untouched by the recession, experiencing a housing boom while the rest of the country struggles with a housing crisis. As new employers have moved in and existing ones have expanded, Aberdeen, whose population had been steady for nearly 60 years, has finally had a growth spurt.

“There has been a lot of job creation in Aberdeen in the last five years,” says Julie Johnson, Executive Director of Absolutely Aberdeen. “We now have four ethanol plants within a 40-mile radius. The wind turbine blade manufacturer, MFG, opened about 5 years ago and they employ 400 people. And we are anticipating the opening of a new state-of-the-art beef processing plant.”

When that plant is fully operational, it is expected to employ 650 people. Meanwhile, established companies like Wheat Growers cooperative and Midstates Print & Media are expanding. Three hundred individual apartments and townhomes were built in the past year to accommodate the influx of people and more are needed. (“Right now we can’t seem to get it done fast enough,” says Johnson.) At the same time, outlying towns like Webster and Britton are also growing.

“We have a trade territory of about 200,000 people who interact with us. So the community size belies what is happening in our economy,” says Johnson, who adds, “There has been a lot of talk about the need to recapture the healthcare market, some of which has gone to Bismarck and Fargo.”

Medical Services

Floor to ceiling windows, stone, and artwork in the hospital’s public areas help create a welcoming atmosphere.

16

Sanford hopes to attract its share of Aberdeen’s healthcare market with a $55 million dollar Medical Center that features an eye-pleasing modern design, advanced technology, patientand family-friendly amenities, and greater access to specialists and advanced emergency services.

“With more providers, you are going to greatly improve your access to Emergency Services,” says Kevin Aston, DO, who moved to Aberdeen from Wisconsin to serve as Medical Director of Emergency Medicine. “Wait times are always a concern, but any time you have

Midwest Medical Edition

Above: Becky Guffin, EdD, Asst. School Superintendent, Kevin Aston, DO, Dir. Of Emergency Medicine Below: Steve Redmond, MD, Aberdeen Family Physician

One of four state-of-the-art operating suites equipped with integrated systems

more facilities with 24/7 access, you are going to be able to better serve the community.”

The new Medical Center’s state-of-theart Emergency Department features a Sonosite ultrasound machine, a mobile unit that enables physicians to perform diagnostic ultrasounds at the patient’s bedside. Among other uses, the Sonosite makes it easier to diagnose internal bleeding and can help guide the placement of central lines. Another piece of equipment, the department’s GlideScope Video Laryngoscope, makes visualization of airways easier in critical situations. In addition to the acute care area, the ED includes an urgent care area, two trauma rooms and seven exam rooms.

There are 32 adult patient rooms in the hospital, five of which can be adapted to create a secure pediatric unit. The obstetrical department is made up of 8 modern LDPR rooms (with amenities like large tubs and in-room sleeping areas) and a nursery with eight cribs.

The remaining eight beds make up the Intensive Care Unit, which is monitored 24 hours a day by Sanford Intensivists.

Outpatient and inpatient surgeries are performed in four operating rooms equipped with state-of-the-art, integrated systems. Cardiology services, including emergency and scheduled procedures, radiological evaluation, angioplasty and other heart treatments are handled in the hospital’s new cardiac cath lab. The hospital also offers therapy services, including physical, occupational and speech therapy, respiratory therapy,

September / October 2012

cardiac rehab services, neurodiagnostics and a sleep lab.

In short, the new hospital is a small but full-service community facility with the services patients have come to expect in a modern medical center.

The Unexpected

Although Sanford is touting the hospital’s high level of patient care, it is the amenities that have caught the attention of many residents. From the natural light in the building’s stone lobby, to the lounge areas, the Internet café, the restaurant-like dining, room service and the healing artwork throughout, Aberdeen is excited by the hospital’s beauty and comfort.

“When they started putting the glass in the building, it changed the whole look of it,” says Guffin. “People are very excited.

One lady said she was waiting to have her baby until the new hospital opened.”

Many are also impressed by the amount of local artwork in the new facility, including not only many of the region’s professional artists but even the work of talented high schoolers. It is a move that served to increase the building’s aesthetic appeal while visually solidifying its link to the community.

“It is really like walking through an art gallery,” says Guffin. “I joke with the CEO that I’m bringing high school kids out here for tours because the art is so amazing.”

“We get a lot of comments from patients, anything from surprise that the ER physician is walking in to see them to the fact that this place is so clean and sparkly that it seems like a nice hotel,” says Dr. Aston. For Aston,

MidwestMedicalEdition.com

it wasn’t the amenities or even the services that brought him from Wisconsin to practice in his wife’s hometown.

“For me, what was appealing was the fact that we were not only designing our own building but our own culture,” he says. “The longer you practice, the harder it is to be an ER doctor. I liked the idea of being a part of something new.”

For his part, Dr. Redmond, who has been with Sanford in Aberdeen since the beginning, is excited about the prospect of new specialists in town (rheumatology and endocrinology are still notably missing). He is also enthusiastic about his improved lunch options. “The food is great in the kitchen; they have a great chef,” he says, noting that he was particularly impressed by the cod.

“They offered to serve it to me with the topping but I turned it down. I wanted to see how good it really was, just plain. I wanted to know how he did it!”

High-end service notwithstanding, will good cod and big windows really have a measurable impact on the health of the community?

Dr. Redmond says, absolutely.

“All of these details improve the quality of service that everyone is delivering, which not only makes it possible for us to give better care for patients, but also makes it easier for the business community to recruit.

When people come here and they see two hospitals that are here, doing their best, a new high school, new YMCA, new hotels, new restaurants, it makes Aberdeen even more attractive for new medical professionals and other businesses.” ■

17

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18

Midwest Medical Edition

September / October 2012

MidwestMedicalEdition.com

19

Medicaid ‘Health

Home’

Pilot Design progresses

By Dave Hewett

S

ince last May a Department of Social Services (DSS) workgroup has been working to design a “Health Home” pilot project for a small portion (about 11,000) of the State’s Medicaid enrollees.

The program is inspired by a Federal program that offers to pay states 90% of the costs of setting up and sustaining these health homes for eight calendar quarters.

