med-midwest medical edition-march 2016
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The Lifesaving Power of Increased
Treatment Options
Clinical Trials
MA
RC
H
2016
Vol. 7 No. 2
The ‘New” Dakota Lions
Sight & Health
A Local Solution for TELEMEDICINE
Avera Advances Rural Cancer Care
The South Dakota Region’s Premier Publication for Healthcare Professionals
Midwest Medical EditionMidwest Medical Edition
One Number Accesses Our Pediatric Surgical Specialists, Any Problem, Anytime.
1.855.850.KIDS (5437) PHYSICIANS’ PRIORITY LINE
Your 24-hour link to pediatric specialists for physician-to-physician consults, referrals, admissions and transport service.
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Gastroenterology & GI Surgery
Orthopedics
Cardiology & Heart Surgery
MEDAd, March 2016.indd 1 1/27/16 3:09 PM
MIDWEST MEDICAL EDITION
REGULAR FEATURES4 | From Us to You
5 | MED on the Web USD Enhances Care in Rural Communities,Regional’s standout employees, Mercy tackles rural obesity, and other content available exclusively on our website
10 | News & Notes Recognitions, new providers, accreditations, and more
35 | Learning Opportunities Spring conferences, symposiums, and other CME Events
IN THIS ISSUE
VOLUME 7, NO. 2 ■ MARCH 2016
Contents
ON THE
COVER19
Why South Dakota
Lions Eye and Tissue Bank is
Now Dakota Lions Sight and
Health
20
Local Company
On the Forefront of Telehealth
Services Qvidity offers affordable
telemedicine solutions for rural hospitals,
clinics, and patients
24Expanded
Cancer Care in Mitchell
and Aberdeen
Sponsored Feature
6 | Safe Patient Handling ■ By Mandy WittExpert advice for avoiding injury in the medical workplace
8 | Safety Sensitive Positions: Are You at Risk? ■ By Amanda McKnelly and Maria Eining
23 | Area Providers Join Federal Initiative
25 | Prairie Lakes Introduces a Cutting Edge Procedure
26 | Technology Enhances Family Bonding with Babies in Neonatal Intensive Care Unit
26 | Merger Will Expand Reach of Local Medical Supply Company
28 | Business Profile: Beckenhauer Construction ■ By Alex Strauss
30 | The Building and Flow of Medical Credentialing ■ By Lavonne McKee
31 | Physician Sunshine Act: Opening the Windows on Physician Financial Involvement with Medical Product Manufacturers■ By Scott Leuning
32 | Effective Solutions for Weight Loss and Heart Health ■ By Holly Swee
34 | “It Gives You a Bigger Voice” Pharmacist explains what prompted him to go back to school for his MBA
Sponsored Feature
Cover photo: David Pearce, PhD, President of Research, Sanford Health
Photo Courtesy Sanford
Growth in South Dakota’s medical market is paying off in more than just new facilities, providers, and proce-dures. It also means new opportunities to be a part of — and even instigate — cutting edge clinical trials. In this month’s cover feature, we talk with top researchers at Sanford about some of their latest studies and what the grow-ing number and variety of clinical trials means for patients and providers in our region.
page 14
By Alex Strauss
The Lifesaving Power of Increased
Treatment Options
Clinical Trials
MA
RC
H2
016
Vol. 7No. 2
A Local Solution for TELEMEDICINE
Avera Advances Rural Cancer Care
The ‘New” Dakota Lions
Sight & Health
The South Dakota Region’s Premier Publication for Healthcare Professionals
Midwest Medical EditionMidwest Medical Edition
Clinical Trials
THE LIFESAVING
POWER OF INCREASED
TREATMENT OPTIONS
4
Reproduction or use of the contents of this
magazine is prohibited.
©2011 Midwest Medical Edition, LLC
Midwest Medical Edition (MED Magazine)
is committed to bringing our readership of
5000 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,
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From Us to YouStaying in Touch with MED
PUBLISHER MED Magazine, LLC Sioux Falls, South Dakota
VICE PRESIDENT
SALES & MARKETING Steffanie Liston-Holtrop
EDITOR IN CHIEF Alex Strauss
GRAPHIC DESIGN Corbo Design
PHOTOGRAPHER studiofotografie
WEB DESIGN Locable
DIGITAL MEDIA
DIRECTOR Jillian Lemons
CONTRIBUTING
WRITERS Maria Eining
Scott Leuning
Lavonne McKee
Amanda McKnelly
Holly Swee
Mandy Witt
STAFF WRITERS Liz Boyd
Caroline Chenault
John Knies
DON’T YOU LOVE IT when the world turns the
corner toward spring? The air across the Plains
states is still plenty cold, but the sun is warmer
and milder days begin to finally seem possible
again.
In the spirit of the season, this issue’s cover feature is
also about possibility and hope. We’re focusing on the new
treatment options and new understanding made possible
by the increasing availability of clinical trials in our region.
Our thanks to the researchers at Sanford Health for sharing
their insight on this timely topic which impacts not only
providers but also patients across the region.
The cold temperatures haven’t slowed down the tide of
medical news coming across our desks this month. From
the rebranding of the South Dakota Lions Eye and Tissue
Bank, to the opening of Mitchell’s brand new medical
campus, to an advanced new procedure available in
Watertown, to new family-bonding technology in Regional’s
NICU, this issue of MED is brimming with news you need
to know. (Be sure to check out this month’s News & Notes
section, too, for many news doctors.)
In this month’s expert columns . . . Midwest Health
Management tackles the difficult topic of physician impair-
ment, RAS has crucial advice on patient handling to avoid
worker injury, and Credentialing USA simplifies the complex
with a handy infographic.
Finally, we are excited to introduce you to Qvidity, a local
telemedicine company raising the bar and lowering the costs
of telemedicine for rural providers. You’ll find more about
the company in their Sponsored Feature.
It is thanks to companies like Qvidity and the advertisers
you see throughout MED that we continue to be able to
bring you this quality publication, year after year, free of
charge. When you see them, thank them!
As always, your comments and contributions are
always welcome. Reach us any time at Info@Midwest
MedicalEdition.com.
Warmly,
—Steff and Alex
Alex Strauss
Steffanie Liston-Holtrop
4
CONTACT INFORMATION
Steffanie Liston-Holtrop, VP Sales & Marketing
605-366-1479 [email protected]
Alex Strauss, Editor in Chief 605-759-3295
MAILING ADDRESS PO Box 90646 Sioux Falls, SD 57109
WEBSITE MidwestMedicalEdition.com
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On the Website this month Enhancing Care in Rural Communities
USD is using telemedicine to link health education facilities in
Vermillion, Pierre, Rapid City and Sioux Falls with 28 rural hospitals
throughout South Dakota. A win for students and patients.
RE-POWER Rural Weight Management StudyAkron Mercy Medical Clinic will take part in an
innovative study of obesity in rural communities.
Regional Health’s Latest “I Am Regional Health” NomineesShining a spotlight on Regional Health’s top employees
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MORE THAN A MAGAZINE,A Medical Community Hub
Midwest Medical Edition 6
HAVE YOU EVER stopped to think about exactly how much patient care providers actually lift in an average shift? It has
been estimated that in an eight hour shift, the cumulative weight that a patient care provider lifts is 1.8 tons. Can you see your-self lifting an elephant or six grand pianos every day? Of course not! But patient care providers lift that much in smaller incre-ments all day long, which adds up and puts them at risk for injury.
Nationwide statistics show that patient care providers are ranked at the top of occupa-tions with high work related injuries (Bureau of Labor Statistics, 2006).
■ 52% of nurses complain of chronic low back pain 38% suffered occupational-related back pain severe enough to require time away from work
■ 20% are transferred to a different unit, position, or change employment
■ 12% leave the profession due to back pain
With a growing obesity rate, higher levels of patient acuity, shorter hospital stays, and the continued increase in nursing workloads, today’s hospitalized patients are more depen-dent on patient care providers for assistance with mobility; putting them at greater risk for injury. Consequences to employers include high workers’ compensation costs, days away from work for injured workers, as well as the need to hire replacement workers. Protecting the health and safety of patient care providers is vital not only to the workers and their employers, but also to the overall health of the nation.
The causes of caregiver injuries are primarily related to the manual lifting and
moving of patients. The primary risk factors for moving patients include forceful exertions, repetition, and awkward postures. Some exam-ples of high risk patient handling activities include:
■ Boosting a patient in bed■ Turning/repositioning■ Lateral transfers■ Vertical transfers to/from bed/
wheelchair/stretcher/toilet/vehicle
■ Assisting a patient from sit to stand/stand to sit
■ Ambulating/walking patients
The goal of safe patient handling is to reduce the physical stresses and injury risk to patient care providers related to manual lifting and transferring of patients, while striving to improve the safety, comfort, and quality of patient transfers. Safe patient handling aims to reduce lifting demands associated with moving patients to 35 pounds or less, as set forth by the National Institute for Occupational Safety and Health (NIOSH).
