MED-Midwest Medical Edition-September/October 2012

Bright Future

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

September

October

2012Vol. 3 Issue 6

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 to ensure access to

health care and education for South Dakotans!

Vote YES on IM#15

Paid for by the South Dakota Association of Healthcare Organizations

ContentsSEPTEMBER / OCTOBER 2012

Midwest Medical Edition

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 | Medicine & 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 | MED’s Annual Call for NominationsMED 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 | Iowa Health Systems Launch Regional Alliance:

Four Iowa healthcare organizations are banking on the promise of strength – and cost savings – in numbers.

12 | New Peds Cardiac Surgery Program to Honor VanderWoudeA month after the death of respected vascular surgeon John VanderWoude, MD,

Sanford announces the region’s first pediatric cardiovascular program.

20 | Medicaid ‘Health Home’ Pilot Design Progresses | By Dave Hewett

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

23 | Sioux Falls Leads the Nation in Cancer Trial Enrollment

28 | To 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.

31 | Rural 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

Cover Feature

page 14Note: AMED“SponsoredFeature”isacommissionedandsponsoredpromotionalarticle.

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 com-munity hospitals. In this month’s Cover Feature, we’ll explore what the new medical center will mean for the com-munity and for the 200,000 people in its trade territory.

SponsoredFeature

a Bright Future

Midwest Medical Edition 2

CONTACT INFOrMATION

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Alex Strauss, Editor in Chief 605-759-3295 [email protected]

Fax 605-271-5486

MAILINg ADDRESS PO Box 90646 Sioux Falls, SD 57109

WEBSITE MidwestMedicalEdition.com

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VP SALES & MArkETING Steffanie Liston-Holtrop EDITOr IN CHIEF Alex Strauss DESIGN/ArT DIrECTION Corbo Design COVEr DESIGN Darrel Fickbohm PHOTOGrAPHEr Kristi Shanks WEB DESIGN 5j Design CONTrIBUTING EDITOr Darrel Fickbohm COPy EDITOr Hannah Weise

CONTrIBUTING WrITErS Heather Boysen Dave Hewett Alice Rokahr

STAFF WrITErS Liz Boyd Caroline Chenault John Knies

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Alex Strauss

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From Us to youStaying in Touch with MED

aLTHOugH 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 sports-

related 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 meet-

ing 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@MidwestMedi-

calEdition.com or [email protected].

—AlexandSteff

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 out-standing 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 announce-ment in a future issue. Watch for an announcement of our first Meddy Award recipients in the November issue of MED.

announcing the Meddy awards

PUBLISHEr MED Magazine, LLC Sioux Falls, South Dakota

VP SALES & MArkETING Steffanie Liston-Holtrop EDITOr IN CHIEF Alex Strauss DESIGN/ArT DIrECTION Corbo Design COVEr DESIGN Darrel Fickbohm PHOTOGrAPHEr Kristi Shanks WEB DESIGN 5j Design CONTrIBUTING EDITOr Darrel Fickbohm COPy EDITOr Hannah Weise

CONTrIBUTING WrITErS Heather Boysen Dave Hewett Alice Rokahr

STAFF WrITErS Liz Boyd Caroline Chenault John Knies

At Midwest Family Care, we’re focused on providing innovative and personalized care for every member of your family. And, when it comes to care, we want to make it convenient for you. That means you can call us and get same-day appointments — and we even have extended hours upon request. Because our patients are our priority, we provide quality time and immediate access to our providers.

Call (605) 444-8650 to make an appointment.

family care.

sfsh.com/primarycare716 E 19TH STREET | S IOUX FALLS , SD 57105

Monday-Friday, 8 a.m. to 5 p.m.

Proud to be Physician Owned and Operated

SURGERY(605) 334-6730

910 E 20th Street, Sioux Falls, SD 57105

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OPEN UPRIGHT MRI 3T IMAGING•X-RAY

(605) 444-8600 toll-free (877) 885-OPEN (6736)

716 E 19th Street, Sioux Falls, SD 57105 www.OpenUprightMRI.com

SPECIALTY CENTERS


AverA

Tricia Merrigan, MD, has joined Avera Medical group Comprehensive Breast Care in

Sioux Falls. Dr.MerriganrecentlycompletedfellowshipinbreastsurgicaloncologyatAkronGeneralMedicalCenterinAkron,Ohio.SheisanMDgraduateofUSDSManddidherresidencyatIowaMethodistMedicalCenterinDesMoines.ShejoinsbreastsurgeonsDr.JulieReilandandDr.WadeDoschinthepractice,whichissoleydedicatedtobreastsurgery.

Sioux Center Community Hospital & Health Center Avera broke ground on its new

hospital and clinic in July.Theceremonytookplaceonthe40-acredevelopmentsitelocatedonB-40and13thAvenueinSiouxCenter.Thenew123,500sq.ft.facilitywillreplacethecurrenthospitalbuiltin1951locatedonHighway75.Thenewfloorplanallowsforadditionalspaceintheoutpatientservicesareawhichaccommodatesthegrowingtrendofsame-daysurgeriesandspecialtycare.Itisexpectedtobecompletedinthefallof2013.

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.ReiderhasworkedatAveraQueenofPeaceHospitalfor14years.ThenewcertificationmeansthatReiderisnowBoardCertifiedinHealthCareManagement.

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

Hospital.KammerreceivedhisBachelor'sDegreeinCriminalJustice/ReligiousStudiesandhisMastersDegreeinPastoralMinistriesfromMountMartyCollegeinYankton.Hehasextensiveexperienceinpastoralcare,havingservedasahospitalchaplaininNebraskaandapastoralcaredirectorinWashington.KammerisBoardCertifiedbytheNationalAssociationofCatholicChaplains.

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,aCreightonnative,hasbeenpresidentofMidwestBankinCreightonforsevenyearsandhasservedontheAveraCreightonHospitalAdvisoryBoardandCreightonAreaHealthServicesBoardofDirectors.Dr.PetersonhaspracticedradiationoncologyatAveraSacredHeartCancerCenterfor12years.

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. Thisyear’sBestHospitals,the23rdannualedition,showcasesmorethan720ofthenation’sroughly5,000hospitals.AveraMcKennanwasalsonationallyrankedNo.38ingynecology.

Avera Heart Hospital in Sioux Falls has been granted a three-year term of accreditation in Carotid Stenting by the Intersocietal Accreditation

Commission (IAC). AveraHeartHospitalisthefifthfacilityinthenationtoreceivethisdesignation.TheIACgrantsaccreditationtofacilitiesthathaveprocessesinplacetoensurequalitypatientcareincompliancewithnationalstandards.

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

& Associates.TheFive-StarrecognitiongoestohospitalsthatachieveaCommunityValueIndexscoreinthetop20percentofallhospitalsintheirgroup.AveraMcKennanwasoneofonlythreehospitalsrecognizedinSouthDakota,andtheonlyoneintheSiouxFallsregion.ThisisthefourthtimeAveraMcKennanhasreceivedthisawardsince2008.

Happenings around the region

News&NotesSouth Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska

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.

The new Digital Art Show is now open in the lobby

of the Avera Prairie Center in Sioux Falls.Thecurrentdisplay,whichrunsthroughOctober6,featurestheworkofNativeAmericanartists.ThedigitalexhibitionisheldinconjunctionwiththeannualNorthernPlainsIndianArtMarket.AlsoondisplayintheDigitalGallerythroughOctoberarethewinningentriesinAvera’ssystem-wideartcontestforstaffandtheirfamilies.