Importantly for the physician community, this is the State’s first foray into the much discussed, much debated “medical home” model of care for a portion of the State’s Medicaid population. For primary care providers especially, the program offers a glimpse into the complexities and detailed consideration that goes into establishing a medical home for a designated portion of the patient base they serve.

The DSS Workgroup includes representatives from SDAHO, the South Dakota State Medical Association, Avera Health, Regional Health, Sanford Health, the Community HealthCare Association of the Dakotas, the South Dakota Council of Community Mental Health Centers, DSS, the Department of Health, and the State Legislature.

The term “health home” is specific to this project. It is similar to, but more specific than, the more generic “medical home” approach to care. This health home pilot project model will be limited to those Medicaid individuals who have two or more chronic conditions, have one chronic condition and the potential onset of a second, and those being treated for behavioral health disorders and a chronic condition. In short, these 11,000 individuals tend to require significant medical attention. The focus on reducing costs will be on shorter and less frequent hospital stays and a reduction in MED Quotes

20

Gone are the days when we are able to ruminate about the theoretical advantages of a program that is designed to manage the overall health of a patient population. emergency room visits. (As opposed to a more general population that might be more attuned to healthy lifestyles, keeping up on vaccinations, etc.) In short this group of patients is much of the 20% of the Medicaid population using 80% of the services.

The Workgroup has brought to light most of the specific aspects that go into designing a health home for a public program. Gone are the days when we are able to ruminate about the theoretical advantages of a program that is designed to manage the overall health of a patient population. No, we’re talking the nitty gritty like: u T he specific quality, patient safety, and patient satisfaction measures that will be used to evaluate the care being delivered by those providers designated as health homes. u The criteria a provider must meet to be designated a “health home”. uT he reimbursement system that balances risk assumption by the providers, the costs of setting up a health home, incentives that reward reducing utilization by keeping the health home patient healthy and reducing the cost of the Medicaid program. u The health information based primarily on claims data needed by the health home to properly evaluate and manage the overall health status of the health home member.

u The performance criteria needed to evaluate the relative success of the program. At its most basic level, those criteria will indicate whether the per member/per month (PMPM) cost of care was reduced, stayed the same, or increased when compared to the traditional fee-for-service program. u The geographic areas of the state where a health home model is feasible. For example, it may not make sense to construct a health home in areas of the state where fewer than 20 people might qualify for the program.And remember, the health home model is based not just with integrated health systems but with primary care providers and community mental health centers as well.

The DSS workgroup is scheduled to conclude its work on August 27th. And while this one project has focused on a very limited number of the state’s population, it has served the broader purpose of broadening the discussion and advancement of a value-based health care delivery system in South Dakota – something we’ve been talking about for quite some time. If you have feedback on the “Health Home” pilot project, please email your comments to: dave.hewett@sdaho.org ■ Dave Hewett is President/CEO of the South Dakota Association of Healthcare Organizations.

“To live long, live slowly.” —Cicero

Midwest Medical Edition

DocuTAP Launches EMR System for Sanford in

Ghana

DocuTAP, a provider of electronic medical records and practice management software went global this summer with the implementation of a custom EMR system for Sanford World Clinics in Ghana, Africa.

DocuTAP’s chief executive officer traveled to Ghana to oversee the implementation and launch of the second EMR system ever to launch in Ghana.

In August 2011, Sanford World Clinics announced the construction and operation of a 10-site network of sustainable primary care clinics (for all ages) to be completed in Ghana over a four-year period.

DocuTAP’s first EMR system

implementation took place at Sanford’s busy Cape Coast clinic this summer.

“We’ve seen how EMR systems can transform the medical care practice and greatly enhance decision-making processes for healthcare providers,” said Jim Slack, VP, Sanford World Clinics. “However, implementing an EMR system or any HIS [Healthcare Information System] in a developing country can be a daunting task.”

Opened in January 2012 as Sanford’s first clinic in Ghana, Sanford’s Cape Coast practice sees in excess of 1,000 patients per week. The clinic provides general health care services to

area children and adults and includes the diagnosis and treatment of common illnesses in the region, especially malaria, diarrhea and respiratory issues. Sanford World Clinics plans to open at least three additional clinics in Ghana by the end of this year.

Rehabilitation Specialists Sioux Falls & Rapid City

The case for EMR systems in developing countries is a frequent topic among doctors, healthcare providers and academic scholars. In some countries, the availability of a reliable EMR system is often seen as a catalyst for development in healthcare delivery. ■

Septe

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September / October 2012

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21

Research Roundup

Local Scientists are seeking and finding answers to pressing medical questions Herbs for Hyperlipdemia Sioux Falls researchers have found evidence that a compound derived from traditional Chinese herbs may offer an alternative treatment for hyperlipidemia, one of the most common risk factors for obesity and cardiovascular disease. The Avera Research Institute and the Avera Institute for Human Genetics have recently published the results of their study on the safety and efficacy of the compound known as berberine.

Berberine was shown to produce mild weight loss while significantly lowering cholesterol and triglyceride levels. The research was replicated in a separate research project, which confirmed decreases in these levels.

Individuals with a body mass index (BMI) greater than 30 were eligible for the clinical trial; participants had to agree to keep all diet, exercise and health habits stable while taking the study compound, about 12 weeks.

Although berberine did not produce significant weight loss in the study, it did have a potent effect on lipid metabolism, notes Yueshan Hu, PhD, author of the research results. The study will be published in an upcoming issue of Phytomedicine.

Erik Ehli, Avera Institute for Human Genetics laboratory technician

Personalizing Plavix Use At the same time, the AIHG, in conjunction with the Avera Heart Hospital and

22

North Central Heart Institute has launched a clinical research study on the connection between genetic make-up and the effectiveness of the anti-clotting drug clopidogrel (Plavix).

As much as 30 percent of the population does not respond to Plavix, putting them at risk for developing a blood clot while taking the medication. Other patients may need a higher dose of the medication than what is typically prescribed as standard of care. The new Plavix and Personalized Medicine Project is offering genetic testing to acute/ intervention patients admitted to the Avera Heart Hospital. The patient’s physician receives the results from the genetic analysis as a recommendation.

Plavix vs. Effient Regional Heart Doctor physician and Medical Director of Black Hills Cardiovascular Research, James Walder, MD, is an author of another Plavix study, published in the June 19 issue of the Journal of the American College of Cardiology (JACC).