Thirty-five years of research has shown us there is no “safe” way to manually lift a patient, and using proper body mechanics alone will not prevent caregiver injury. Use of safe patient handling equipment combined with effective training on safe work practices is the only proven way to reduce caregiver injuries associated with moving and transferring patients. Use of safe patient handling equipment has been shown to reduce exposure of manual lifting injuries by up to 95%.
A comprehensive safe patient handling program is necessary to effectively reduce the risk of caregiver injury. ■Mandy Witt, OTR/L, is an Ergonomics and Loss
Control Specialist with RAS.
Find the key elements of a safe patient handling program–as well as the long-term
benefits of such a program–in the full version of this article on our website.
When Sioux Falls audiologist Bob Froke developed ringing in his ears after a bout of the flu last year, he assumed it would clear up. When it didn’t, and hearing loss also set in, he was suddenly thrust into an experience through which he’d so often counseled patients.
“I had to put a lot of extra energy into concentration and focus just to make sure that I was getting everything,” recalls Froke. “There were always little gaps. A couple of times, I gave some pretty off-the-wall answers and someone would says ‘That’s not what we’re talking about’.”
But, whereas a ‘typical’ patient goes through a an average grieving and denial process of about 7 years before finally addressing hearing loss, Froke knew he didn’t have that kind of time.
“I had to come to grips with it pretty quickly because I thought ‘You’re in the profession. Better get real about it, fast.’ So I had to hurry up my grieving process,” says Froke.
That’s not to say he didn’t grieve. And deny. And justify. And all of the other things his hearing loss patients do. In the upcoming April/May issue of MED, we’ll explore Froke’s story and how this kind of “shoe on the other foot” experience can impact the way healthcare professionals relate to and care for their patients.
In the Next Issue . . .
By Mandy Witt
Safe Patient Handling
A New Perspective
March 2016 7MidwestMedicalEdition.com
8
THERE ARE OCCUPATIONS in our communities that are considered “safety sensitive” because they are responsible for the welfare and safety of others. Safety sensitive positions include pilots, police officers, fire-
fighters, attorneys and healthcare professionals. Because these individuals have a responsibility to the public, these positions require personal accountability and public oversight and are often regulated by a licensing board or similar authority.
Like all professionals, workers in safety sensitive positions are susceptible to illnesses that can lead to impairment. Such illnesses are common in society; both depression and alcoholism each reportedly affect 1 in 10 Americans. If a safety sensitive worker is impaired, errors may occur which could cause significant harm to themselves or others.
Fortunately, there is an organization in South Dakota that provides confidential assessments, resources and ongoing monitoring of individuals at-risk for impairment. Midwest Health Management Services is a confidential, clinical resource for people in safety sensitive positions, including healthcare professionals. MWHMS was founded to assist professionals and organizations, to be a resource in addressing any of the following:
■ Education regarding health and
wellbeing for professionals in
safety sensitive positions
■ Education and assistance and evaluation
if substance use or mental health
concerns are identified
■ Referral to appropriate treatment
services and ongoing monitoring
of continued recovery status.
To date, MWHMS has provided assistance to more than 420 professionals and students across South Dakota. Monitored recovery services offered by MWHMS follow and replicate strategies used by State Physician Health Programs (PHP) and the Federal Aviation Medicine Advisory Service.
Studies of PHP programs, including the Domino Study and the
Dupont Study revealed that, nationally, PHP participants demonstrate a 78% success in recovery without relapse at an average of over 7 years of monitoring. Long-term success rates of pilot monitoring programs reported by the aviation industry note abstinence rates exceeding 85%. These rates are in stark contrast to recovery rates for the general public, as generally, only about 40% remain in remission at 1-year follow-up.
When an ill professional engages in appropriate treatment and monitored recovery services, a highly valuable resource is preserved and is a benefit to the public. In addition, given the morbidity and mortality related to untreated and undertreated substance use and mental health disorders, professional monitoring programs offer great advantages in recovery outcomes.
A vibrant monitored recovery program for professionals in safety sensitive positions can actually enhance public safety by encouraging early intervention, reducing risk associated with potentially impairing health conditions. Assisting professionals in safety sensitive positions to obtain the appropriate treatment and continued care is key. Professional monitoring programs acknowl-edge a primary concern for public safety, while taking into account that appropriate intervention and monitoring can save a career, a reputation, or even a life.
MWHMS welcomes questions or referrals from any source including, peers, self, physicians, colleagues, attorneys, treatment centers, family or friends. ■
Amanda McKnelly and Maria Eining are co-owners of Sioux Falls-based
Midwest Health Management Services.
By Amanda McKnelly and Maria Eining
SAFETY SENSITIVE POSITIONS
ARE YOU AT RISK?
Domino, K.B., Hornbein, T.F., Pollissar, N.L., Renner, G., Johnson, J., Alberti, S & Hankes, L. (2005) Risk factors for relapse in healthcare professionals with substance use disorders. Journal of the American Medical Association, 293, 1453-1460.
DuPont, R., McLellan, A.T., Carr, G., Gendel, M., & Skipper, G.E. (2009) How are addicted physicians treated? A national survey of physician health programs. Journal of Substance Abuse Treatment. 37(1), 1-7.
Aviation Medicine Advisory Service, FAA-Sanctioned pilot alcohol abuse programs in business aviation. Accessed online on 7/4/2011.at http://aviationmedicine.com/articles/index.cfm?fuseaction=printVersion&articleID=18
Sponsored Feature
March 2016 9MidwestMedicalEdition.com
News & NotesSouth Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska
AVERA
Avera has announced an
agreement to lease operations
of the Rock Rapids community
hospital and clinics beginning
in May 2019. The community hospital is owned by Merrill Pioneer Community Hospital Association, which in the past has leased hospital operations to Sanford Health. Partnering with Avera, the Hospital Association plans to build a new hospital and clinic in Rock Rapids.
Avera Marketing won the
top national Judge’s Choice
Award for its “Butt Seriously”
colorectal cancer awareness
campaign in the 2015 Cancer Awareness Advertising Awards. Other Avera awards earned in the competition included two Gold Awards for the 4-D Breast Care radio ad series and Pink Ribbon Campaign and a Silver Award for the Avera Cancer Institute Magazine.
Avera McKennan Hospital
& University Health Center
in Sioux Falls was named in
Becker’s 2015 edition of “100
hospitals with great women’s
health programs” for the
second year in a row. Avera Queen of Peace Hospital in Mitchell was named to the list of 52 hospitals with the lowest all-cause unplanned readmission rates. Avera Queen of Peace is the only South Dakota hospital named to this list.
Avera Urgent Care in Mitchell
has become AveraNow Walk-in
Clinic. In addition, the clinic will move to the new Grassland Health Campus in March.
Avera Medical Group Liver
Disease Sioux Falls has added
new FDA-approved technology
that provides non-invasive,
painless and immediate
assessment of liver fibrosis
(scarring). FibroScan, also called transient elastography, is a technique used to measure liver stiffness and provides assessment of liver fibrosis including liver cirrhosis. Liver disease often advances without specific symptoms. FibroScan provides specialists with a tool to catch liver disease in its earliest stages.
HIMSS Analytics has awarded
Avera McKennan Hospital
& University Health Center
with a Stage 7 Award. HIMSS Analytics developed the EMR Adoption Model in 2005 to evaluate the progress and impact of EMR in hospitals in the HIMSS Analytics Database. The final stage, Stage 7, represents an advanced patient record environment. During the second quarter of 2015, only 3.7 percent of the more than 5,400 U.S. hospitals in the HIMSS Analytics Database received the Stage 7 Award.
BLACK HILLS
Black Hills Surgical Hospital
has been ranked Number 6
in the nation out of more
than 3,000 hospitals for high
quality patient care by Modern Healthcare, a weekly healthcare magazine. The rankings are based on high quality clinical processes, high levels of patient experience and satisfaction, and high efficiency in providing healthcare in a cost effective manner. Black Hills Surgical Hospital is the only South Dakota hospital listed in the rankings.
Board-certified
orthopedic
surgeon Paul
Miller, MD,
has joined
Regional
Health. Dr. Miller has 28 years’ experience and joins the system from MPG Orthopaedic Specialists in Oklahoma. His practice is located on the first floor of Regional Medical Clinic – Western Hills Professional Building in Rapid City.
The following new providers have also joined Regional Health:
Andrea Baier,
MD, Palliative Care, Rapid City Regional Hospital.
Andrew Brevik,
DO, Hospital Medicine, Rapid City Regional Hospital.
Jessica Brosz,
CNP, Cardiology, Regional Heart Doctors, Rapid City.
Michelle Gourley,
CNP, Cardiology, Regional Heart Doctors, Rapid City.
Holli Moeller-
Montiel, CNP, Occupational Medicine, Regional Urgent Care, Rapid City.
Patricia Schroeder,
CNP, Cardiology, Regional Heart Doctors, Rapid City.
Ashley Tupper,
FNP, Family Medicine, Regional Medical Clinic, Newcastle, Wyo.