September / October 2012 5MidwestMedicalEdition.com

Western south DAkotA

SEVERAL NEW PHYSICIANS HAVE JOINED REgIONAL MEDICAL CLINIC:

Pulmonologist Anne Bagley, DO,

andcompletedherresidencyinInternalMedicineatMaineMedical

CenterinPortland,Maine,andherfellowshipinPulmonologyatLaheyClinicinBurlington,Massachusetts.

Neurosurgeon Mark Monasky,

MD, completedhisresidencyinNeurosurgeryattheUniversityof

Maryland&StockTraumaUnitinBaltimoreandfinishedafellowshipinPediatricNeurosurgeryattheChildren’sMedicalCenter&HumanaHospitalinDallas.

A native of Rapid City, general Surgeon William Stone, MD, received his MD from Sanford

uSD School of MedicineandcompletedhisresidencyinGeneralSurgeryatSynergyMedicalEducationAllianceinSaginaw,Michigan.Drs.Bagley,MonaskyandStonewillpracticeintheWesternHillsProfessionalBuildinginRapidCity.

Nephrologist, Mazen Nemeh,

MD completedhisresidencyininternalmedicineattheUniversityofSouth

Dakota(USD)SchoolofMedicineinSiouxFalls.HecompletedhisfellowshipinNephrologyattheUniversityofCaliforniainLosAngelesandtheUniversityofUtahinSaltLakeCity.HeisaformerChiefofNephrologyattheUSDSchoolofMedicineandhasbeenaprivatepracticephysicianinSiouxFallsforthepast10years

Infectious Disease Specialist Mahendra Poudel,

MD,completedhisresidencyinInternalMedicalatDanbury

Hospital,anaffiliateoftheYaleUniversitySchoolofMedicine.HealsorecentlyfinishedafellowshipinInfectiousDiseasefromOchsnerClinicFoundationinNewOrleans.Dr.PoudelwillholdanInfectiousDiseases/HIVclinicattheFamilyMedicineResidencyClinicinRapidCity.HeandDr.NemehwillpracticeintheAspenCentreat640FlormannStreetinRapidCity.

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. WesternHillsrecentlyunderwentamajorexpansionandrenovation,whichoffersadditionalspaceandresourcesforUrology,ENT,andAudiologypatients.

The Black Hills community has raised $95,000 for the Children’s Miracle Network

(CMN). Eighteenthousandducksweresponsoredinthisyear’s23rdannualGreatBlackHillsDuckRaceonSunday,July29.FundswillbeusedtoprovideservicesandequipmentforillandinjuredchildrenintheBlackHillsareaservedbyRapidCityRegionalHospital.

Black Hills urgent Care (BHuC), a division of the physician-owned 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.

BHUCofferscareforcommonillnessesandinjuries,women’shealth/papsmear,labservices,vaccinations/immunizations,travelmedicine,basicandsportsphysicals,DOTdrugscreensandphysicals,andoccupationalmedicine

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. Medicalstudentsinthethird-andfourth-yearclassesnominatethefacultymembersfortheawards,whichhavebeengivensince1990.ThefacultymembersarefromhealthcarefacilitiesinYankton,SiouxFalls,FortMeade,andRapidCity.

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

Specialist (CCDS). BovardisonlythesecondpersoninSouthDakotatoearnthiscertification.


News&NotescontinuedSouth Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska

sAnforD

Sanford has hired pediatric cardiac surgeon Brett Mettler, MD, to develop a child heart surgery program at Sanford

Children’s Hospital. ANebraskanative,Dr.MettlergraduatedfromUSDSMandisapediatricsurgicaldirectoratVanderbiltUniversityMedicalCenterwherehewillcontinuetoalsopractice.SanfordhasreportedlybeennegotiatingwithDr.Mettlersince2011.UntilitisdecidedwhetherhewillmovetoSiouxFallsfulltime,SanfordHealthstafferswilltrainatVanderbilt.

Sanford Health broke ground this

summer on the largest private construction project in the

history of the Dakotas, thenewSanfordFargoMedicalCenter.Settoopenin2016,themedicalcenterisa$541millionproject,oneofthelargestinthenationtobreakgroundthisyear. Aftercontinuedevaluationoflocalmarketneeds,theproject’ssizehasgrownsinceitsinitialannouncementin2010.In2011alone,SanfordFargosawaninepercentincreaseinhospitaladmissionsandaneightpercentriseinemergencyvisits.

Bismark-based Medcenter

One and Sanford Healthhavecompletedtheirmerger.Aspartoftheagreement,SanfordHealthwillinvest$200millionoverthenext10yearsinBismarck-MandanandwesternNorthDakota,includinganewsuperclinicinDickinson.TheclinicwillfeatureallthecurrentservicesprovidedinDickinsonalongwithspaceforadditionalphysicians,awalk-inclinic,anambulatorysurgerycenteranddiagnosticservices.MedcenterOnewilloperateundertheSanfordHealthname.

South Dakota’s first cardiovascular fellowship program welcomed its first fellows at the Sanford Heart

Hospital this summer.ThenewUSDSMprogramisoneof187cardiovascularfellowshipsapprovedfordevelopmentintheU.S.Thethree-yearprogramwilltraintwofellowsperyearandincluderotationsinareassuchascardiaccatheterization,coronarycriticalcare,electrophysiology,non-invasivecardiacevaluations,cardiacresearchandothers.RotationswilloccurprimarilyatSanfordHeartHospital,withsomerotationsattheSiouxFallsVAHospital.

Sanford Cancer in Sioux Falls will continue to participate in the National Cancer Institute’s NCI Community Cancer Centers

Program (NCCCC).SanfordhasbeenamemberoftheNCCCPsinceitsinceptionin2007andhasbeenawarded$939,590tofundparticipationinthenetworkforthenexttwoyears.Sanfordwasoneof21awardedfundsforaprogramextension.

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.InadditiontohisrolewithSanford’sInternationalAdvisoryBoard,HallrecentlybecameaspokespersonfortheEdithSanfordBreastCancerFoundation’s“SuitUptoStopBreastCancer”grassrootswater-basedchallenge.“SuitUptoStopBreastCancer”encouragesconsumerstocreateaswimming,water-walkingorwateraerobicschallengeandobtainsponsorsforthechallenge.

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.SanfordenhanceditsEMRsysteminthelastyearbyimplementingcomputerizedproviderordermanagement(CPOM).SanfordHealthasasystemhasimplementedCPOMin20+hospitalsthroughoutSouthDakota,NorthDakota,MinnesotaandIowa.RespondentstotheMostWiredsurveycompleted662surveys,representing1,570hospitals,orroughly27percentofallU.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. AnativeofSpencer,Iowa,StadsvoldreceivedaBSinExerciseSciencefromtheUniversityofIowaandaDOfromDesMoinesUniversity—OsteopathicMedicalCenter.HecompletedhisresidencyinPhysicalMedicineandRehabilitationattheUniversityofWisconsin,Madisonwherehealsoservedaschiefresident.StadsvoldinlicensedinIowaandSouthDakota.

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.

MercyMedicalCenterhasbeenrecognizedasaBestPracticefacilityforitssuperioraccomplishmentsinreducingenvironmentalimpactandimprovingoverallhealthcaresustainabilitythroughmedicaldevicerecycling.

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

Medical Center.Dr.PiersonsucceedsDr.LarrySellersintheroleafterDr.SellersreturnedtoprivatepracticewithMercyInternalMedicine.Dr.PiersonhasbeenapartoftheSiouxlandmedicalcommunitysince1992whenhejoinedCardiovascularAssociates,P.C.(CVA).