This study focused on results of the Recovery Trial, which compared the offset of the anti-platelet effects of prasugrel (Effient) and clopidogrel (Plavix). Effient and Plavix are commonly prescribed in combination with aspirin to help prevent blood clots that can block blood flow and cause a heart attack or stroke, but because anti-platelet medications prolong bleeding, they should be interrupted when possible for a period of time prior to surgery. Current recommendations regarding the period of time the newer anti-platelet drug Effient should be stopped prior to performing surgery are based on assumptions made from

other trials which were not designed to prospectively answer this question. The Recovery Trial was designed to test and/or validate these assumptions. As detailed in the journal article, the results of the Recovery Trial showed that patients on Effient took longer to recover their platelet function than those on Plavix.

The Recovery Trial was conducted at Black Hills Cardiovascular Research and four other U.S. clinical research sites.

T1D Trial Reaches Full Enrollment Sanford’s Pancreatic Insulin Response in type 1 diabetes (REPAIR-T1D) trial has reached full enrollment The study is testing two FDA-approved drugs, sitagliptin and lansoprazole, for their potential clinical benefits in T1D patients.

The trial needed 54 participants to complete a 24 month study. Thirty-six patients received test medications and 18 received placebos, given as capsules daily for 12 months, followed by a 12-month follow-up. Participants in this masked study are all between ages 11-45 and began the study within six months of diagnosis. The study is being led by newly appointed Sanford Project Broin Chair Alex Rabinovitch, MD. “While it will still be months before we can release research results, we are encouraged by the success of the patient enrollment in this trial,” says Dr. Rabinovitch.

A majority of the patients enrolled in the trial came from the Sanford Health system in Sioux Falls, SD and Fargo, ND with patients also coming from Children’s Hospital and Clinics of Minnesota in St. Paul and Rady Children’s Hospital in San Diego. ■

Midwest Medical Edition

A childhood cancer survivor.

A voice for hope.

Celebrate National Childhood Cancer Awareness Month and Cancer Survivorship Day with health care advocate and childhood cancer survivor Ted Kennedy, Jr. Learn more about Mr. Kennedy’s passion for helping others during a keynote address. Meet the Sanford Children’s pediatric hematology/oncology team — the only fellowship trained team of its kind in the region.

When: 7 p.m., September 22 Where: Washington Pavilion, Sioux Falls For complimentary tickets, visit sanfordchildrens.org, Keyword: “Voice For Hope.”

Ted Kennedy, Jr. Sponsored in part by grant funding through Hyundai Hope On Wheels.

200-46670-0169 8/12

Sioux Falls Leads the Nation

Bankers Trust Company of South Dakota

in Cancer Trial Enrollment

The Sioux Falls community had the highest enrollment in the country for the American Cancer Society’s national Cancer Prevention Study-3 (CPS-3). The Society had a goal to enroll 1000 people from Sioux Falls during its enrollment push August 14 to 18. With the support of enrollment site partners Avera McKennan, Sanford Health, the City of Sioux Falls, Citibank, First Premier Bank and Premier Bankcard, a total of 1534 people were enrolled – the highest of any individual American Cancer Society chapter in the nation.

CPS-3 is a long-term study focused on the lifestyle and genetic factors that cause or prevent cancer. The American Cancer Society’s Epidemiology Research Program is looking for men and women between 30 and 65 who have no personal history of cancer. The ultimate goal is to enroll at least 300,000 adults from various racial and ethnic backgrounds from across the U.S. Enrollment for CPS-3 will start in Rapid City in 2013. ■ MED Quotes “ It is a wise man's part, rather to avoid sickness, than

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September / October 2012

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23

Medicine

&Arts

Life is short but art endures —Hippocrates

A

s the matter-of-fact voice of Arthur Cowden, DO, begins to relate his musical and professional past, it sounds much like the history of a 70’s rock and roll band—ironic and quirky with many moves and many different incarnations on the way to the present.

Dr. Cowden is a Geriatrician at the Sioux Falls VA Hospital, but his roots are down South. It all started in medical school in Miami, Florida. According to Cowden, an insistent professor of bio-chemistry “buttonholed” the young student just as medical school began and, after learning about his musical experience, said, “You’ve no business being in medical school and not also being a musician—go get yourself a recorder.”

After the momentum slowed a bit, however, the school’s group found that he had some experience with brass instruments, so the young Arthur Cowden went on a quest to buy a sackbut (a sort of renaissance trombone) to add to the student/faculty ensemble. Dr. Cowden recalls the day he purchased an instrument after stumbling in from the sunny Florida street.

“When my eyes finally got used to the practically dark music store, I realized that the thick smoke in the place was actually marijuana. Eventually the eccentric owner, who had never met me before, came out and sent me home with an instrument, on trial.”

And so it began…

Melding the interests of music and medicine seems to have some constant factors in the lives of many physicians. Dr. Cowden’s easygoing manner as he tells of his many musical adventures points to a life in good balance. “I had a geriatric rotation in south Florida and I incorporated music into it. The students that I involved soon understood that they had to participate, too, if they were ever going to get their medical licenses!”

A wide and varied set of musical projects followed; including a Latin band called The Rhythm Doctors who were featured on Hispanic radio in the Miami area. His career has included some unlikely gigs, too, such as a Celtic band in a Mexican restaurant in

By Darrel Fickbohm Barrow, Alaska where it has snowed on the Fourth of July. The irony of finding himself in these situations is not lost on Dr. Cowden.

In answer to the question of where he finds the time, Dr. Cowden admits that he has never felt fully employed if he is not doing about 70 hours a week. Practice time can be hard to come by when the schedule’s demands are high, but solutions simply require some creativity. Realizing that practice is necessary every day, Dr. Cowden often sets some short rehearsal time for himself between patients.

His latest musical incarnation is a jazz and blues set that call themselves Mac & the Ringbinders. It includes other local musicians such as Dick Rausis, Ivona Dreyer, Monty Bernard, Erik Jensen, and Marian

Casey. They will be playing the Sioux Falls venue Touch of Europe again in September.