Happenings around the region
Midwest Medical Edition 10
News & Notes
“ ”The life so short, the craft so long to learn. — Hippocrates MED QUOTES
SANFORD
Two new vice presidents have
joined the Sanford Health
Network. Dale Gillogly brings more than 25 years of experience in healthcare administration. He most recently served as a regional administrator for Avera McKennan Hospital. Terry Mahar joins Sanford from Home Health and Hospice in Minnesota where he worked as the regional director. He was also a senior management healthcare consultant at Eide Bailly for more than 15 years.
Two new members have joined
Sanford Health’s Board of
Trustees: James E. Cain and Melissa C. Hinton. Cain is the co-founder and chairman of Cain Brothers in New York, and he is actively engaged with the firm’s clients and the nation’s leading healthcare providers. Hinton is a partner with Evans, Haigh & Hinton, LLP. The majority of her practice is focused on the area of healthcare law.
Daniel Lister, MD, is now
offering orthopedic outreach
services at Sanford Webster
Medical Center. Lister graduated from the University of California-Irvine College of Medicine and completed his residency and internship at the Letterman Army Medical Center in San Francisco. He is certified by the American Board of Orthopedic Surgery. Dr. Lister, who also practices in Aberdeen, will offer appointments one day per month in Webster.
SIOUXLAND
Hematologist/
oncologist Susan
Roeder, DO, has
joined the June
E. Nylen Cancer
Center. Roeder comes to Sioux City after 13 years at the Roy J. and Lucille A. College of Medicine, University of Iowa where she served as Clinical Outreach Director and clinical associate professor for the Division of Hematology, Oncology and Blood & Marrow Transplantation. Roeder earner her DO from the University of Osteopathic Medicine and Health Sciences in Des Moines and did a fellowship in hematology/oncology at the University of Colorado, Denver.
Mercy Medical Center—
Sioux City will host more
than 1,700 Siouxland
women at its fifteenth
annual Women’s Night Out
on Thursday, April 7th at
the Sioux City Convention
Center. Proceeds will benefit Mercy’s Child Advocacy Center, which was recently re-accredited by National Children’s Alliance. Since 1989, Mercy’s Child Advocacy Center has served more than 15,000 abused children and their families. See Learning Opportunities on the inside back cover for more information on the fundraiser.
Mercy Medical Center honored
local physicians at the Medical
Staff Appreciation Dinner
meeting at the Marina Inn
on January 21st. The Golden Heart award was presented to Dr. Matthew Timm, Pender Mercy Medical Clinics, Dr. Jeffrey Krohn, Kingsley Mercy Medical Clinic and Dr. Mary Schneider, Siouxland Women’s Health Care, PC. for exceptional customer service, great bedside manner, timely response, and compassion.
Sara Karpuk,
PA-C, has joined
the staff at
Mercy Internal
Medicine
and Pediatric
Clinic. Karpuk earned an MS in Physician Assistant Studies from the University of Iowa Carver College of Medicine. Most recently, she has worked as a physician assistant at Siouxland Community Health Center in Urgent Care.
wel
Midwest HealthManagement Services
SD Health Professionals Assistance Program
Seek HELP Find HOPE
www.mwhms.comph | 605-275-4711fax | 605-275-4715
Helping Professionals
Stay on Track
March 2016 MidwestMedicalEdition.com 11
News & Notes
Happenings around the region
South Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska
Board Certified Family Nurse
Practitioner Staci Schweder,
ARNP, has joined the staff at
Mercy Singing Hills Family
Medicine. Schweder holds an MS from Briar Cliff University. Most recently, she was an ARNP at Family Medicine Clinic in LeMars, Curaquick Urgent Care and Tri-State Physicians. Schweder has also taught nursing as an Adjunct Faculty member at Briar Cliff University.
Sandra Gutierrez
has joined the
Mercy Medical
Center board
of directors. Ms. Gutierrez
is the co-owner/manager of Mundo Latino Spanish newspaper and an insurance agent for MetLife Auto and Home–both in South Sioux City, Nebraska.
Mercy Home Care is among
the top ten home health
agencies in the nation
according to a ranking
published by LexisNexis
Risk Solutions. LexisNexis performed rankings of home health and hospice services based on annual claims and patient volumes. The rankings help home health and hospice service companies better understand their market positions, dynamics and environment.
OTHER
Dr. Tim Ridgway of Brandon
has been named Executive
Dean of the University of
South Dakota Sanford School
of Medicine. Dr. Ridgway currently serves as Dean of Faculty Affairs at the medical school and is a practicing gastroenterologist. As Executive Dean, Dr. Ridgway will represent the school’s dean, Dr. Mary Nettleman, if she is unavailable, and he will also serve as a senior advisor to the medical school.
Midwest Medical Edition
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12
News & Notes
William G. Mayhan, PhD,
has been named dean of the
division of Basic Biomedical
Sciences at the University
of South Dakota Sanford
School of Medicine. An Omaha, Nebraska native, Dr. Mayhan received his BS from Creighton University, and his PhD from the University of Nebraska. Dr. Mayhan comes to the medical school from Louisiana State University (LSU) Health Sciences Center, Shreveport, where he was head of the Department of Cellular Biology and Anatomy.
Dr. Russell Wilke has been
named the new chair of
the University of South
Dakota Sanford School of
Medicine’s Department of
Internal Medicine. Wilke is a practicing general internist and also holds the position of enterprise director of pharmacogenetics at Sanford Imagenetics. He received both his MD and his PhD in pharmacology and toxicology from the Medical College of Wisconsin. Wilke replaces Dr. LuAnn Eidsness who is retiring.
Dr. Keith M.
Baumgarten,
an orthopedic
surgeon with
Orthopedic
Institute
who has worked with
professional sports teams
at several levels, is quoted
in an in-depth article by
ESPN Senior Writer Bonnie
D. Ford on Human Growth
Hormone. It is titled, “A study might change the way sports thinks about human growth hormone”.
Greg Carlson,
PhD, is the
new CEO of
CNOS, PC,
in Dakota
Dunes.
Dr. Carlson previously served 11 years as the CEO of a 500-bed community hospital in Owensboro, Kentucky and 5 years as COO of Marian Health Center (now Mercy Medical Center) from 1990-1994. He holds a PhD in Health Services and Policy from the University of South Carolina, and a Bachelors in Business and Political Science from Southwest Minnesota State University.
Prairie Lakes Healthcare
System has been named
a recipient of the Women’s
Choice Award as one of
America’s Best Hospitals
for Emergency Care for
a third consecutive year. This designation is the only Emergency Care award that identifies healthcare institutions based on female patient satisfaction and preferences.
Ophthalmologist Dr. Vance
Thompson of Sioux Falls
was a principal investigator
for the FDA-monitored
clinical trial for the
FDA-approved AcuFocus
KAMRA corneal inlay and
he testified before the FDA
on the inlay’s efficacy. The KAMRA corneal inlay was approved by the FDA in April of 2015. The corneal inlay is an implantable device designed to correct near vision in patients with presbyopia.
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March 2016 MidwestMedicalEdition.com 13
Clinical Trials
THE LIFESAVING
POWER OF INCREASED
TREATMENT OPTIONS
14
By Alex Strauss
BIOMEDICAL RESEARCH stud-ies conducted on human participants are universally known in the profes-sion as “clinical trials”. But for the
President of Research at Sanford Health, the term is just too limited.
“I prefer the phrase ‘increased treatment options’, because that’s what clinical trials really are,” says David Pearce, PhD, Senior Scientist with Sanford Children’s Health Research Center and director of the Pearce Lab.
“Biomedical science and medicine are always advancing. When you are treating a patient, you have the standard of care. But [through clinical trials] you also have the ability to offer them the most up-to-date technology or intervention for their malady that may eventually become the standard of care.”
While bench research can take place almost anywhere innovative thinkers and a well-equipped laboratory exist, clinical trials require a sufficient number of eligible human partici-pants and, often, significantly more funding. Less than a decade ago, there were few of these “increased treatment options” available in the South Dakota region. But as the area’s population has grown and the number of qualified physician scientists and researchers has increased, institutions like Sanford have committed more resources to clinical trials and have been rewarded for their efforts.
“Sanford has expanded Sanford Research because there was a feeling that our research needs to impact patients,” says Dr. Pearce whose own research has focused on the molecular basis of inherited pediatric neurodegenerative diseases. “We have basic and translational research, but we have also invested in advancing our clinical research.”
The effort got a major boost when Sanford was admitted into an elite group of 34 health-care institutions that are part of the National Cancer Institute’s Community Oncology Research Program. NCORP sites participate in NCI cancer prevention, control, screening and post-treatment surveillance clinical trials. Sanford Health’s large footprint means that
many of the region’s cancer patients are able to take part in large-scale national trials they might never have been able to access just a few years ago .
Clinical trials lead to more clinical trials in a sort of snowball effect. An institution’s involve-ment in NCORP-style community based clinical trials can, as it has in Sanford’s case, open the door to what Dr. Pearce calls commercial trials. A growing number of pharmaceutical companies and device manufacturers now look to South Dakota as a good place to run an FDA trial. “Reputation is everything in research,” says Dr. Pearce.