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

Dr.SublaearnedhisMDfromthe

GovernmentMedicalCollegeinIndiaandcompletedfellowshipsinInterventionalCardiologyatDukeUniversityMedicalCenterandinCardiovascularDiseasesatMayoClinic,wherehemostrecentlyworked.Dr.SublaisaDiplomatoftheAmericanBoardofCriticalCareMedicineandtheAmericanBoardofInternalMedicine.

September / October 2012 7MidwestMedicalEdition.com 7

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

(ClinicalLabProducts)Magazine.Medicallaboratoriesarenominatedbytheirpeers,andselectedbyapanelofindustryexperts.Selectionforthishonorisbasedonhowwellthelabredefinestheindustry’sbestpracticestoprovidethebestqualityservicetocliniciansandpatients.

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.AyiwillcontinuetohaveanofficeatMercyMedicalCenterandwillserveastheMedicalDirectorofHospitalEpidemiologyandtheChairpersonoftheInfectionControlcommittee.Dr.Ayiiswell-knownintheSiouxlandarea.ShehasorganizedanannualInfectiousDiseaseSymposiumthathasgrowninpopularityamongSiouxlandareahealthcareproviders.In2008,Dr.Ayiauthoredthebook,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.InitsninthannualCommunityValueIndex®(CVI)study,Cleverley+AssociatesnamedSt.Luke’soneofthetophospitalsnationwide.St.Luke’sistheonlySiouxlandareahospitalincludedonthelistof“CommunityValueFive-Star”facilities.

other

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

in Ophthalmology. Dr.DickesjoinedtheWillcocksonEyeAssociatesinAugust2011andseespatientsinbothYankton,SDandNorfolk,NE.Dr.Dickes’practiceinvolvesgeneralophthalmology,cataractandimplantsurgery,lasersurgery,glaucomaanddiabeteseyemanagement,andeyelidsurgery.

Prairie Lakes Healthcare System in Watertown, SD has promoted Mary Petersen, RN, to the position

of Vice President.Petersenwilloverseesurgicalservicesandthecathlabandwillprovideleadershipforthedevelopmentofhospital-basedservices.PetersenhasworkedatPrairieLakesfor7yearsandholdsanassociateofappliednursingdegreefromtheUniversityofSouthDakotaandBAininterdisciplinarystudies(businessandnursing)fromMountMartyCollege.

Medical Oncologist/Hematologist Homam Alkaied, MD, has joined Prairie Lakes

Healthcare System. Dr.AlkaiedisboardcertifiedinInternalandGeriatricMedicineandboardeligibleinMedicalOncologyandHematology.HecompletedhisresidencyandfellowshipsinHematology/OncologyandGeriatricMedicineatStatenIslandUniversityHospitalinNewYork.

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.TheeventwillbehostedbyBrookingsHealthSystem.KeynotepresentersincludeLindaJ.Smith,aninternationallyknownlactationconsultantandauthor,andDr.RaylenePhillips,aneonatologistattheDepartmentofPediatricsatLomaLindaUniversityChildren’sHospital,LomaLinda,California.

YANKTON MEDICAL CLINIC, PC, HAS ADDED A NuMBER OF NEW PROVIDERS:

Rheumatologist Leann Maska, MD is

a uSDSMgraduatewhocompletedherInternalmedicineresidencyatSanford

andherRheumatologyFellowshipattheUniversityofNebraskaMedicalCenter.SheisboardcertifiedinInternalmedicineandboardeligibleinRheumatology.

general Surgeon Ryan J. garry, MD, is a graduate

of uSDSMwhocompletedhisgeneralsurgery

residencyatExemplaSt.JosephinDenverandIowaMethodistMedicalCenterinDesMoines.

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

isagraduateoftheUniversityof

IowaCarverCollegeofmedicineinIowaCity.HecompletedhisInternalMedicineresidencyattheUniversityofIowaandhiscardiovascularmedicinefellowshipattheUniversityofMichigan.Dr.IrwinisalsocertifiedinAdvancedCardiaclifeSupportandAdvancedTraumaLifeSupport.

Jennifer Mcginnis,

CNP, MSN, isagraduateoftheFamilyNursePractionerGraduateProgramatBriarCliffUniversity

inSiouxCity.SheearnedherBachelorofScienceinNursingfromMountMartyCollege.McGinniswillcollaboratewithYMCphysicianDr.ScottWeberandwillassisttheclinic’sfamilymedicinephysiciansinprovidingcomprehensiveprimarycare.


A talk with MED Advisor

Patty Peters, MD

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.

FAMILY PRACTICE PHYSICIAN

Iowa health systems launch RegIonal allIanceFOuR OF IOWA’S PREMIER HEALTHCARE ORgANIzATIONSunited thissummertocreateasinglehealthcareallianceinIowaandcontiguousareas.Theannouncementwasmadeinamulti-citypressconferenceinJune.

ThenewUniversityofIowaHealthAlliance(UIHA)includesMercyHealthNetwork,GenesisHealthSystem,Mercy-CedarRapids,andIowaCity-basedUniversityofIowaHealthCareandiscomprisedofover50hospitalsandmorethan160clinics.

UIHAwillcreateaplatformforsharingexpertise,selectedsupportservicesandinformationtechnologiesneededtosucceedintheemerging“accountablecare”systemsandpaymentprograms.Membersdescribethearrangementasthe“bestofbothworlds,”allowingeachorganizationtomaintainitslegacyandindependence,whilepromotingclinicalintegrationandcarecoordination.Itdoesnotinvolveamergerofassetsorchangesinownershiporcontrol.Thestructureisdesignedtosustainandhonorthemembers’localmissionsandgovernanceauthorities,whileparticipatinginalargerefforttoleadneededchangesinthehealthcaresystem.ThealliancealsoisdesignedtoencourageadditionalhealthcareprovidersinIowaandcontiguousstatestojoinandparticipateintheseimportantinitiatives.

ExAMPLES OF SPECIFIC uIHA EFFORTS WILL INCLuDE:v StrengtheningprimarycaretoensureIowanshaveaccess

toa“medicalhome”v Assistingmembersindevelopingperformancemetricsandcomparative

reportingtosupportimprovementefforts,i.e.usingcomparativedatatoidentifyandsharebestpracticesandreducethevariationsincare,whichwillimprovequalityandlowercosts

v Developingprogramstodetermineandaddressthehealthstatusofcommunitiesserved

v Developingeducationalprogramsforhealthcareproviders,patientsandconsumers

v Developingtechniquesandsystemsforimprovingpatients’engagementinmanagingtheirhealth.

v Sharingthehighcostsoftheinformationsystemsandexpertsneededtoanalyzeclinicaldataandconvertitintoinformationthatcanbeusedbyphysiciansandotherstoimprovecareandbettermanagepopulationsofpatientswithchronicdiseases

v Sharingexpertiseandoperationalcostsassociatedwithdevelopmentof“accountablecare”initiatives,enablingthememberstoevaluateandparticipateinnewpaymentprogramsofferedbygovernmentalandcommercialinsuranceprograms

COLLABORATINg IN RESEARCH INITIATIVES“Webelievebyworkingtogetherwecanachievethenecessaryexpertiseandsize–the

skillandscale–tobesuccessfulintothefutureandtobringrealvaluetoourpatientsandcommunities,”saidDaveVellinga,presidentandCEOofMercyHealthNetwork(MHN).