People sometimes wonder why someone would perform in front of other people—why they would subject themselves to that kind of pressure and vulnerability, and Dr. Cowden pauses for a moment as he thinks.

“When you pull these things off—these performances—even when it’s not totally satisfactory…you just feel a kind of high. The feeling is: alright, now let’s go party.”

His last statement comes as an afterthought, but its importance is immediately evident as it could easily apply to medicine as well as music: “The only thing you can really do wrong is lose your nerve.” ■

Arthur Cowden, DO Geriatrician Medical Minstrel

&

Moving session in Barrow, Alaska (Dr. Cowden playing trumpet)

24

Midwest Medical Edition

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

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September / October 2012

MidwestMedicalEdition.com

25

The Nurses’ Station Nursing News from Around the Region

The Year of the Nurse:

Sanford Nurses Join Together for Learning and Future Growth / Nurses from across Sanford Health’s 130-thousand square foot system joined together in Sioux Falls during a two-day Nursing Symposium at the end of July. The event at the Sioux Falls Convention Center featured two keynote speakers: Tim Porter-O’Grady, DM, an international healthcare consultant from Atlanta and Kathleen Bartholomew, MN, RN. The Nursing Symposium is a part of The Year of the Nurse at Sanford Health. All year Sanford Health has been lifting up the nursing profession within the organization. Among other things, nurses were honored at a special All Aglow event in Fargo, Bemidji and Sioux Falls. Sanford Health is offering nursing education scholarships, an opportunity to travel to a World Clinic location and to spend the day with an executive. The year has celebrated a legacy of service, honored achievements in nursing and applauded the role nurses play within the system.

“Our nurses are what make our organization,” says Diana Berkland, Sanford’s Chief Nursing Officer for Sioux Falls. “We celebrate the work they do and we are happy to offer them advancement and educational opportunities like this symposium.” ■

Darilee Waddell received the July DAISY Award for Extraordinary Nurses & Kimberley Weyer received the June DAISY Award at Rapid City Regional Hospital (RCRH.) Waddell is an RN in the Cardiac Interventional Unit and has worked at the hospital for 15 years. A patient’s family recognized Waddell for her calm demeanor and for taking the time to answer their questions.

Weyer is an RN in the Emergency Department and has worked at the hospital for 11 years. A patient’s family acknowledged Weyer for staying with their loved one from the time he entered the Emergency Department as a patient to when he was life-flighted to another facility, which occurred well after Weyer’s work shift had ended. RCRH honors one extraordinary nurse each month with a certificate, pin, tote bag, and a Healer’s Touch sculpture hand-carved by artists of the Shona Tribe in Africa. ■.

Mercy Medical

Center’S Debra Twyford

has been named Worksite Wellness RN. In her new role, Twyford will help

Retired Siouxland Nurse to Receive Prestigious Spellman Award / Longtime Siouxland

develop worksite health and wellness pro-

nursing leader Verna Welte will be the recipient of the prestigious Dr. George G. Spellman Annual Service Award from the Mercy Medical Center Foundation. The award will be presented to Ms. Welte at the Mercy Foundation’s annual gala on Saturday, November 3 in South Sioux City. Welte retired from Mercy Medical Center in 1997 as the Vice-President of Patient Care Services. She was one of Siouxland’s first female health care administrators and paved the way for other women in the industry.

Welte began her nursing career in 1955 after graduating from Briar Cliff with a BS in nursing. She joined St. Vincent’s Hospital in 1957 as an instructor in the St. Vincent School of Nursing and was one of the key players in the 1977 consolidation of St. Vincent and St. Joseph Hospitals.

In 1972, Welte was named the Director of Nursing at St. Vincent’s and from there assumed a variety of leadership roles in hospital administration, emerging as one of Siouxland’s first female health care executives. Her selection as the 2012 Spellman honoree takes on an added dimension because of her professional relationship with Dr. Spellman.

Welte and Dr. Spellman spearheaded the establishment of the second Critical Care Unit in the state of Iowa and she also is responsible, along with former colleague Connie Spain, for creating the city’s first inpatient substance abuse unit at St. Vincent Hospital. ■

onsite nursing services provided by Mercy

26

grams and will assist in administering the Business Health to area employers.

As an Occupational Health Nurse and Wellness Coach at Mercy Business Health Services, Twyford has provided onsite occupational health nursing, wellness coaching and core wellness screenings to various companies.

Twyford received her Associate Degree of Nursing from Western Iowa Tech Community College in Sioux City and completed the 12-week Intrinsic Coaching Development Series for health and wellness professionals. She is a Certified Occupational Hearing Conservationist, a certified Freedom from Smoking facilitator, CPR Instructor for the American Red Cross and a National Exercise Trainers Association Certified Group Exercise Instructor. ■.

Midwest Medical Edition

SD Joins Action Coalition to Support Nursing Excellence N anette F it z gerald has received the 2011 George S.

Mickelson Award for Nursing Excellence at Rapid City Regional Hospital (RCRH.) Fitzgerald works as a Certified Lactation Consultant and has been employed at the hospital for 26 years.

Fitzgerald is recognized as a dedicated and caring member of the health care team. She demonstrates excellent interpersonal relationship skills with staff members, physicians, patients and their families. She is described as “a role model for nursing, demonstrating enthusiasm, knowledge and respect for others.” RCRH managers nominate nurses to receive this honor. All nurses, except nursing administrators and managers, are eligible to receive the award. ■

September / October 2012

Avera Sacred Heart Hospital and Yankton Rural Area Health Education Center (AHEC) are participants in a state-wide Action Coalition for the Future of Nursing: Campaign for Action, coordinated through the Center to Champion Nursing in America (CCNA), an initiative of AARP, the AARP Foundation and the Robert Wood Johnson Foundation (RWJF).

Yankton Rural AHEC and Avera Sacred Heart Hospital are working with the campaign to implement the recommendations of the landmark Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health.

Action Coalitions comprised of nursing, other health care, business, consumer and other leaders are the driving force of the campaign at the local and state levels. Specifically, the Campaign for Action is working to implement the recommendations of the IOM report with an emphasis on:

♦ Strengthening nurse education and training ♦ Enabling nurses to practice to the full extent of their education and training ♦ Advancing interprofessional collaboration among health care professionals to ensure coordinated and improved patient care

♦ Expanding leadership ranks to ensure nurses have a voice on management teams, in boardrooms and during policy debates

♦ Improving health care workforce data collection to better assess and project workforce requirements.