The third category of trials happening with increasing frequency are those initiated by local clinicians or researchers. “Every year, we have had more applications to the FDA generated by us, our own intellectual ideas,” says Pearce. “In these cases, one of our own investigators has developed an approach or a compound.”
Beyond the obvious advantages of increased treatment options for area patients and their physicians, the availability of more clinical trials has had another positive effect. “It allows us to attract some fantastic physicians in oncology, radiation oncology, breast surgery, and a number of other areas. These doctors want to be able to offer the very latest treatment options to their patients. So it really has a knock-on effect,” says Dr. Pearce.
Although Sanford makes an effort to keep providers up-to-date on the various open clinical trials, like other area institutions, it also lists all available trials on its website for easy reference by any physician looking for an alternative or, in some cases, an add-on to the standard of care for patients who have few options.
“It is important to remember than a clinical trial is not an experiment and that a treatment has already been extensively tested in the labora-tory before it is even approved to be tried in people,” says Dr. Pearce. “My message to clinicians is that you should always consider these additional treatment options and clinical trials as possibilities for your patients who qualify.”
March 2016 15March 2016 MidwestMedicalEdition.com
Steven Powell, MD
Gerard David, MD
A VACCINE FOR EBOLAWith ebola continuing to resurface in the wake of last year’s outbreak in Africa, research being conducted by infectious disease physician and researcher Gerard David, MD, is especially timely. David and his colleagues are conducting a Phase 3 randomized placebo controlled multicenter safety study on the immunogenicity of an ebola vaccine.
“The vaccine uses a recombinant vesicular stomatitis virus in which the protein of this virus is replaced with ebola protein,” explains Dr. David. “Our goal is to determine whether this is immunogenic and whether it is safe.”
The study, sponsored by Merck Pharmaceu-ticals, had met its 1125 patient enrollment goal (including 17 participants from Sanford) just a month after it opened in August 2015. Most participants are healthcare workers. They will have three follow-up visits to report side effects and be tested for antibody titers over the course of the six month study.
“There is currently no vaccine for Ebola,” says Dr. David. “This trial has very good potential, although it is too early to say how effective the vaccine will be.”
THE ROLE OF GENET-ICS IN CANCERThe role that a patient’s genes play in the devel-opment, progression or treatment response of their disease is another major focus for area researchers. The recently-concluded GEMMA (Genetic Exploration of the Molecular Basis of Malignancy in Adults) trial utilized next- generation gene sequencing technology to analyze tumor samples and provide real-time clinical information to the care teams of 120 adults with rare or recurrent cancer.
“One thing we learned from the GEMMA trial is that patients really want access to these kinds of treatments but that insurance doesn’t always want to pay for it and physicians don’t always know how to interpret it,” says Sioux Falls oncologist and clinical researcher Steven Powell, MD.
For this reason, the next generation of GEMMA–COMPASS (Community Oncology use of Molecular Profiling to Personalize the Approach to Specialized Cancer Treatment at Sanford) will offer genetic testing to any children or adults with incurable cancer, with the goal of helping to direct them toward the most effective treatment.
Immunotherapy is another area of interest for Dr. Powell, who is leading a trial of the PD-1 inhibitor pembrolizumab as a way to enhance the effects of standard chemotherapy for head and neck cancer. “This allows us to use a lower dose of chemotherapy. So we are hoping for higher cure rates with less toxicity,” says Powell.
New and Notable Sanford Research Trials
“ My message to clinicians is that you should always consider these additional treatment options and clinical trials as possibilities for your patients who qualify.” —David Pearce, PhD
Midwest Medical Edition 16
Patrick Kelly, MD
Open Clinical Trials in South Dakota
Although clinical trials are often associated with cancer treatment, hundreds of trials in a variety of disciplines are underway in the state of South Dakota alone and many more in the surrounding states. Below is a partial list of disease processes being studied by researchers in our region. A full list of open clinical trials and their eligibility criteria are available on each institution’s website.
• Acute MyeloidLeukemia
• Alzheimer’s Disease
• Aneurysm
• Atherosclerosis
• Brain Cancer
• Breast Cancer
• Cataracts
• COPD
• Coronary Artery Disease
• Crohn’s Disease
• Cystic Fibrosis
• Type 1 Diabetes
• Type 2 Diabetes
• Gastric Cancer
• Genitourinary dysfunction
• Head andNeck Cancer
• Heart Disease
• Heart Failure
• Hypertension
• Infectious Disease
• InflammatoryBowel Disease
• Interstitial Cystitis
• Leukemia
• Lung Cancer
• Lymphoma
• Multiple Myeloma
• Musculoskeletal Disease
• Neurological Disorders(Huntington’s, MS,Neuropathy)
• Non-Hodgkin’s Lymphoma
• Ovarian Cancer
• Phenylketonuria
• Pancreatic Cancer
• Prostate Cancer
• Pulmonary ArterialHypertension
• Rheumatoid Arthritis
• Sexual Dysfunction
• Squamous CellCarcinoma
• Stroke
• Various pediatriccancers
• Vascular Diseases
• Vitamin DDeficiency
A NEW STENT GRAFT FOR TAAASanford physician inventor Patrick Kelly, MD, recently operated on the first patient treated as part of the clinical study of a new kind of stent graft for thoracoabdominal aortic aneurysm. Dr. Kelly says the Medtronic Valiant TAAA Stent Graft System, which he developed, allows for minimally invasive repair of a type of aneurysm for which the open-procedure mortality rate is 25 percent.
“As an artery becomes diseased, it becomes deformed. To develop a graft that is going to match everyone’s anatomy is virtually impossible,” says Dr. Kelly who designed his alternative stent when faced with a particularly challenging case of aortic disease. “Our design makes no attempt to try to match people’s anatomy so we are not limited by their anatomy.”
Kelly credits his ability to “think outside the box” and design a creative solution to his background as a structural engineer. Based on the positive responses of the first 29 patients treated with the new stent, Sanford entered into a license agreement with Medtronic to produce the final design which is now the subject of the multi-center clinical trial.
“This procedure marked an important first step in the process to obtain FDA approval,” says Dr. Kelly.
Kelly was also recently involved in a collabora-tion with USD to create drug coated balloons for the treatment of peripheral artery disease.
March 2016 17March 2016 MidwestMedicalEdition.com
Nationally Recognized �e University of South Dakota School of Health Sciences
South Dakota’s only comprehensive health sciences school is a recognized, national leader in interprofessional education. We help advance and de�ne healthcare in our state and nation. Our exceptional faculty excels at teaching, researching, mentoring. Ten standout programs bene�t our students and our communities.
Addiction StudiesDental HygieneHealth SciencesMedical Laboratory SciencesNursingOccupational �erapyPhysical �erapyPhysician Assistant StudiesPublic HealthSocial Work
We develop scholars, practitioners and leaders in health andhuman services to serve South Dakota and beyond.
Nationally Recognized �e University of South Dakota School of Health Sciences
South Dakota’s only comprehensive health sciences school is a recognized, national leader in interprofessional education. We help advance and de�ne healthcare in our state and nation. Our exceptional faculty excels at teaching, researching, mentoring. Ten standout programs bene�t our students and our communities.
Addiction StudiesDental HygieneHealth SciencesMedical Laboratory SciencesNursingOccupational �erapyPhysical �erapyPhysician Assistant StudiesPublic HealthSocial Work
We develop scholars, practitioners and leaders in health andhuman services to serve South Dakota and beyond.
www.usd.edu/heal th
Midwest Medical Edition 18
IF YOU HAVE been in the area for more than a handful of years, you probably remember that the South Dakota Lions Eye and Tissue bank
adopted this name in 2012 to better reflect its growing involvement in tissue (not just corneal) recovery and distribution.
After all, the former Lions Eye Bank also recovers bone and skin, tendons, heart valves, and veins for transplantation. Experts there also prepare corneas for advanced sur-gical procedures, work closely with local and national research partners, provide public education about organ and tissue donation, and even offer EMS training. Calling them-selves an “eye bank” just did not cover it.
Now, the organization is rebranding itself once again to reflect an expansion of its service area and of its mission to restore the gifts of both sight and better health.
“We had an increased need for corneal tissue and at the same time the eye bank in
North Dakota was struggling because of regulatory changes,” says Dakota Sight and Health CEO Marcy Dimond. “Partner-ing with an agency that had a local presence and a similar mission not only helped us meet our demand but also helped to grow their program.”
Since implementing the partnership with North Dakota in 2015, the organiza-tion has consolidated staff to a single headquarters in Sioux Falls with satellite offices in Rapid City, Bismarck and Fargo. More importantly, it has doubled the number of corneas coming from North Dakota and increased distribution by 48 percent in 18 months.
“Part of reframing the name was to better identify the region that we serve and to really raise up our mission by keeping it front and center,” says Dimond.
Meanwhile, Dakota Lions Sight and Health continues to expand the scope of
its services and its tissue recovery efforts. The orga-nization works closely with law e n f o r c e m e n t , coroners, and with hospice to identify tissue donation oppor-t un it ies that might otherwise be missed when an indi-vidual dies in a setting other than the hospital.