MHNwasestablishedinthemid-1990sasasimilarmodelofbothownedandcon-tractedhealthcareorganizationsworkingcollaborativelyinIowa.ExecutivesfromallfouroftheorganizationsformingUIHAnotedtheyhavelongstandingrelationshipsandahistoryofworkingtogetheronselectedprojects.

“TheformationofUIHAisasignificantstepforwardbecauseitformalizesourrela-tionshipsandcreatesaninfrastructuretoachieverealimprovementandcostsavings,”saysDougCropper,presidentandCEOofGHS.“However,inmanywaysit’sjustthenextlogicalstepinthecollegialrelationshipsbetweenourorganizationsthatweallvalue.”■

ChildrensOmaha.org

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.


AVERA HEALTH HAS INTRODuCED ITS FIRST MOBILE health care app for smart phones and mobile devices. AveraHealthToGoisfreeandgivespatientstoolstomanageandtracktheir personal health information, allowing them to be “moreactivepartnersintheirhealthcare”,accordingtoAvera.

“Healthcareofthefuturewillbemorepreventativeinnature,andwillharnessthelatesttechnology.We’reproudtobetakingthisinnovativestep,”saysMichelleLavallee,SeniorVicePresidentofInnovationandChiefMarketingOfficeratAveraMcKennanHospital&UniversityHealthCenter.

It’sestimatedthat1.4billionsmartphoneswillbeinuseby

2015and500millionwillhaveahealth-relatedapplicationloadedonthem.Some5billionappsweredownloadedin2012,andthat’sexpectedtoincreaseto21billionby2013.LavalleesaysAverawantedtoofferahealthappfromalocallyknownandtrustedsource.

Avera Health To Go offers health trackers for healthinformationsuchasbloodpressure,bloodsugar,cholesterol,mood,weight,pregnancy,migraines,andmedications.Theinformationstaysconfidentialandgoesno further than thephone itself, unless the phone user chooses to share itelectronically.

Avera releases Sioux Falls’ First Health Care App for Mobile Devices

CONSuMERS CAN ALSO uSE THE APP TO:v Gainimmediatefirstaidinformation

v FindthenearestAveraphysicianinSouthDakota,Iowa,Minnesota,NebraskaandNorthDakota—includingmorethan560AveraMedicalGroupphysiciansandspecialistswithtoolsthatincludeaphysicianfinder,GPS“wayfinding”toclinics,andaclick-to-callcontactdirectory

v GetthelatestAveranewsandhealthtips,includingtheAveraStoryCenterblog

v ReadcurrenthealthinformationfromtheMayoClinic

v Storeinsuranceinformationandascannedimageofinsurancecard(s)

v CheckEDandurgentcarewaittimes

OwnersofmobiledevicescangototheAppleorAndroidappsstoreontheirdevicetofindAveraHealthToGointhealpha-beticallisting.AverapartneredwithAxialExchangetocreatetheapp,whichwasdevelopedwithlocalinformationandexper-tise.Forexample,theapp’smyMoodtrackerwascreatedwithinsightfromAverapsychiatristDr.MatthewStanley.■

MEDQuotes

“ Wherever the art of Medicine

is loved, there is also the love

of Humanity.” —Hippocrates


THE LEgACY OF SIOux FALLS CARDIO-vascularsurgeonJohnVanderWoude,whodiedinJulyattheageof58,willcontinueinthe form of a newly announced SanfordPediatricCardiovascularSurgeryProgram.ThehealthsystemannouncedinAugustattheannualSanfordChildren’sGalathatishashiredapediatriccardiacsurgeonfromVanderbilt tohelpbuild theprogram.Dr.BrettMettler is a Nebraska native and agraduate of USDSM who is expected toperform his first surgery in Sioux Fallsnextspring.Untilhisdeathofnon-Hodg-kin’s Lymphoma, Dr. VanderWoude hadperformedbothpediatricandadultcardio-vascular surgeries at Sanford and hadbeguntolaythegroundworkforthepedi-atriccardiovascularsurgicalprogram.

“ItisatestamenttoJohnandhisfamily’sstrength,” says Sanford internist andcolleagueDr.MikeWildeofVanderWoude’swillingnesstostepintothisnewarea.“Hedidpediatriccardiacsurgeryandtookthatonwiththesamepassionasanythingelse.Hewasthenchallengedwithseeingaverybroadrangeofpatientagesandpersonalities.Hewas helping to improve the programrecentlyandtheworkhestartedwillbenefit

childrenandfamiliesofthisareaforyearstocome.”

Dr. VanderWoude was a Sioux FallsnativeandastandoutstudentatWashingtonHighSchool,Augustana,USDSchoolofMedicine,andWashingtonUniversityinSt.Louiswherehedidhisresidency.Ahighly-respected fellowship-trained surgeon,VanderWoudewasanearlypioneerincardiacsurgeryinSiouxFallsasapartofNorthCentralHeartInstituteintheearly1990’s.HeleftthestatetodoadditionaltraininginpediatriccardiacsurgeryandlaterjoinedwhatisnowSanfordUSDMedicalCenterasDirectorofCardiothoracicSurgery.Overtheyears,Dr.VanderWoudeservedonSan-ford’s Board of Trustees and Board ofGovernorsandwashighlyinstrumentalincreatingthenewSanfordHeartHospital.

“Dr.JohnVanderWoudehada‘can-do’attitude,whichincardiacsurgerycanmeanaheroicapproachtocare,”saysDr.CharlesO’Brien,PresidentofSanfordUSDMedicalCenter.“Johnsavedmanyalifebysaying,‘Yes,Icanhelpyou’whenothersmayhavebackedoff.Youhavetohaveskillsandtrustinthemtomakethatwork.John’sintensitycontributedtoa largenumberofpatients

andfamilieswhofeelhewascaringforonlythem.Thisisbecausehewas.Thisattention,combinedwithhisgreatskill,betteredmanylives.”

“Johnwasalwaysaprofessionalphysi-cian thatwould reallydoanythingforapatient,”addsWilde.“Youhearthatclichéoverandagain,buthelivedit.Hewasaguywholivedandactedwhathesaid.Hedidn’tspeakoften,howeverwhenhedid itwasincrediblymeaningful.WhenJohnspoke,itwouldoftentimesalterthecourseoftheworkthatyouweredoing.

“Thepatientswesharedhadalotoffaithinhimandyouknewwhenhewasseeingpatientshewasdoingthingsproperlyandwaspassionateaboutwhathewasdoing.Hewasubiquitouslyrespectedbyallofusphysicians.Hewasagenuinelyniceguywhoyoucouldlaughwith.Hewashumbleanddowntoearth.”

According to Sanford, their doctorslast year referred 129 pediatric heartsurgerycandidatestoout-of-statehospitals.Dr.VanderWoude’s familyhas set up anendowmentwiththeSanfordHealthFounda-tiontohelpraisefundsforthenewpediatriccardiovascularsurgeryprogram.■

new Peds caRdIac suRgeRy PRogRam

will honor VandeRwoude

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

Obviously, it is easier for physicians 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 ”


QUALITY

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Providing Custom SolutionsConsulting, Outsourced Services or Management

Your practice, just like the human body when all systems are functioning smoothly, has the potential to operate like a well-oiled machine. The end result is quality service in every area – we know this is the excellence you strive for.Your partnership with Surgical Management Professionals (SMP) allows you to leverage the expertise of our executives through a full scope of physician billing and practice management services. It is SMP’s goal to help you achieve the level of excellence you desire.