For more information about the Campaign for Action go to www.thefutureofnursing.org.

MidwestMedicalEdition.com

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CNOS orthopaedic surgeon Ryan Meis, MD, practices sports medicine on the side lines.

To Improve Health CNOS Foundation T Broadens its Mission in Siouxland

Dr. Ralph Reeder, CNOS neurosurgeon, interacting with CNOS Foundation Science Classic campers

28

he mission of the CNOS Foundation is at once simple and profound.

Originally created by CNOS and the Siouxland Surgery Center as a not-for-profit vehicle for providing sports medicine services to area schools, the Foundation has evolved into something much broader. Today, its straightforward but far-reaching mission is ‘To Improve Health’.

“It has been exciting to watch this foundation evolve from one which focused primarily on sports medicine and performance to an organization whose entire focus is now on improving the health of our community,” says Mike Hurlburt, CEO of the Dakota Dunes-based foundation.

In keeping with its sports-centered beginnings, the 5-year-old CNOS Foundation has jumped into its larger mission with both feet. Through a team of 13 certified athletic trainers and another 10 to 12 specially-trained Velocity Sports Performance coaches, the Foundation is making a name for itself across Siouxland offering ♦ sports medicine services and performance programs to high schools and colleges ♦ sports training, camps and health education for children and youth ♦ symposiums and socials for area medical providers, trainers and coaches ♦ summer science camps ♦ community wellness events and screenings ♦ partnerships with other health-focused organizations ♦ community sporting events “One of our biggest challenges is trying to change peoples’ definition of what ‘sport’ is,” says Suzi Gausman, Executive Director of the CNOS Foundation. “We believe that life is sport. So, as our way of giving back to the community, we want to really come alongside people and support them in their health and wellness pursuits, whatever form those pursuits might take.”

Midwest Medical Edition Sponsored Feature

Sports Medicine & Performance Although it is branching out, the reputation of the CNOS Foundation is still firmly rooted in its quality sports medicine and performance services. Seven Siouxland area high schools and two local colleges (Briar Cliff and Morningside) have contracts with CNOS Foundation certified athletic trainers for full-time sports medicine services. This can range from hands-on training and advice during practice, to taping up ankles and icing injuries at games to recommending the appropriate ‘next steps’ for treatment. Another 40 area schools take advantage of these kinds of services on a weekly basis through the Foundation’s outreach programs.

As the area’s only Velocity Sports Performance franchise, the CNOS Foundation also offers high-level performance training designed to improve core strength, power, speed and agility. Certified Velocity Sports Performance coaches conduct 8-week summer programs for high school and college students and spread their knowledge further through a unique program model.

“Unlike other Velocity franchises which offer training on site, we are a ‘hub and spoke’ program,” explains Gausman. “We are committed to reaching out into the community by training coaches and then sending them out into schools. Doing it this way means that Siouxland students are able to take advantage of this kind of high-level training (Olympic gold-medalist Allyson Felix is a notable Velocity success story) at a fraction of what it would otherwise cost.”

An estimated 1200 Siouxland area children enjoyed the benefits of Velocity Sports Performance training this summer.

The Foundation’s sports medicine and performance services don’t stop with school-aged athletes. CNOS Foundation certified athletic trainers offer free injury evaluations to the public, both on site at the CNOS Clinic and at injury screening clinics elsewhere in the community.

Education

Sporting Events

Education is a major component of the CNOS Foundation’s evolving mission. The Foundation sponsors three medical symposiums a year in Neuroscience, Othopedics and Sports Medicine for healthcare providers throughout the region. CNOS Clinic professionals and guest speakers provide half-day training designed to support area professionals in the evaluation and treatment of patients with a range of neurological or orthopedic disorders or sports-related issues. CNOS Foundation symposiums are accredited by the Iowa Medical Society to provide continuing education credit to physicians, physician assistants, nurses and athletic trainers and certificates of completion to NPs, PTs and OTs. “These symposiums are a way of improving community health by improving the strength of the medical community,” says Hurlburt, echoing the Foundation’s belief that good health encompasses the brain as well as the body.

On the other end of the academic spectrum is the CNOS Foundation Summer Science Classic, offered for the first time this summer. During these week-long camps, area certified teachers, CNOS Foundation staff and CNOS Clinic rehabilitation experts guided middle school students through a hands-on exploration of the chemistry, physics, anatomy and physiology of movement.

The CNOS Foundation also supports community health events such as the YMCA’s annual Healthy Kids Day and the HyVee Kids Triatholon and works in conjunction with non-profit agencies such as Girls, Inc., Big Brothers, Big Sisters, Camp High Hopes and the Boys and Girls Homes to offer a variety of tailored health education programs.

“We are trying to expand our focus to encompass total health and wellbeing,” says Gausman.

Thousands of Siouxland area athletes and sports fans have come to know and appreciate the CNOS Foundation through its annual Classic sporting events. The Foundation’s annual Football Classic, Golf Classic, Baseball Classic and Basketball Classic have become staples of the local sports community, providing lively entertainment for attendees and a rare opportunity for young participants.

“Our Classic events provide an opportunity for some of the athletes that we work with to compete at a higher level and at a high-end facility, like the Tyson Events Center,” says Gausman.

For the first time in 2012, the Foundation sponsored ‘Creating Captains”, a characterbuilding camp for elementary and middle school students that teaches discipline and character qualities along with football knowledge and skills. Taught by former Nebraska football player Matt Davison, the camp was the largest Creating Captains has ever had with 105 kids. CNOS Foundation support allowed campers to attend for just $10.

The Foundation’s community focus even extends to the makeup of its governing board. The board of directors includes CNOS and Siouxland Surgery Center employees, as well as community members who are not affiliated with either organization. In an effort to remain focused on the Foundation’s mission, the variety of perspectives from board members keeps the Foundation socially accountable to provide true community benefit.

“We take our responsibility seriously,” says Hurlburt. “We are developing our key curricula around the pillars that support our reason for doing what we do every single day. The message is that every person is an athlete; it can no longer be defined by sports.