Anxious to stay on the leading edge of up-and-coming fields such as cancer research and genomics, DLSH is also committed to keeping as much tissue as pos-sible in the Dakotas.
“This is an exciting time for us as we continue to grow and renew our focus on our communities,” says Dimond. ■
Why The “South Dakota Lions Eye and Tissue Bank” is now
“Dakota Lions Sight and Health”By Alex Strauss
Dakota Lions Sight and Health headquarters in Sioux Falls. Photo courtesy DLSH
Marcy Dimond
Photo courtesy DLSH
.
March 2016 19MidwestMedicalEdition.com
Services
Local Company On the Forefront
of Telehealth
20
Sponsored Feature
If you, your practice,
or healthcare system
are considering adding
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begun evaluating soft-
ware solutions, or are
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but looking at new or better solutions, then
you need not look further than your own
backyard for the industry’s up and coming
telehealth company – Qvidity.
Qvidity, formed in 2014 by Dr. Jeremy
Storm (a local infectious disease physician and
telemedicine specialist) and Brian Brua (owner,
Fused Interactive) is a telemedicine software
and consulting company based in Sioux Falls,
SD. Qvidity licenses its proprietary telehealth
platform, Qvidity Direct, to doctors, medical
practices, hospitals, and other healthcare
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for their patients.
“We believed in 2014 that telemedicine
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go mobile. As it turns out, we were right.”
Features of Qvidity include HIPAA compliant
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“Because of its versatility, we get calls from
potential clients and industry leaders nearly every
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Prices range from $30-$70/month per using
provider. Qvidity’s branded (white label) sub-
scription platform starts at $50/month. For new
clients, Qvidity charges either a one-time brand-
ing/launch fee or a free launch option with a
per visit fee. “Our prices are what we believe a
physician would reasonably want to pay to
have a telemedicine solution.” Dr. Storm states
that with even minimal use, providers can profit
from Qvidity. “Other solutions are priced so
high that they are a loss leader. Our business
model is different. We want our clients to profit
from using telemedicine in their practices.”
Dr. Storm states that 2015 saw the approval
of over 200 bills related to telehealth. Studies
show that not only are patients and providers
ready to adopt telemedicine, but that
telemedicine will save the U.S. economy billions
of dollars annually. CMS, Medicare, the VA, and
private insurers are rapidly loosening regulations
and improving reimbursement. “Up until now,
telehealth was too costly, poorly reimbursed,
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ready technology, and patient demand.”
Telemedicine utilization is expected to
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with most doctor visits occurring remotely via
connected devices. “You will no longer have to
sit and wait at the doctor’s office. You will see
your doctor from the convenience of work or
home.” Telemedicine is also seen as having the
potential to revolutionize healthcare in remote
and underserved areas, including developing
countries. “We provide telehealth functionality
not only to regional and national clients, but are
expanding into the international market as well.”
Qvidity does this thru the use of language
translation technology, which is a standard offer-
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Qvidity’s clients include providers from
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chiatry to name a few. While hospitals and
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at a faster rate than small to medium sized
practices, Dr. Storm states adoption is expected
to double year over year throughout the
industry and into all segments. “ACO’s and large
healthcare systems were early adopters, but we
are seeing a growing demand among small to
medium sized hospitals and medical practices.”
Dr. Storm says that the use of Qvidity’s technol-
ogy could even expand into non-healthcare
related businesses, such as banking, law,
and other types of sales and consulting. “If a
company has a need for secure messaging,
secure video, scheduling, and payment process-
ing, we can service them,” Dr. Storm says.
In addition, Qvidity provides professional
consulting related to telehealth. “We assist our
clients with understanding state and national
law, scope of practice, and how to grow a robust
and profitable telemedicine service line.” Qvidity
is also partnering with regional and national
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offers affordable solutions for rural hospitals, clinics, and patients
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21MidwestMedicalEdition.com
New Leader at Sanford Health’s Imagenetics Research ProgramCORNELIUS BOERKOEL, MD, PHD, has joined Sanford Health as the executive director of the Sanford Imagenetics Research Center on Genomic and Molecular Medicine.
Boerkoel will use his more than 30 years of research and clini-cal expertise to investigate new ways of expanding Sanford Imagenetics through development of genetic and genomic medicine tools for primary care medical practice at Sanford Health. Sanford Imagenetics is an initiative that brings personalized medicine and pharmacogenetic testing into primary care for adult patients.
“Boerkoel’s experience as a physician scientist makes him a perfect fit for this role and a natural addition to Sanford Imagenetics,” says Gene Hoyme, MD, chief of genetics and genomic medicine at Sanford Health.
Boerkoel most recently served as a staff clinician and directed the translational laboratory at the National Institutes of Health Undiagnosed Diseases Program. He is also a co-founder of the Rare Disease Foundation.
“Sanford’s vision for genomic medicine is thoughtful, logical and attentive to the interaction between genetic and ecological factors,” says Boerkoel. “We have a great opportunity to revolu-tionize the integration of genetics within internal medicine.”
Boerkoel received his MD and PhD degrees from Case Western Reserve University School of Medicine in Cleveland and completed his residency at the University of Washington in Seattle. He also completed a fellowship in clinical genetics at The Hospital for Sick Children of Toronto. Boerkoel joined Sanford Health in February. ■
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Midwest Medical Edition 22
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DID YOU KNOW?
S IOUX FALLS PLASTIC surgeon Richard Howard, MD, says it was T-Ball that originally prompted him to establish his practice in Sioux Falls in 1992. Specifically, his son Tommy’s T-Ball.
“We were living in Kansas City at the time and we had one son. It was T-Ball season and, if I wanted to catch a game, it was a 45 minute drive there and then another 45 minutes back to the office to finish up,” says Dr. Howard. “An hour and a half to watch one game. Living in the big city had pros and cons but, at that point, the cons were outweighing the pros by a long shot.”Leaning on advice from his father that
“a man who fails his family fails his life”, Dr. Howard moved his family and surgical practice to Sioux Falls, enjoyed as much T-Ball as he could, and never looked back.Twenty-three years later, that emphasis
on family appears to be paying off in spades. Not only did Thomas Howard, MD, decide to follow his father into medicine, but he has recently decided – after some considerable debate – to follow him into his Sioux Falls practice.
“Tom told me years ago that he was abso-lutely not going to go into plastic surgery,” recalls Dr. Howard with a laugh. “He got into medical school at USD and arranged most of his rotations outside of Sioux Falls. He decided that he wanted to do cardiovas-cular surgery.”
But things changed for Dr. Tom Howard when he realized how the cardiovascular landscape had changed in recent years.“Interventional cardiologists have
become so proficient that the surgeons tend to get the very sickest patients. That means more challenges, longer recovery, more problems,” says the younger Dr. Howard, who completed his Plastic & Reconstruc-tive Surgery residency at the University of Oklahoma in June. “With plastics, everyone seemed really happy and excited to go to work. Their patients tend to be happier, too. It all seemed much more attractive.”After discussions with his dad and evalu-
ation of the local medical landscape, the idea of coming home to Sioux Falls with his wife Katie (also a Sioux Falls native) and young son seemed more attractive, too.“My dad and I get along great,” says
Tom. “He’s a wonderful teacher, a talented surgeon, and great with people. I would be missing a great opportunity if I went any-where else.”
“I’m confident knowing Tom’s personal-ity, his high standards, and how he approaches taking care of people, that he will do very well here,” says Dr. Richard, who is hoping to cut back his own workload by 25 to 30 percent. “I think it will be a lot of fun. And the timing for me right now couldn’t be better.”Like his father, Dr. Tom Howard says he
enjoys the personal nature of plastic surgery
and the opportunity to get to know patients over time, such as over the course of a breast reconstruction. As much as he knows he stands to learn from his dad, he’s also hoping to be able to teach some, too.“I am hoping that he will show me some
of the old tried-and-true things that always work and I’ll be able to show him some things that are on the forefront of the specialty,” says Tom, who will be studying for his board exam in the fall.
For his part, Dr. Richard Howard, whose Sioux Falls Center for Plastic and Recon-structive Surgery has been primarily a solo practice, is glad to be gaining not only a partner he likes and trusts, but also a closer relationship with his three-and-a-half year old grandson, Benjamin.“He’s my only grandson and now I am
going to get to go to his T-Ball games,” says Dr. Howard. ■
NOTE: Dr. Tom will join Dr. Richard in practice at the Sioux Falls Center for Plastic and Reconstructive Surgery in August.
By Alex Strauss
For Drs. Richard and Tom Howard, Plastic Surgery is a Family Affair
Father and son in the “T-Ball” days
Dr. Tom Howard and his father,
Dr. Richard Howard
Contact information: 6301 S. Minnesota Ave. Suite 300 Sioux Falls, SD 57108 605-334-1930
Then and Now
New Area Providers Join Federal InitiativeSIOUX FALLS SPECIALTY HOSPITAL, Brown Clinic in Watertown, and the Yankton Medical Clinic are now part of a Medicare Accountable Care Organization (ACO), a national initiative of CMS designed to manage healthcare costs and quality. They are among 121 new participating oragnizations across the country announced in January.