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Enhanced Through PartnershipACCORDINg TO THE IOWA HOSPITAL

Association, Mercy Medical Center inSioux City provided $19.2 million incommunitybenefitandSt.Luke’sHealthSystemanother$13.9millionduring2011.

AcrossIowa,theIHAreportshowsthatthestate’shospitalsprovidedacombinedtotal of $1.4 billion in benefits to theircommunities in theformofservicesandprogramslikehealthscreenings,supportgroups,immunizations,nutritionalservicesandtransportationprograms.

ThesamereportshowsthatSt.Luke’sreportednearly$3.5millionincharitycareaswellasapproximately$900,000insub-sidizedhealthorcommunityservicesthat,while necessary to Siouxland, result inthousandsofdollars in losseseachyear.Mercyreported$5millionincharitycareand$6.4million insubsidizedhealthorcommunityservices.Together,SiouxCity’stwohospitalsreportedover$7.7millioninMedicaid losses or unreimbursed costsassociatedwithtreatingMedicaidpatients.

Communitybenefits are thebasis ofcommunityhospitals’non-profittaxexemp-tion statusandarenot formarketingorpromotionalpurposes.■

Sioux City hospitals provide millions in community benefit

a Bright Future

September / October 2012 15

By Alex Strauss

It Is somethIng oF a status symBolFoR a cIty the sIze oF aBeRdeen.WhileSouthDakota’s third largest citymayneverhost theOlympicsorbethesiteofaHollywoodblockbuster,withthe

openingoftheSanfordAberdeenMedicalCenterthissummer,itcannowboastnotonebuttworegionalhospitals.

“Istepinsideandwonder‘AmIstillinAberdeen?’,”saysBeckyGuffin,a20-yearAberdeenresidentandAssistantSuperintendentfortheAberdeenSchoolDistrict.“Itisanamazingstructure.Youcantellthateverylastdetailissointentional,fromthelocalartworktothelargewindowstothehigh-endtechnology.Itfeelsverycomfortingandwelcoming.”

WhileGuffinalsositsontheAdvisoryBoardforthenewhospitalandforSanfordHealth,otherAberdeenresidentsapparentlyagreewithher.Morethanacenturyafterthecity’sfirsthospital(whatwastobecomeAveraSt.Luke’s)begantotakerootinthemidstofadiph-theriaepidemic,itssecondhospital–a48-bed,threestorystructureattachedtotheexistingSanfordClinic–openeditsdoorsforapublicopenhouse.

“Ithinkmostpeopleareexcited,”saysSteveRedmond,MD,afamilyphysicianwhohaspracticedinAberdeenfor20years.In1994,Dr.RedmondjoinedUnitedClinic,Aberdeen’sfirstmulti-specialtygroup,whicheventuallybecameSanfordHealthAberdeenClinic.

“Attheopenhouse,theywereamazedbythelookofthehospital,”hesays.“Ithinktheyweresurprisedattheamountoflocalartused,whichreallyconnectsittocommunity.It’salsoaverypatient-friendlydesign,withgoodseparationbetweenthepublicandprivateareas.And,ofcourse,theyareexcitedaboutwhatitwillmeanforhealthcareinourcommunity.”

Whatitwillmean,accordingtoDr.Redmond,ischoice.Andchoice,hesays,benefitseveryone.

“Havingahealthcarefacilitylikethisinourcommunitymakeseveryonealittlebitbetter.Ithinkitmakeseveryonestepuptheirgame.Thepeopleinthecommunitybenefitfromthat,regardlessofwhichhospitaltheygoto.”

aberdeen Welcomes its Second Hospital

Sanford’s eight LDrP rooms feature

warm colors, natural light and plenty

of room for family and friends.


gRowth sPuRtAlthoughitdidnotseeitsfirstpatientsuntilthissummer,Sanford’sfirst‘fromthegroundup’communityhospitalhasbeenintheworksforyears,evenbeforethehealthsystem’sexpansionintoNorthDakota.AccordingtoAberdeenoffi-cials,thecityhasbeenvirtuallyuntouchedbythe recession, experiencingahousingboomwhiletherestofthecountrystruggleswithahousingcrisis.Asnewemployershavemovedinandexistingoneshaveexpanded,Aberdeen,whosepopulationhadbeensteadyfornearly60years,hasfinallyhadagrowthspurt.

“TherehasbeenalotofjobcreationinAber-deeninthelastfiveyears,”saysJulieJohnson,ExecutiveDirectorofAbsolutelyAberdeen.“Wenowhavefourethanolplantswithina40-mileradius.Thewindturbineblademanufacturer,MFG,openedabout5yearsagoandtheyemploy400people.Andweareanticipatingtheopeningofanewstate-of-the-artbeefprocessingplant.”

Whenthatplantisfullyoperational, it isexpected toemploy650people.Meanwhile,established companies likeWheat GrowerscooperativeandMidstatesPrint&Mediaareexpanding.Threehundredindividualapartmentsandtownhomeswerebuiltinthepastyeartoaccommodatetheinfluxofpeopleandmoreareneeded.(“Rightnowwecan’tseemtogetitdonefastenough,”saysJohnson.)Atthesametime,outlying towns likeWebsterandBrittonarealsogrowing.

“Wehaveatradeterritoryofabout200,000peoplewhointeractwithus.Sothecommunitysizebelieswhatishappeninginoureconomy,”saysJohnson,whoadds,“Therehasbeenalotoftalkabouttheneedtorecapturethehealthcaremarket,someofwhichhasgonetoBismarckandFargo.”

medIcal seRVIcesSanfordhopestoattractitsshareofAberdeen’shealthcaremarketwith a $55million dollarMedicalCenterthatfeaturesaneye-pleasingmoderndesign,advancedtechnology,patient-and family-friendly amenities, and greateraccesstospecialistsandadvancedemergencyservices.

“Withmore providers, you are going togreatlyimproveyouraccesstoEmergencySer-vices,”saysKevinAston,DO,whomovedtoAberdeenfromWisconsintoserveasMedicalDirectorofEmergencyMedicine.“Waittimesarealwaysaconcern,butanytimeyouhave

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


more facilitieswith24/7access,youaregoing to be able to better serve thecommunity.”

ThenewMedicalCenter’sstate-of-the-art Emergency Department features aSonositeultrasoundmachine,amobileunitthatenablesphysicianstoperformdiagnosticultrasoundsatthepatient’sbedside.Amongotheruses,theSonositemakesiteasiertodiagnose internal bleeding and can helpguidetheplacementofcentrallines.Anotherpiece of equipment, the department’sGlideScopeVideoLaryngoscope,makesvisualizationofairwayseasier incriticalsituations.Inadditiontotheacutecarearea,theEDincludesanurgentcarearea, twotraumaroomsandsevenexamrooms.

Thereare32adultpatientroomsinthehospital,fiveofwhichcanbeadaptedtocreateasecurepediatricunit.Theobstetricaldepart-mentismadeupof8modernLDPRrooms(withamenitieslikelargetubsandin-roomsleepingareas)andanurserywitheightcribs.TheremainingeightbedsmakeuptheInten-siveCareUnit,whichismonitored24hoursadaybySanfordIntensivists.

Outpatientandinpatientsurgeriesareperformed in four operating roomsequippedwithstate-of-the-art,integratedsystems.Cardiologyservices, includingemergency and scheduled procedures,radiologicalevaluation,angioplastyandother heart treatments are handled inthehospital’snewcardiaccath lab.Thehospital also offers therapy services,including physical, occupational andspeech therapy, respiratory therapy,

cardiac rehabservices,neurodiagnosticsandasleeplab.