It needs to be defined by life.”

Brian Fink, Velocity Sports Performance Trainer, in the weight room at Briar Cliff University.

September / October 2012

MidwestMedicalEdition.com

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The Rally by the Numbers Hospitals in the Black Hills are breathing a collective sigh of relief with this year’s 72nd annual Sturgis Motorcycle Rally behind them.

The seven Regional Health facilities report just under 700 rally-related visits to their emergency rooms during this year’s rally week, August 6 to 12. The total of 696 ER visit during the 2012 rally week was up by about 50 from the year before, but still a far cry from the peek number of ER visits – 1044 – recorded during the 2006 rally. Day-to-day inpatient numbers were comparable to previous years.

As in past years, most of the ER visits happened at Sturgis Regional and Rapid City Regional Hospitals. Regional Health spends months preparing for rally week, which more than doubles the area’s population, with strategic meetings and planning sessions, similar to the way other facilities might prepare to handle natural disasters.

Although the final figures were not in at the time of printing, early estimates suggest that more than 500,000 people attended this year’s Sturgis rally. Nine people were killed in rally-related accidents. ■

30

Midwest Medical Edition

Rural Communities

Welcome Health Professions Students

Program prepares future healthcare professionals to live and work in rural areas This summer, a dozen college students studying health careers got a firsthand look at the ups downs of healthcare in rural South Dakota. The students were part of the Rural Experiences for Health Professions Students (REHPS) Summer Experience, a collaborative effort between state universities and the communities selected as “Best Practice Model” sites.

A program of the Yankton Rural Area Health Education Center (AHEC), REHPS connects inter professional students enrolled in medical, physician assistant, doctor of nursing practice, and pharmacy programs through the University of SD (USD) and SD State University (SDSU) with healthcare professionals practicing in six rural SD communities. Since 2011, the program has expanded from three sites: Redfield, Parkston, and Wessington Springs, to six sites with the addition of Winner, Philip and Wagner.

“We were able to see a time-lapse picture of how the family practice clinic functions, something that is difficult to accomplish on the morning preceptorships that we have in medical school,” says medical student Anthony Loewen. In addition to the real-life career experience, students were involved in community projects designed to provide interaction outside the clinical setting and immerse them in community life during their four week stay.

“Students are more likely to return to facilities and communities where they have had rich, positive experiences early in their

training,” says Kassy Youmans, REHPS Program Manager. “The REHPS program is designed to allow communities and students to make this happen.” The REHPS Program also provides a framework for community leaders to follow in an effort to successfully recruit and retain healthcare professionals.

Student participants are asked to complete a survey before and after their experience. Results of the 2012 survey were encouraging for those committed to tackling the problem of healthcare access in rural areas: v 9 2% of students strongly agreed or agreed that their four week rural experience made it more likely that they

would consider rural healthcare for their future profession v 100% of students felt they had a better understanding of rural healthcare and felt more comfortable in the rural healthcare setting v 75% of students said they strongly agreed or agreed that the facility they were placed in would be a place they would consider for future employment.

Communities interested in becoming 2013 sites for the program can contact the Yankton Rural Area Health Education Center (AHEC) at 605-655-1400 or email kassy.youmans@yrahec.org. ■

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September / October 2012

MidwestMedicalEdition.com

31

Grape Expectations

The Chicken and the Egg

I

recently had a discussion matter, my friend and I have decided that the question will never be solved. Both of with a friend of mine about the us cannot count how many times customers “chicken and egg theory of wine”. have come to us asking for a wine they have We are both in the wine industry and had somewhere else. Do we always succeed like to share information with one another. in the quest of having the perfect wine for I find her information very valuable as she all of our customers? Unfortunately the is on the restaurant side of the business answer is no, but fortunately we have both while I am on the retail side.

Do wine drinkers look for what they come to the conclusion that with the enormous amount of choices we can offer, we have purchased in a retail establishment when they go out to eat, or do diners come can come pretty darn close. Better yet, we to a retail establishment to buy something can often give customers something unexthey have consumed while eating at a respected and even better than what they were taurant? This is the “chicken and egg theory actually looking for. of wine”. Do you find that you discover more Americans love wine. In 2011, the United wine in restaurants or in wine shops? Once States surpassed all other wine drinking countries including France, Italy, Spain, they are discovered, then what do you do?

Search them out in shops or ask your favorite Austria and Germany in per capita consumprestaurants to add them to the menu? I really tion of wine. We are number one! What this hope that it goes both ways. I often “find” means for all of us is that our choices are becoming more and more abundant. Because new wines because they are brought to me we love our wine, we are now seeing prodby people who have had them, loved them, ucts that we’ve never been able to get from and want to get their hands on more. other countries. These days, everyone wants Over shared bottles of wine, with customers and Horizontal friends 3.875 weighing on 2012 the ISSUE20120821_Layout to sell their wine in America. 11:20 AM Page 1 Quarter Page x 5.275in SEPT 1 8/21/2012

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I was recently able to pour a Beaujolais Blanc (yes, the French don’t like to put anything on their labels that will tell us what is actually in the bottle, but in this case Blanc means Chardonnay) at one of our wine dinners and what a wonderful experience! The French region of Beaujolais is well know for its Gamay Beaujolais but very little is known about the white wines produced there, with good reason.

Less than 2% of the entire region produces white wine and almost none of it is exported. Only 400 cases of this wine were produced by this little winery and we managed to secure a small amount.

I’ve never had a Beaujolais Blanc before so I was very excited to try this wine. What a beautiful little white with bright crisp notes on the palate and wonderful purity of the chardonnay grape flavor itself having not been obliterated with oak aging. Better yet, even with its rarity in the U.S. market, it came at a price that astonished me: It was under $20!

As for the “chicken and egg theory of wine”, my friend got a few calls and requests for this amazing Beaujolais Blanc at her restaurant and she called me to ask if I’ve ever heard of it. Unfortunately for her, in this case I was the chicken and she was the egg. I’m saving her a bottle of it so the next time we get together, we can share. ■

Midwest Medical Edition

September / October 2012

MidwestMedicalEdition.com

33

Trust Modification…

But what if it says Irrevocable?