Dakota Healthcare Partners, DBA AccoCare, in Sioux Falls was selected as one of 100 new Medicare Shared Savings Program Accountable Care Organizations (ACOs), bringing the total to 434 Shared Savings Program ACOs serving over 7.7 million beneficiaries nationwide.
Doctors, hospitals and healthcare providers establish ACOs in order to work together to provide quality coordinated care to their patients, while helping to slow healthcare cost growth. Beneficiaries seeing healthcare providers in ACOs can choose whether to see a doctor inside or outside of the ACO. ACOs receive a portion of the Medicare savings gener-ated from lowering the growth in healthcare costs as long as they also meet quality standards for care.
Since ACOs first began participating in the program in early 2012, thousands of healthcare providers have signed on to participate in the program. The new and renewing ACOs, announced in January, brought approximately 15,000 additional physicians into the ACO program.
ACOs continue to show promising results on cost savings. In 2014, they had a combined total net program savings of $411 million for 333 Medicare Shared Savings Program (Shared Savings Program) ACOs and 20 Pioneer ACOs.
Based on 2014 quality and financial performance results for Shared Savings Program ACOs who started the program in 2012, 2013, and 2014, ACOs that reported in both 2013 and 2014 improved on 27 of the 33 quality measures, including patients’ ratings of clinicians’ communication, beneficiaries’ rating of their doctors, screening for tobacco use and cessation, screening for high blood pressure, and Electronic Health Record use. Shared Savings Program ACOs also outperformed group practices reporting quality on 18 out of 22 measures. ■Source: AccoCare
Visit our website for more information about the Shared Savings Program
and list of new and renewing ACOs.
March 2016 23MidwestMedicalEdition.com
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Our extensive selection of intravenous nutritional therapies can be custom tailored to your patient’s needs. We use patient information during intake assessment and specific lab work in conjunction with current conditions and medical history to determine the best protocol to provide integrative care and meet each patient’s needs and goals. By fusing traditional and nutritional medicine together, we can truly offer the best in whole person care for everyone we serve in health and healing.
For more information see www.rebalancesf.com or call 605.275.0001 to speak with one of our health care providers.
Healing Happens Here
Are your patients getting the nutrients they need?
MITCHELL RESIDENTS HAD their first opportunity to meet the area’s new medical oncologist, Kathleen Naegele, DO, at a January open house celebrating Avera Cancer Institute Mitchell’s 15th Anniversary. The event was also a celebration of the installa-tion of a fully digital Elekta Infinity linear accelerator.
The new machine, which is the same model recently installed in the newly-relocated Avera Cancer Institute Aberdeen, is more precise and features an increased number of leaves and a built-in CT. “Patients can now get the same care here as they could in Sioux Falls, which means they can stay closer to home for treatment,” says Dr. Naegele.
A Chicago native, Dr. Naegele completed her hematology/oncology fellowship and internal medicine residency at Midwestern University in Chicago and recently moved to Mitchell from Kingman, Arizona. She joins radiation oncologist Stephen Dick, MD, and medical oncologist Anwarul Haq, MD, and says she is excited about the collaborative spirit she has found in Mitchell.
“It is a very well-oiled machine with a high level of respect among the physicians,” says Dr. Naegele. “That is not something that you can really know about a place until you get there. You just hope.”
Another milestone for the Cancer Institute in both Mtichell and Aberdeen is the recent installation of new high-tech chemotherapy chairs. “The new chairs are not only more comfortable but they are equipped with wifi-connected tablets, vibration, and heaters and can be tipped back quickly if a patient has a reaction, which is very important,” says Dr. Naegele.
At the same time, Avera Cancer Institute in Aberdeen doubled its space in January when it moved into the newly constructed Don and Carmen Meyer Center of Excellence. The new facility houses the practices of medical oncologist Richard Conkin, MD, and radiation oncologist Troy Adolfson, MD. ■
Expanded Cancer Care in
Mitchell and Aberdeen
The Don and Carmen Meyer Center of Excellence, the new home of Avera Cancer
Institute Aberdeen
Avera Cancer Institute Mitchell’s new fully-digital Elekta Infinity linear accelerator.
Photo courtesy Avera.Photo courtesy Avera.
Midwest Medical Edition 24
MED QUOTES “ Spring is the time of plans and projects. — Leo Tolstoy”
NEW GRASSLAND HEALTH CAMPUS OPENS IN MITCHELLAVERA OFFICIALLY OPENS
the new Avera Medical Group
Family Health Center on the
Grassland Health Campus in
Mitchell this month.
The 70,000 square foot,
three-story Health Center
offers comprehensive medical
services provided by 16 physi-
cians, four advanced practice
providers, a psychologist, and
trained care teams.
Specialties include family
medicine, internal medicine,
pediatrics, general surgery,
and urology, as well as derma-
tology starting this summer.
Behavioral health services are
integrated with primary care
at this location.
OTHER SERVICES INCLUDE
■ Urgent care which willbe known as AveraNow
■ On on-site pharmacywith drive-through
■ Dialysis (relocating fromAvera Queen of Peace)
■ Laboratory
■ Diagnostic imaging
“This is the location for
the future of healthcare in
Mitchell, and it all starts with
the opening of this beautiful
healthcare facility,” says
Tom Clark, Avera Queen of
Peace Regional President
and CEO. “The design focuses
on patient-centered care
and comprehensive services,
offered at one convenient
location.” ■
PRAIRIE LAKES INTRODUCES A CUTTING EDGE PROCEDUREPRAIRIE LAKES Healthcare System is one of the first facilities in South Dakota to implant a UroLift System, a less invasive option to relieve symptoms of an enlarged prostate.
Dr. Henri Lanctin, Urologist, implanted the first UroLift System on Monday, February 1st. The UroLift System is a new treatment option for Benign Prostatic Hyperplasia (enlarged prostate) patients who are looking for an alternative to drugs or major surgery. Typically, patients can go home on the same day of the procedure and see rapid symptom relief.
Over 500 million men suffer from Benign Prostatic Hyperplasia. Having an enlarged prostate is not associated with prostate cancer and is not life threatening, but can affect the urinary tract. Symptoms of an enlarged prostate can impact the quality of life and may result in the loss of sleep. The UroLift System is the first and only treatment that does not remove prostate tissue and does not negatively impact a man’s sexual function. ■
SOUTH DAKOTASYMPHONY ORCHESTRA
SDSO
The Music of John Williams, Hans Zimmer, and more
THE SYMPHONYSTRIKES BACK
SATURDAY, APRIL 9 AT 7:30 PM IN THE MARY W. SOMMERVOLD HALL OF THE WASHINGTON PAVILION
Call for Tickets (605) 367-6000 www.sdsymphony.org THIS CONCERT GENEROUSLY SPONSORED BY:
Photo courtesy Avera.
March 2016 25MidwestMedicalEdition.com
A NEW REAL-TIME, live-streaming video system called NICVIEW is up and running in Claire’s Place, the Neonatal Intensive Care Unit (NICU) at Rapid City Regional Hospital. NICVIEW allows families to see their babies in the NICU anytime, anywhere on any device with Internet access.
When newborn babies need specialized, critical care at Rapid City Regional Hospital, they can spend anywhere from days to months in the NICU. This can be a difficult time for families who want to see their child, but cannot spend 24 hours a day in the NICU. NICVIEW is the next best thing to being there, because it can reduce the unease of separation from the baby, supplement actual visits, and enhance family bonding.
The NICVIEW system consists of a simple unobtrusive camera mounted close to a baby’s bed that delivers streamed video
images around the clock, so families can watch their newborn anytime. Live streaming is only accessible to specified users, using passwords issued by the NICU staff.
The NICVIEW system, which cost just under $50,000, includes cameras, software and mounting hardware. This technology, enhancing family-centered care for patients, was paid for by funds from both Children’s Miracle Network Hospitals® at Regional Health and the Rapid City Regional Hospital Volunteer Auxiliary.
“We are happy to provide this new tech-nology, in partnership with the Auxiliary, which will benefit the hospital’s smallest patients and their families throughout the region. This is a great example of Regional Health’s efforts to fulfill its purpose of helping patients and communities live well,” said Angie Kliewer, Regional Health Foundation Director. ■
The new NICVIEW camera hangs over the bed of baby Tate Lammers as his mother holds her phone
to demonstrate how the new live-streaming video system works. Photo courtesy Regional.
Merger Will Expand Reach of Local Medical Supply Company
New Technology Enhances Family Bonding with Babies in Neonatal Intensive Care Unit
SIOUX FALLS-BASED medical supply distrib-
utor Kreisers, Inc. is one of a trio of companies
joining forces to form one large distribution
company known as Concordance Healthcare
Solutions.
When the merger is complete, the
combined organization will serve more than
1,300 hospitals, 1,000 extended care/home
care providers and 5,000 physician practices
and cover about 70 percent of the US popula-
tion. Kreiser’s CEO Dave Larson will serve
on the Senior Advisory Board of the new
organization.
Joining with Kreisers to form Concordance
Healthcare Solutions are MMS of Earth City,
Missouri and Seneca Medical of TIffin, Ohio.