Inshort,thenewhospitalisasmallbutfull-service community facilitywith theservicespatientshavecometoexpectinamodernmedicalcenter.

the unexPectedAlthoughSanfordistoutingthehospital’shighlevelofpatientcare,itistheamenitiesthathavecaughttheattentionofmanyresidents.Fromthenaturallightinthebuilding’sstonelobby,totheloungeareas,theInternetcafé,theres-taurant-like dining, room service and thehealing artwork throughout, Aberdeen isexcitedbythehospital’sbeautyandcomfort.

“Whentheystartedputtingtheglassinthebuilding,itchangedthewholelookofit,”saysGuffin.“Peopleareveryexcited.Oneladysaidshewaswaitingtohaveherbabyuntilthenewhospitalopened.”

Manyarealsoimpressedbytheamountoflocalartworkinthenewfacility,includingnotonlymanyoftheregion’sprofessionalartistsbuteventheworkoftalentedhighschoolers.Itisamovethatservedtoincreasethebuilding’saestheticappealwhilevisuallysolidifyingitslinktothecommunity.

“Itisreallylikewalkingthroughanartgallery,”saysGuffin.“IjokewiththeCEOthatI’mbringinghighschoolkidsoutherefortoursbecausetheartissoamazing.”

“Wegetalotofcommentsfrompatients,anythingfromsurprisethattheERphysicianiswalkingintoseethemtothefactthatthisplaceissocleanandsparklythatitseemslikeanicehotel,”saysDr.Aston.ForAston,

itwasn’ttheamenitiesoreventheservicesthatbroughthimfromWisconsintopracticeinhiswife’shometown.

“Forme,whatwasappealingwasthefactthatwewerenotonlydesigningourownbuildingbutourownculture,”hesays.“Thelongeryoupractice,theharderitistobeanERdoctor.Ilikedtheideaofbeingapartofsomethingnew.”

Forhispart,Dr.Redmond,whohasbeenwithSanfordinAberdeensincethebegin-ning,isexcitedabouttheprospectofnewspecialistsintown(rheumatologyandendo-crinologyarestillnotablymissing).Heisalsoenthusiasticabouthisimprovedlunchoptions.“Thefoodisgreatinthekitchen;theyhaveagreatchef,”hesays,notingthathewasparticularlyimpressedbythecod.“Theyofferedtoserveittomewiththetop-pingbutIturneditdown.Iwantedtoseehowgooditreallywas,justplain.Iwantedtoknowhowhedidit!”

High-endservicenotwithstanding,willgoodcodandbigwindowsreallyhaveamea-surableimpactonthehealthofthecommunity?Dr.Redmondsays,absolutely.

“Allofthesedetailsimprovethequalityofservicethateveryoneisdelivering,whichnotonlymakes itpossibleforus togivebettercareforpatients,butalsomakes iteasierforthebusinesscommunitytorecruit.Whenpeoplecomehereandtheyseetwohospitalsthatarehere,doingtheirbest,anewhighschool,newYMCA,newhotels,newrestaurants, itmakesAberdeenevenmoreattractivefornewmedicalprofession-alsandotherbusinesses.”■

Above: Becky Guffin, EdD, Asst. School Superintendent,kevin Aston, DO, Dir. Of Emergency MedicineBelow: Steve redmond, MD, Aberdeen Family Physician

One of four state-of-the-art operating suites

equipped with integrated systems


Schedule your annual mammogram and send the women in your life a reminder.

breastscreen.sanfordhealth.org(855) 35-EDITH

Make the dateParty of one or party of four. Whether you make it a “me day” or a date with friends, schedule your annual mammogram.

Encourage women everywhere to get their mammograms. Because early detection saves lives.

100-

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5-45

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8/12


SINCE LAST MAY A DEPARTMENTof Social Services (DSS) work-grouphasbeenworkingtodesigna“HealthHome”pilotprojectfora

small portion (about 11,000) of theState’sMedicaidenrollees.

Theprogram is inspiredbyaFederalprogramthatofferstopaystates90%ofthecostsofsettingupandsustainingthesehealthhomesforeightcalendarquarters.

Importantlyforthephysiciancommunity,thisistheState’sfirstforayintothemuchdiscussed,muchdebated“medicalhome”modelofcare foraportionof theState’sMedicaidpopulation.Forprimarycarepro-viders especially, the program offers aglimpseintothecomplexitiesanddetailedconsiderationthatgoesintoestablishingamedicalhomeforadesignatedportionofthepatientbasetheyserve.

TheDSSWorkgroupincludesrepresen-tativesfromSDAHO,theSouthDakotaStateMedicalAssociation,AveraHealth,RegionalHealth, SanfordHealth, the CommunityHealthCareAssociationoftheDakotas,theSouthDakotaCouncilofCommunityMentalHealthCenters,DSS, theDepartmentofHealth,andtheStateLegislature.

Theterm“healthhome”isspecifictothisproject.Itissimilarto,butmorespecificthan,themoregeneric“medicalhome”approachtocare.ThishealthhomepilotprojectmodelwillbelimitedtothoseMedicaidindividualswhohavetwoormorechronicconditions,haveonechronicconditionandthepotentialonsetofasecond,andthosebeingtreatedforbehavioralhealthdisordersandachroniccon-dition.Inshort,these11,000individualstendtorequiresignificantmedicalattention.Thefocusonreducingcostswillbeonshorterandlessfrequenthospitalstaysandareductionin

emergencyroomvisits.(Asopposedtoamoregeneralpopulationthatmightbemoreattunedtohealthylifestyles,keepinguponvaccina-tions,etc.)Inshortthisgroupofpatientsismuchofthe20%oftheMedicaidpopulationusing80%oftheservices.

TheWorkgrouphasbroughttolightmostofthespecificaspectsthatgointodesigningahealthhomeforapublicprogram.Gonearethedayswhenweareabletoruminateaboutthetheoreticaladvantagesofapro-gramthatisdesignedtomanagetheoverallhealthofapatientpopulation.No,we’retalkingthenittygrittylike:

u Thespecificquality,patientsafety,andpatientsatisfactionmeasuresthatwillbeusedtoevaluatethecarebeingdeliveredbythoseprovidersdesignatedashealthhomes.

u Thecriteriaaprovidermustmeettobedesignateda“healthhome”.

u Thereimbursementsystemthatbalancesriskassumptionbytheproviders,thecostsofsettingupahealthhome,incentivesthatrewardreducingutilizationbykeepingthehealthhomepatienthealthyandreducingthecostoftheMedicaidprogram.

u Thehealthinformationbasedprimarilyonclaimsdataneededbythehealthhometoproperlyevaluateandmanagetheover-all health status of the health homemember.

u Theperformancecriterianeededtoevalu-atetherelativesuccessoftheprogram.Atitsmostbasic level, thosecriteriawillindicate whether the per member/permonth(PMPM)costofcarewasreduced,stayedthesame,orincreasedwhencom-pared to the traditional fee-for-serviceprogram.

u Thegeographicareasofthestatewhereahealthhomemodelisfeasible.Forexam-ple,itmaynotmakesensetoconstructahealthhomeinareasofthestatewherefewerthan20peoplemightqualifyfortheprogram.Andremember,thehealthhomemodelisbasednotjustwithintegratedhealthsystemsbutwithprimarycarepro-viders and community mental healthcentersaswell.