M

By Alice Rokahr, JD

any of you have probably heard of the old adage, “Where there’s a will, there’s a way”. While this saying wasn’t intended to apply to an actual estate document such as a trust, today it can.

For many years, the general rule was that if a trust was irrevocable, the only way to change it was by going to court; and even then, the courts were reluctant to make changes. Over the past fifteen years, this rule has changed and many states have modernized and updated the trust laws to reflect what is now referred to as ‘modern trust law’. However, states have not uniformly modified the laws in the same manner so it is very important to comparison shop since you are NOT required to create or modify a trust in the state where you reside or where the trust was originally executed.

South Dakota is nationally recognized as having the most flexible trust laws in the nation. In fact, South Dakota is the only state in the nation with a Governor’s task force designed to review and keep abreast of the most recent developments in the area of trusts so that our state can remain a leader in attracting clients with wealth. Since 1986, South Dakota has been a favorable state for trust administration. One reason is because of the ease by which a trust – even an irrevocable one – can be modified and updated.

For example, if your ancestor created a trust that directs the payment of net income, and those distributions have dwindled to almost nothing in the current economic environment, the beneficiaries of the trust may be able to modify the trust to enable more generous payouts. Other reasons a family may want to modify the trust are to address a change in circumstances, to allow more family involvement in investment and distribution decisions, or to save taxes.

Under South Dakota law, an irrevocable trust can be modified when all beneficiaries

34

consent. The law does not require an approval by the court; but, it is sometimes preferable to get a court order for IRS clarification. What happens if the trust was written in another state? You still may be able to have the trust administered in South Dakota. The State where the trust is administered is called the ‘situs’. With consent of all beneficiaries, most trusts can be moved to a new situs. Once moved, the laws of the new state govern for amending or reforming a trust. Older trusts are often silent about the ability to move the trust to a new location. As a general rule, these trusts can be moved and then modified.

Decanting is another method of amending an irrevocable trust. Decanting a trust is similar to decanting a wine. Essentially,

it means to distribute the assets from the existing trust to a new trust with the same beneficiaries but with amended and updated terms. State laws vary widely on the types of changes that can be included in the new trust. Only a handful of States have a procedure for decanting. Again, South Dakota is recognized as having the most flexible and broad power when decanting.

Bottom line, there are ways to modify an irrevocable trust. For more information on how a trust can be modified, reformed or decanted, you should consult with an attorney who specializes in this area. ■ Alice Rokahr is the Wealth Planning Officer at Bankers Trust Company of South Dakota.

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Midwest Medical Edition

Smooth

T r ansitions Brookings Launches First-in-Nation Free Postpartum Doula Program

Regional HealtH

Recognized for Best Practices

Congratulations!

Several Regional Health employees were selected to share their research and best practices with health care professionals from throughout the United States at the 2012 Premier Breakthroughs Conference and Exhibition in Nashville, TN. Premier Presenters Viv Derby, Clinical Quality Coordinator, Rapid City

Regional Hospital – “No CAUTI Zone”

randee mason, Director of Clinical Integration, Regional Health & Lynn simons, Director of Patient Services, Sturgis Regional Hospital – “Putting the Patient First:

A Team Approach to Maximizing Patient Flow”

Angi Kiewel, Assistant Director, Adult ICU, Rapid City Regional Hospital & Angie Haugen, Assistant Director Respiratory Care, Rapid City Regional Hospital – “Bundling Care to Save Lives:

Priceless”

Angi Kiewel, Assistant Director, Adult ICU, Rapid City Regional

Hospital – “Increasing Organ Donor Designation Through ‘Trusted Messengers’–Nurses!”

Lori Lewis, Data & Training Specialist, Rapid City Regional Hospital – “Position Control Process and Tools”

Daniel mendez, Director of Education & Development,

Regional Health – “Equipping Leaders Today to Meet the Challenges of Tomorrow”

Volunteer labor doula Taylor Mertz assisting soon-to-be mother Katy VanderWal at Brookings Health System.

Building on the popularity of its volunteer labor doula program launched last fall, Brookings Health System is now offering patients access to care after the birth through volunteer postpartum doulas. It is the first organization in the nation to offer these services at no charge.

“We’ve had a positive response from parents regarding our volunteer doulas helping them during the delivery process,” said Chief Nursing Officer Tammy Hillestad. “Our volunteer doulas are passionate about the entire childbirth experience, including taking care of mother, baby and family after delivery. They are eager to provide physical and emotional support to new moms and their families.”

Labor doulas are women who provide continuous labor support during childbirth, work together with the mother and her partner to assist with emotional and physical support, and use relaxation techniques such as positioning and massage.

Postpartum doulas help parents transition and adjust to having a newborn in the child’s first few days of life. They help parents with issues such as infant feeding, emotional and physical recovery from birth, mother-baby bonding, infant soothing and basic newborn care during their postpartum stay at Brookings Health System.

Brookings Health System’s volunteer doula program officially launched Oct. 1, 2011, in response to community feedback from three birth experience focus groups. Seventeen trained doulas volunteer one, 24-hour shift per month to help area parents during their birth experience. ■

September / October 2012

susan mcKinney, rn, eICU Quality Coordinator

Rapid City Regional Hospital – “Standardized ICU Excellence-Telemedicine, The Great Plains Way”

sandra Ogunremi, DHA, Administrator/Project Management, Regional Health Physicians – “Growing Your Organization through External Funding” & “Improving Quality Outcomes and Customer Satisfaction within Every Healthcare Setting”

Jody thompson & Jodi Kor, Assistant Laboratory Directors, Rapid City Regional Hospital – “Managing Change in a LEAN Laboratory”

Premier POster bOArD Presenters Phil boettcher, Director Ortho, Neuro, Surgery, Rapid City Regional Hospital – “Clinical Partners: The Clinical Education of the Future”

tiffany Clendenen, Pharmacy Director

Spearfish Regional Hospital – “An Infusion of Growth” & “Telepharmacy-Expanding Pharmacist Coverage”

brandon Cruse, Management Engineering Analyst,

Rapid City Regional Hospital – “Reducing Emergency Room Patient Throughput Time”

Kristi mcGill, IT User Access Security Analyst,

Regional Health – “Going Regional with Access & Security”

nancy nelson, Administrative Director of Patient Care Services, Rapid City Regional Hospital – “Registered Nurse Residency Making a Difference”

Peggy O’sullivan, Director of Patient Services,

Spearfish Regional Surgery Center – “Dialing up Families Centering Patient Care”

www.regionalhealth.com/premier

MidwestMedicalEdition.com

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2013 Call for Nominations

MED Magazine MED Magazine is seeking Nominations for Cover and Feature Article topics for 2013.