According to a press release, the new company
will focus on distributing medical supplies
and equipment, providing healthcare supply
chain services, supporting healthcare providers
to improve patient experience, supporting
population health and reducing the per-
episode cost of care.
Concordance will have approximately 1,000
employees, 19 distribution centers and $1.1
billion in annual sales. “We have 19 warehouses,
which are close to our customers, with the
potential of expansion from there,” says Larson.
“I believe that Kreisers will be perceived as more
credible by our larger customers.”
The three companies bring different areas
of expertise to the new company. “Kreisers
has a strong presence in both acute care and
alternate site, and it has a very strong govern-
ment division, which we’re all excited about,”
says MMS Executive Vice President Tom Harris
who will serve as one of the co-presidents of
the new company.
The transition is expected to be completed
in the first quarter of 2016. ■
Midwest Medical Edition 26
MULTIPLE SCLEROSIS (MS) – once considered an “adults-only” disease – is increasingly being diagnosed in children and adolescents, a fact that puts pediatri-cians on the front lines when it comes to recognizing its symptoms.
“Up until recently, we had never thought of MS as a childhood disease,” says pediatric neurologist Geetanjali Rathore, MD, with Children’s Hospital & Medical Center in Omaha. According to Dr. Rathore, an esti-mated 10 percent of all MS cases now present before age 18.
The National Multiple Sclerosis Society says as many as 8 to 10 thousand American children age 18 and under have MS, and another 10 to 15 thousand have experienced at least one symptom suggestive of MS. The disease involves an immune-mediated process in which an abnormal response of the body’s immune system is directed against the central nervous system.
“If a person is diagnosed with MS at age 40, they will accumulate disabilities as the disease progresses,” Dr. Rathore says. “But a person who is diagnosed at age 15 will accumulate significantly more disabilities as
the disease progresses through the course of their life. This emphasizes the need for early diagnosis and treatment.”
Dr. Rathore says that diagnosing MS in children is more challenging than in adults because many other childhood disorders, such as acute demyelinating encepha lomyel i t i s , exhibit similar symptoms and characteristics.
“Most pediatricians do not expect to find MS in children so they may not be looking for it,” Dr. Rathore says. “But if a child pres-ents symptoms that indicate the possibility of MS, the pediatrician should refer to a spe-cialist who is experienced in diagnosing and treating MS.”
Dr. Rathore says a diagnosis requires evidence of damage in at least two separate areas of the central nervous system – which includes the brain, spinal cord and optic nerves – and evidence that the damage occurred at least one month apart while also eliminating all other possible diagnoses.
“It is a combination of clinical evaluation, a recent episode and MRI evidence of a prior event,” Dr. Rathore says. “With this information, we can diagnose MS at the patient’s first clinical presentation. With many neurological disorders, early treatment leads to better outcomes.”
Dr. Rathore and her colleagues at the Neurology Clinic at Children’s regularly diagnose and treat disorders of the nervous system and diseases of the brain, spinal cord, nerves and muscles. In addition to her work in pediatric MS, Dr. Rathore has a special interest in other pediatric autoimmune disorders. ■
April 27-29, 2016Holiday Inn City Centre, Sioux Falls, SD
South Dakota Medical Group Management Association
Spring Conference
For the full schedule or to register, visit our website at sdmgma.org Like us on Facebook at www.facebook.com/sdmgma Follow us on Twitter @SDMGMA
Jason Kotecki, CSP Artist, Author & Professional Speaker
Danielle Crough, Ph.D., SPHR, SHRM-SCP Senior Consultant – Human Capital, Silverstone Group
Jennifer Pollack, JD MGMA Government Affairs Representative
Holly Arends, CHSPProgram Manager, Great Plains Quality Innovation Network, SD Foundation for Medical Care
Featuring:
Multiple Sclerosis No Longer Just an Adult Disease
March 2016 27MidwestMedicalEdition.com
WHEN Norfolk, Nebraska -based Beckenhauer Con-struction was establishedin 1878, hospitals and
health clinics in the Great Plains were few and far between, even given the area’s small population.
By the early 1950’s, when Beckenhauer was called upon to help build some of the region’s first hospitals, the company’s leaders could see the writing on the wall; healthcare construction in the Plains states had nowhere to go but up.
Today, more than 130 years later, both the population and the healthcare infra-structure that serves it, have exploded. Beckenhauer CEO Buster Beckenhauer says healthcare projects now make up 75 percent of the company’s business. And that is just the way they like it.
“We have to keep up with what’s chang-ing in the industry because healthcare trends and the needs of our healthcare customers are constantly changing,” says Beckenhauer whose firm is part of a nationwide association of companies that specialize in healthcare construction.
In addition to attending conventions
and seminars on healthcare construction, Beckenhauer says the team often makes site visits to larger medical centers–like the prestigious Texas Children’s Hospital in Houston–in a continual effort to stay on the cutting edge of medical facility design and building.
“We have learned a lot, for instance,
from the Texas Children’s Hospital, includ-ing new ideas about how we do infection control and negative air monitoring which we can then share with clients who need help in this area,” says Beckenhauer. “Any-time we can learn how to do things better and faster, it not only helps us as a company, but it helps our healthcare clients.”
In most of their healthcare projects, the company prefers to take on the role of con-struction manager or design/build contractor, which Beckenhauer says allows them to lend their expertise to a building or renovation project from the very beginning.
“A lot of the success of a project comes down to the planning and sequencing of each subcontractor’s part,” says Beckenhauer. “This is especially true in healthcare where you often have to maintain and monitor the safety of the environment in the facility while the project is going on.”
Utilizing leading edge LEAN Design principles for streamlined construction scheduling, Beckenhauer says the company has been able to cut the timeline for most projects by 20% or more. saving customers not only time but money. The technique is proving its value in a recent $16 million dollar
Business Profile
Beckenhauer Construction
Inside the Jennie M. Melham Medical Center in Broken Bow, Nebraska
Kearney County Medical Center in Minden, Nebraska
By Alex Strauss
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Midwest Medical Edition 28
Paul Cink, MD, FACS Bethany Helvig, MD, FACS Peter Kasznica, MD Kenneth Scott, MD, FACS Thomas Tamura, MD Daniel Todd, MD, FACS
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library renovation project at Wayne State University, where it had to be “business as usual” for students during construction.
“In hospitals, our philosophy is to be invisible and to get done as quickly as possible while maintaining safety for everyone by monitoring and vali-dating what we are doing in terms of infection control and negative air monitoring,” says Beckenhauer.
Although Beckenhauer Construc-tion has many repeat customers across Nebraska, the company’s next goal is to expand its presence in the
South Dakota region with an office in Yankton. They are already making inroads in Burke, South Dakota–one of many rural towns with an aging hospital–where they are in talks to develop what Beckenhauer says may be a sort of “super clinic”. ■
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March 2016 29MidwestMedicalEdition.com
THERE IS A FLOW in which the initial medical credentialing is done and within this flow there are four steps. Step one is the
national level, step two is the state level, step three is the local level and step four is the regional level. Each step is built upon the previous step, creating a work flow in which this process is completed.
STEP ONE – THE NATIONAL LEVEL The follow items are building blocks to this
step and must be completed in this step.
♦ National Provider Identifier number
♦ medical credentialing portfolio
♦ DEA license,
♦ Malpractice Insurance
♦ Board certification or a letter
stating you’ve been granted to
sit for your specialty boards
♦ Self-query to the National
Practitioner Data Bank
STEP TWO – THE STATE LEVEL There are only two building blocks to this level
but in order for it to go smoothly the first step
should be built and the information placed in your
medical credentialing portfolio.
♦ State medical license
♦ State controlled substance license
(if required by the state and applicable
to your specialty)
STEP THREE – THE LOCAL LEVEL To start this step, it is required for you to have
completed both steps one and two.
♦ Hospital and clinical privileges.
Note: The clinic privileges is most likely where
you will be practicing, they need to have a
full copy of your medical credentialing
portfolio on file so they may be a certified
facility. The clinic where you choose to
practice will let you know where you need to
receive hospital privileges, this is where you’ll
need to apply for hospital privileges.
STEP FOUR – THE REGIONAL LEVEL. You’ll need to have your clinical privileges and
information to apply for third party payer
reimbursement. This level is an extensive level
in paperwork and the credentialing specialist
at your practicing facility may help you with this
endeavor.
As you build and complete each step of the credentialing process, the downward flow of third party reimbursement will follow. ■
Lavonne McKee is found and President of
Credentialing USA based in Alcester, South
Dakota.
By Lavonne McKee
The Building and Flow of Medical Credentialing
The most beautiful thing we can experience is the mysterious. It is the source of all true art and science. — Albert Einstein
“”
MED QUOTES
Midwest Medical Edition 30
By Scott Leuning
Physician Sunshine Act Opening the Windows on Physician Financial Involvement with Medical Product Manufacturers
PHYSICIANS HAVE long played an important role in the develop-ment and use of medical devices and new pharmaceuticals. For
many years, the financial role that physi-cians had with medical manufacturers was kept behind the scenes.