TheDSSworkgroup is scheduled toconcludeitsworkonAugust27th.Andwhilethis one project has focused on a verylimitednumberofthestate’spopulation,ithasservedthebroaderpurposeofbroaden-ing thediscussionandadvancementofavalue-basedhealthcaredeliverysysteminSouthDakota–somethingwe’vebeentalk-ingaboutforquitesometime.Ifyouhavefeedback on the “Health Home” pilotproject, please emailyour comments to:[email protected]■

Dave Hewett is President/CEO of the South

Dakota Association of Healthcare

Organizations.

Medicaid ‘Health Home’ Pilot DeSign ProgreSSeS By Dave Hewett

MEDQuotes “To live long, live slowly.” —Cicero

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.


DOCuTAP, A PROVIDER OF electronic medical records andpractice management softwarewent global this summer withtheimplementationofacustomEMRsystemforSanfordWorldClinics in Ghana, Africa.DocuTAP’s chief executiveofficer traveled to Ghana tooverseetheimplementationandlaunch of the second EMRsystemevertolaunchinGhana.

In August 2011, SanfordWorld Clinics announced theconstructionandoperationofa10-sitenetworkofsustainableprimary care clinics (for allages)tobecompletedinGhanaover a four-year period.DocuTAP’sfirstEMRsystem

implementation took place atSanford’sbusyCapeCoastclinicthissummer.

“We’ve seen how EMRsystemscantransformthemedi-cal care practice and greatlyenhancedecision-makingpro-cessesforhealthcareproviders,”said Jim Slack, VP, SanfordWorldClinics.“However,imple-mentinganEMRsystemoranyHIS [Healthcare InformationSystem]inadevelopingcountrycanbeadauntingtask.”

OpenedinJanuary2012asSanford’sfirstclinicinGhana,Sanford’sCapeCoastpracticeseesinexcessof1,000patientsperweek.Theclinicprovidesgeneralhealthcareservicesto

area children and adults andincludes the diagnosis andtreatmentofcommonillnessesin the region, especiallymalaria,diarrheaandrespira-tory issues. Sanford WorldClinicsplans toopenat leastthree additional clinics inGhanabytheendofthisyear.

ThecaseforEMRsystemsin developing countries is afrequent topicamongdoctors,healthcare providers andacademic scholars. In somecountries, theavailabilityofareliableEMR system is oftenseenasacatalystfordevelop-mentinhealthcaredelivery.■

DocuTAP Launches EMr System

for Sanford in GHANA

Rehabilitation Specialists Sioux Falls & Rapid City

Inpatient · Pediatric Rehabilitation

· Medically Complex Program

Our 18-bed specialty hospital at Children’s Care in Sioux Falls offers cost-effective care for children through age 21 who need intensive rehabilitation and 24-hour medical monitoring and

nursing services: · IV Therapy · Tracheostomy Care · Ventilator Use & Weaning · Suctioning, Oxygen Administration · Skilled Nursing Observation following casting or surgeries · Nutritional therapy via gastrostomy, jejunostomy, NG or NJ

· Intensive Occupational Therapy, Physical Therapy, Speech-Language Pathology · Respiratory Therapy

Outpatient · Pediatric Rehabilitation

· Orthotics, Prosthetics, & Mobility Solutions for all Ages

Our outpatient centers in Sioux Falls and Rapid City provide one-stop care:

· Tone Evaluation And Management Clinic · Physical Therapy · Occupational Therapy · Speech-Language Pathology · Audiology

· Assistive Technology · Wheelchair Seating & Positioning · Equipment Repair & Adaptation · Cranial Remolding · Orthotics · Prosthetics

Julie Johnson, MD Medical Director of

Rehabilitation Services

September 16-22 is National Rehabilitation Week!

New phone numbers as of August 22 · Sioux Falls Inpatient: (605) 444-9556 FAX: (605) 444-9662 · Sioux Falls Outpatient: (605) 444-9700 FAX: (605) 444-9701 · Rapid City Outpatient: (605) 791-7400 FAX: (605) 791-7401

CHILDREN’S CARE2501 W. 26th St., Sioux Falls, SD 571057110 Jordan Drive, Rapid City, SD 57702

1020 West 18th St., Sioux Falls, SD 57104 www.cchs.org


HERBS FOR HYpERLIpDEMIASIOUxFALLSRESEARCHERShavefoundevidencethatacompoundderivedfromtra-ditional Chinese herbs may offer analternativetreatmentforhyperlipidemia,oneofthemostcommonriskfactorsforobesityand cardiovascular disease. The AveraResearchInstituteandtheAveraInstituteforHumanGeneticshaverecentlypublishedtheresultsoftheirstudyonthesafetyandeffi-cacyofthecompoundknownasberberine.

Berberinewas shown toproducemildweightlosswhilesignificantlyloweringcho-lesterolandtriglyceridelevels.Theresearchwasreplicatedinaseparateresearchproject,whichconfirmeddecreasesintheselevels.Individualswithabodymassindex(BMI)greaterthan30wereeligiblefortheclinicaltrial;participantshadtoagreetokeepalldiet,exerciseandhealthhabitsstablewhiletakingthestudycompound,about12weeks.

Althoughberberinedidnotproducesig-nificantweightlossinthestudy,itdidhaveapotenteffectonlipidmetabolism,notesYueshanHu,PhD,authorof theresearchresults.ThestudywillbepublishedinanupcomingissueofPhytomedicine.

pERSONALIzING pLAvIx USEATTHESAMETIME,theAIHG,incon-junctionwiththeAveraHeartHospitaland

NorthCentralHeartInstitutehaslaunchedaclinicalresearchstudyontheconnectionbetweengeneticmake-upandtheeffective-nessoftheanti-clottingdrugclopidogrel(Plavix).

Asmuchas30percentofthepopulationdoesnotrespondtoPlavix,puttingthematriskfordevelopingabloodclotwhiletakingthemedication.Otherpatientsmayneedahigherdoseofthemedicationthanwhatistypicallyprescribedasstandardofcare.ThenewPlavixandPersonalizedMedicineProj-ect is offering genetic testing to acute/interventionpatientsadmittedtotheAveraHeart Hospital. The patient’s physicianreceivestheresultsfromthegeneticanalysisasarecommendation.

pLAvIx vS. EFFIENTREGIONALHEARTDOCTORphysicianandMedicalDirectorof Black Hills CardiovascularResearch,JamesWalder,MD,is

anauthorofanotherPlavixstudy,publishedin theJune19issueof theJournalof theAmericanCollegeofCardiology(JACC).

This study focused on results of theRecoveryTrial,whichcomparedtheoffsetof the anti-platelet effects of prasugrel(Effient)andclopidogrel(Plavix).Effientand Plavix are commonly prescribed incombinationwithaspirin tohelppreventbloodclots thatcanblockbloodflowandcauseaheartattackorstroke,butbecauseanti-plateletmedicationsprolongbleeding,theyshouldbe interruptedwhenpossibleforaperiodoftimepriortosurgery.Currentrecommendationsregardingtheperiodoftime theneweranti-plateletdrugEffientshouldbestoppedpriortoperformingsur-geryarebasedonassumptionsmadefrom

other trials whichwere not designed toprospectively answer this question. TheRecoveryTrialwasdesignedtotestand/orvalidatetheseassumptions.Asdetailedinthejournalarticle,theresultsoftheRecov-eryTrialshowedthatpatientsonEffienttooklongertorecovertheirplateletfunctionthanthoseonPlavix.

TheRecoveryTrialwasconductedatBlackHillsCardiovascularResearchandfourotherU.S.clinicalresearchsites.