MED is committed to focusing on pioneering physicians, institutions, programs and technologies that are paving the way for the future of healthcare in our region.

No one knows these pioneers better than MED readers.

If you know of a person or program that deserves a closer look, tell us about them.

(Self-referrals are permitted!) Send us the following information via fax, mail or email.

Med Nomination Form Please include the following information: Name of Nominee_______________________________________________________________________________________________________ Location of Practice______________________________________________________________________________________________________ Reason for Nomination___________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ Your Name_____________________________________________________________________________________________________________ Your Contact Information_________________________________________________________________________________________________

Mail / Fax or email this form to: PO Box 90646 Sioux Falls, SD 57109—Fax 605-271-5486—email Alex@MidwestMedicalEdition.com

MED reaches more than 5000 doctors and other healthcare professionals across our region 8 times a year. If you know of an upcoming class, seminar, webinar, or other educational event in the region in which these clinicians may want to participate, help us share it in MED. Send your submissions for the Learning Opportunities calendar to the editor at Alex@MidwestMedicalEdition.com.

Learning Opportunities September – November 2012 September 13 - 14. .. .. .. .. .. .. 37th Annual South Dakota Perinatal Association Conference

Location: The Lodge at Deadwood

Registration and information: www.sdperinatal.org, 333-5210

September 14 . .. .. .. .. .. .. .. .. Community Response to Child Abuse

L ocation: Sanford

Information: Nikki.Terveer@SanfordHealth.org

September 14 . .. .. .. .. .. .. .. .. Diabetes Care Conference 8:00 am – 4:15 pm Location: Sanford Center, Dakota Room

CNE/CME Credit available Information: 605-312-6971 Registration: Nikki.Terveer@SanfordHealth.org

September 15 . .. .. .. .. .. .. .. .. American Heart Association Black Hills Heart Walk 9:00 am L ocation: Main Street Square, Rapid City

Information & Registration: Robin Albers, 605-754-6267, Robin.Albers@heart.org For a personalized fundraising website: http://heartwalk.kintera.org/westcentralsd

September 17 – 18 . . . . . . . . . . . . Medical-Surgical Nurse Certification Review Course 7:30 am – 4:00 pm Location: Sanford Research/USD Sanford Center

Information & Regisration: Aleta.Vanderbeek@SanfordHealthy.org, 605-328-6377

September 19- 21. .. .. .. .. . SDAHO 86th Annual Convention

Location: Sheraton Inn, Sioux Falls

Registration and information: www.sdaho.org Information: Rhonda.christenseen@sdaho.org, 605-361-2281

September 20 . .. .. .. .. .. .. .. .. ACHE Annual Breakfast: “The New Science of Leadership” 8:00 am – 9:00 am Location: Sioux Falls Convention Center

Registration: www.SDAHO.org

September 21-22 . . . . . . . . . . . . . . 2012 Avera Cancer Institute Oncology Symposium

Location: The Prairie Center

Information: www.AveraMcKennan.org; click on Events Calendar Registration: mckeducation@avera.org or call 322-8950

September 26 . .. .. .. .. .. .. .. .. Perinatal Clinical Update 8:00 am – 4:00 pm Location: Sanford Center

Information: SanfordHealth.org

September 27 – 28 . . . . . . . . . . . . 2012 Upper Midwest Regional Pediatric Conference

L ocation: The Marina Inn & Conference Center Information: www.umrpconference.com or (712) 279-3235

September 28. . . . . . . . . . . . . . . . . . Avera Transplant Institute Symposium 8:00 am – 2:00 pm Location: The Prairie Center

Information: www.AveraMcKennan.org; click on Events Calendar Registration: mckeducation@avera.org or call 322-8950

September 29 . .. .. .. .. .. .. .. .. First Annual Genomic Medicine Symposium

L ocation: Sanford

Information: Nikki.Terveer@SanfordHealth.org

October 4 . .. .. .. .. .. .. .. .. .. .. Avera Rural Health Conference 8:30 am – 4:00 pm Location: Sioux Falls Convention Center

Information: www.AveraMcKennan.org; click on Events Calendar Registration: events.coordinator@avera.org or call 322-4645

October 10-11 . .. .. .. .. .. .. .. .. CAE Health Simulation in Rural America Conference 8:00 am – 5:30 pm Location: Sioux Falls Convention Center

Information: Sandi Durick, 605-773-3366, Sandra.durck@state.sd.us

October 12 . . . . . . . . . . . . . . . . . . . . CNOS Foundation Neuroscience Symposium 7:15 am – noon Location: River’s Bed Conference Center, Sioux City

Credits available for Physicians, PA’s, Nurses and Athletic Trainers

October 16 – 17 . .. .. .. .. .. .. .. Sanford Surgical and Trauma Symposiums

Information: SanfordHealth.org, keywords ‘Surgical and Trauma Symposiums’

October 17. .. .. .. .. .. .. .. .. .. .. 28th Annual Cardiology Conference 9:00 am – 3:00 pm Location: Sioux City Convention Center

Information & Registration: www.stlukes.org/professional-education

November 2 . .. .. .. .. .. .. .. .. .. 30th Annual North Central Heart Fall Cardiac Symposium 8:00 am – 5:00 pm Location: Sioux Falls Convention Center

Information: www.northcentralheart.com Registration: jhatch@ncheart.com, 605-977-5316

November 9 . .. .. .. .. .. .. .. .. .. 5th Annual SD eHealth IT Summit 8:00 am – 5:00 pm Location: Ramkota Inn, Sioux Falls

Information & Registration: http://healthpoint.dsu.edu/summit2012

Sanford Heart Hospital A few steps away Our board-certified cardiac care experts are connected to other specialists right next door at Sanford USD Medical Center. So your patients have complete care for the whole body. Just a few steps away.

Your heart. Our hands. Connected.

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