However, in 2010, as part of the Affordable Care Act (ACA), the Physician Payments Sunshine Act (“Sunshine Act”) was enacted into law. Under this provision of the ACA, medical product manufacturers became required to disclose to the Centers for Medicare and Medicaid Services (CMS) any payments or other transfers of value made to physicians or teaching hospitals. The Sunshine Act also requires certain manufacturers and group purchasing organizations (GPOs) to disclose any physician ownership or investment interests held in those companies. The data collected by CMS will be published annually in a publicly-searchable database.
It is not uncommon for there to be a financial relationship between medical product manufacturers and physicians, ranging from free meals to consulting or speaker fees to direct research funding. Those relationships can have positive outcomes, particularly in the area of medical research, where consulting and research funding is often the impetus for the development of new devices or drugs.
However, those financial relationships can also create conflicts of interest, or at least perceived conflicts of interest, on issues such as what is the incentive behind a physician’s decision to utilize a certain medication for his/her patients. The purpose of the Sunshine Act was to create transpar-ency with respect to the financial relationship between medical device and drug manufac-turers and the physicians who use and promote their products. It imposes penalties ranging from $1,000-$10,000 for each pay-ment that a manufacturer or GPO fails to
report, with a maximum annual penalty of $150,000.
One of the primary concerns regarding the Sunshine Act is that merely disclosing the amount of payments received by any particular physician does not distinguish between “appropriate” physician-industry interaction and payments from industry for “inappropriate” physician support of a product or device. ■
Scott Leuning is an attorney with Goosmann
Law Firm.
For a deeper look at the impact, and potential pitfalls of the
Sunshine Act, read the full version of Scott’s article on our website.
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March 2016 31MidwestMedicalEdition.com
THE LATEST research presents a new way of thinking about beef: Lean beef can be part of a solution for heart health and weight loss.
A new study was published in the American Journal of Clinical Nutrition by researchers from Penn State University, which concluded that animal protein foods – including lean beef – can be just as effectiveas plant proteins in achieving weight lossand improving risk factors for metabolicsyndrome as part of a heart-healthy dietarypattern1. You may have heard about theDASH (Dietary Approaches to Stop Hyper-tension) dietary pattern that is consideredthe “gold standard” heart-healthy diet thatfeatures fruits, vegetables, low-fat dairy and protein, predominantly from plant sources,and limits red meat and sweets. The DASHdietary pattern is a commonly prescribeddiet by physicians to help reduce cardiovas-cular disease risk factors in their patients.However, there is a growing body of evidence that shows lean beef can be part of a heart-healthy diet, too.
Research from Penn State University previously published in the American Journal of Clinical Nutrition and the Journal of Human Hypertension demonstrated that eating lean beef, as part of a heart-healthy dietary pattern rich in fruits, vegetables and low-fat dairy, can significantly help reduce blood pressure2 and reduce levels of total and LDL “bad” cholesterol 3. It should be noted that this evidence suggests that it is the total protein intake–not the type of protein–that is instrumental in reducing blood pressure as part of a DASH-like dietary pattern. ■
Holly Swee, RD, LN, is Director of Nutrition &
Consumer Information at the South Dakota Beef
Industry Council
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1 Hill AM, et al. Type and amount of dietary protein in the treatment of metabolic syndrome: a randomized controlled trial. Am J Clin Nutr 2015;102:757-70.
2 Roussell MA, et al. Effects of a DASH-like diet containing lean beef on vascular health. J Hum Hypertens 2014;28:600-5.
3 Roussell MA, et al. Beef in an Optimal Lean Diet study: effects on lipids, lipoproteins, and apolipoproteins. Am J Clin Nutr 2012;95:9-16.
Midwest Medical Edition 32
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March 2016 33MidwestMedicalEdition.com
By Alex Strauss
Midwest Medical Edition 34
LUKE MERKEL HAD only been out of pharmacy school for three years when he began to realize that life had more in
store for him.“I knew that if I was going to leave
my mark and pursue something I was passionate about, it was going to be in the healthcare administration arena rather than in the more traditional clinical side of things,” says Merkel.
But when he looked around his organi-zation, one thing was clear: Leaders had more letters by their names.
“I have never been one who believes that you should need an extra degree to prove you’re qualified for something,” says Merkel who was then the Pharmacy Operation Coordinator at Avera McKennan Hospital in Sioux Falls. “But it shined through pretty clearly at Avera that to go places and to be considered for promotion, you had to come to the table prepared with more than just ‘I’m a good learner’.”
When he decided to pursue his MBA (with encouragement from his superiors), Merkel says he considered online programs, but decided on the University of Sioux
Falls Healthcare MBA for a more personal experience that he could still do without leaving town. He started in September of 2013.
“The fact that I was regularly interacting with both the professors and the other members of my cohort, who had a wide variety of backgrounds, was one of the most valuable parts of the program,” says Merkel. “We were all learning from each other all the time. It really helped me grow my network and open up opportunities that I never would have had otherwise.”
Because his cohort was relatively small, Merkel was careful to come to every class well-prepared, ready to share his own experience and knowledge with his fellow students. Like other area healthcare professionals, he says the ‘give and take’ of the USF program gave him not only an understanding of crucial business funda-mentals, but also a better understanding of himself, his goals, and his potential.
“The program really helped me to be more open to new opportunities and experiences,” says Merkel. One of those opportunities came his way in the last couple of months, when he was hired as
Pharmacy Clinical Specialist for Avera Health Plans.
“At Avera Health Plans, I’ll be able to use what I learned in the MBA program, as well as my clinical pharmacy skills,” says Merkel. “From the business side of things, understanding how a health plan really works is going to serve me well.”
Finally, beyond the business knowledge he’s gained, Merkel says completing the Healthcare MBA program while maintain-ing his job and other responsibilities gave him a big boost in confidence.
“It really gives you a bigger voice. I am so much more well-versed and well-rounded now.” ■
“It Gives You a Bigger Voice”
Learning Opportunities Spring 2016
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 [email protected].
March 21 – 22 8:00 am - 6:00 pm
7:30 am - 12:00 pm
March 31 8:15 am - 4:00 pm
April 7 4:00 pm - 10:00 pm
April 8 8:00 am - 4:00 pm
April 13 7:30 am - 4:00 pm
April 21– 22 8:00 am - 3:30 pm
April 27 - 29 8:00 am - 5:00 pm
April 29 - 30 8:00 am - 6:00 pm
April 29 8:00 am - 4:30 pm
May 6 8:00 am - 4:30 pm
May 11 8:30 am - 4:00 pm
SAVE THE DATE
4th Annual Regional Health Sports Medicine Symposium
Location: The Lodge at Deadwood
Information: [email protected], 605-755-8015
Registration: Regionalhealth.com/sportsmed
Avera Transplant Institute Symposium
Location: Prairie Center, Avera McKennan
Information: [email protected], 605-322-7879
Registration: Avera.org/conferences
Mercy Women’s Night Out
Location: Sioux City Convention Center
Tickets: www.VisitSiouxCity.org
Information: www.mercysiouxcity.com/womens-night-out-486
15th Annual Avera Pediatric Symposium
Location: Prairie Center, Avera McKennan
Information: Avera Education Events, 605-322-7879
Registration: Avera.org/conferences
24th Annual Avera Trauma SymposiumLocation: Sioux Falls Convention Center
Information & Registration: Avera.org/conferences
SDHIMSS/SDHIMA Spring ForumLocation: University Center, Sioux Falls
Information: [email protected]
SDMGMA Spring ConferenceLocation: Holiday Inn City Centre, Sioux Falls
Information and Registration: sdmgma.org
10th Annual Sanford Sports Medicine SymposiumLocation: Ramkota Hotel & Conference Center, Sioux Falls
Information: 605-312-7808
Edith Sanford Breast Center Symposium Location: Sanford Center, Sioux Falls
Information: [email protected]
21st Annual North Central Heart Vascular SymposiumLocation: Sioux Falls Convention Center
Information & Registration: Avera.org/conferences
UnityPoint Health-St. Luke’s 42nd Annual Perinatal Conference Location: UnityPoint Health-St. Luke’s Auditorium, Sioux City
Information & Registration: unitypoint.org/siouxcity/services-professional-eduction.aspx
June 24 - 25 — 38th Annual Sanford Black Hills Pediatric Symposium
Brian Aamlid, MD Jason Anderson, DPM
Matthew Anderson, MD C. Dustin Bechtold, MD
Hillary Becker, MD Geoffrey Haft, MD
David Hoversten, MD Jason Hurd, MD
Kristofer Kimber, MD Chad Kurtenbach, MDGregory Neely, MD Adam Nichols, DPM
Bradley Reeves, MD Verle Valentine, MDRobert Van Demark, MD Timothy Walker, MD
Call (605) 328-2663 to refer a patient.
A BETTER GAME PLAN
When your patient sustains an injury or suffers from chronic joint pain, put Sanford into your game plan of care. From non-surgical techniques to total joint replacement, this entire team of experts is here to help our medical colleagues like you with:
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Sports medicine · Total joint · Foot & ankle · Hand · Pediatrics