T1D TRIAL REACHES FULL ENROLLMENTSANFORD’S PANCREATIC INSULINResponseintype1diabetes(REPAIR-T1D)trialhasreachedfullenrollmentThestudyis testingtwoFDA-approveddrugs,sita-gliptinandlansoprazole,fortheirpotentialclinicalbenefitsinT1Dpatients.

The trial needed 54 participants tocomplete a 24 month study. Thirty-sixpatients received testmedicationsand18receivedplacebos,givenascapsulesdailyfor12months,followedbya12-monthfol-low-up.Participantsinthismaskedstudyareallbetweenages11-45andbeganthestudywithinsixmonthsofdiagnosis.ThestudyisbeingledbynewlyappointedSanfordProjectBroinChairAlexRabinovitch,MD.

“Whileitwillstillbemonthsbeforewecanreleaseresearchresults,weareencour-agedbythesuccessofthepatientenrollmentinthistrial,”saysDr.Rabinovitch.

AmajorityofthepatientsenrolledinthetrialcamefromtheSanfordHealthsystemin Sioux Falls, SD and Fargo, NDwithpatients also coming from Children’sHospitalandClinicsofMinnesota inSt.Paul and Rady Children’s Hospital inSanDiego.■

research roundupLocal Scientists are seeking and finding answers to pressing medical questions

Erik Ehli, Avera Institute for Human Genetics laboratory technician


A childhood cancer survivor.A voice for hope.Ted Kennedy, Jr.

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.”

200-46670-0169 8/12Sponsored in part by grant funding through Hyundai Hope On Wheels.

THE SIOux FALLS COMMuNITY HAD THE HIgHEST ENROLLMENTinthecountryfortheAmericanCancerSoci-ety’snationalCancerPreventionStudy-3(CPS-3).TheSocietyhad agoal to enroll 1000people fromSiouxFalls during itsenrollmentpushAugust14 to18.With thesupportofenroll-mentsitepartnersAveraMcKennan,SanfordHealth,theCityofSiouxFalls,Citibank,FirstPremierBankandPremierBank-card,atotalof1534peoplewereenrolled–thehighestofanyindividualAmericanCancerSocietychapterinthenation.

CPS-3isa long-termstudyfocusedonthe lifestyleandgeneticfactors thatcauseorpreventcancer. TheAmericanCancerSociety’sEpidemiologyResearchProgramislookingformenandwomenbetween30and65whohavenopersonalhistoryofcancer.Theultimategoalistoenrollatleast300,000adultsfromvariousracialandethnicbackgroundsfromacrosstheU.S.EnrollmentforCPS-3willstartinRapidCityin2013.■

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AS THE MATTER-OF-FACTVOICE

OF ARTHuR COWDEN, DO,beginstorelatehismusicaland professional past, it sounds

muchlikethehistoryofa70’srockandrollband—ironic and quirkywithmanymovesandmanydifferent incarnationsonthewaytothepresent.

Dr.CowdenisaGeriatricianattheSiouxFallsVAHospital,buthis rootsaredownSouth. It all started in medical school inMiami,Florida.AccordingtoCowden,aninsistentprofessorofbio-chemistry“button-holed”theyoungstudentjustasmedicalschoolbeganand,afterlearningabouthismusicalexperience,said,“You’venobusinessbeinginmedicalschoolandnotalsobeingamusi-cian—gogetyourselfarecorder.”

Afterthemomentumslowedabit,how-ever,theschool’sgroupfoundthathehadsomeexperiencewithbrassinstruments,sotheyoungArthurCowdenwentonaquesttobuyasackbut(asortofrenaissancetrombone)toaddtothestudent/facultyensemble.Dr.Cowden recalls the day he purchased aninstrumentafterstumblinginfromthesunnyFloridastreet.

“Whenmyeyesfinallygotusedtothepracticallydarkmusicstore,Irealizedthatthethicksmokeintheplacewasactuallymarijuana.Eventuallytheeccentricowner,whohadnevermetmebefore,cameoutandsentmehomewithaninstrument,ontrial.”

Andsoitbegan…Meldingtheinterestsofmusicandmedi-

cineseemstohavesomeconstantfactorsinthelivesofmanyphysicians.Dr.Cowden’seasygoingmannerashetellsofhismanymusicaladventurespointstoalifeingoodbalance.“IhadageriatricrotationinsouthFloridaandIincorporatedmusicintoit.ThestudentsthatIinvolvedsoonunderstoodthattheyhadtoparticipate,too,iftheywereevergoingtogettheirmedicallicenses!”

Awideandvariedsetofmusicalprojectsfollowed;includingaLatinbandcalledTheRhythmDoctorswhowerefeaturedonHis-panicradiointheMiamiarea.Hiscareerhasincludedsomeunlikelygigs,too,suchasaCeltic band in a Mexican restaurant in

Barrow,AlaskawhereithassnowedontheFourthofJuly.TheironyoffindinghimselfinthesesituationsisnotlostonDr.Cowden.

Inanswertothequestionofwherehefindsthetime,Dr.Cowdenadmitsthathehasneverfelt fullyemployedifhe isnotdoingabout70hoursaweek.Practicetimecanbehardtocomebywhentheschedule’sdemands are high, but solutions simplyrequiresomecreativity.Realizingthatprac-ticeisnecessaryeveryday,Dr.Cowdenoftensetssomeshortrehearsal timeforhimselfbetweenpatients.

HislatestmusicalincarnationisajazzandbluessetthatcallthemselvesMac&theRingbinders. It includesother localmusi-cianssuchasDickRausis, IvonaDreyer,MontyBernard,ErikJensen,andMarian

Casey. They will be playing the SiouxFalls venue Touch of Europe again inSeptember.

Peoplesometimeswonderwhysomeonewouldperforminfrontofotherpeople—whytheywouldsubjectthemselvestothatkindofpressureandvulnerability,andDr.Cowdenpausesforamomentashethinks.

“Whenyoupullthesethingsoff—theseperformances—evenwhenit’snot totallysatisfactory…youjustfeelakindofhigh.Thefeelingis:alright,nowlet’sgoparty.”

His last statement comes as an after-thought,butitsimportanceisimmediatelyevidentasitcouldeasilyapplytomedicineaswellasmusic:

“Theonlythingyoucanreallydowrongisloseyournerve.”■

Life is short but art endures —Hippocrates

geriatrician &Medical Minstrel

arthur Cowden, Do

By Darrel Fickbohm

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

Medicine&Arts


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I selected ProAssurance because they stand behind my good medicine. In spite of the maelstrom of change, I am protected, respected, and heard.

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geriatrician &Medical Minstrel


Nursing News from Around the region

The Nurses’ Station

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.TheeventattheSiouxFallsConventionCenterfeaturedtwokeynotespeakers:TimPorter-O’Grady,DM,aninterna-tionalhealthcareconsultantfromAtlantaandKathleenBartholomew,MN,RN.

TheNursingSymposiumisapartofTheYearoftheNurseatSanfordHealth.AllyearSanfordHealthhasbeenliftingupthenursingprofessionwithintheorganization.Amongother things,nurseswerehonoredataspecialAllAglowevent inFargo,BemidjiandSiouxFalls.SanfordHealthisofferingnursingeducationscholarships,anopportunitytotraveltoaWorldCliniclocationandtospendthedaywithanexecutive.Theyearhascelebratedalegacyofservice,honoredachievementsinnursingandapplaudedtherolenursesplaywithinthesystem.

“Ournursesarewhatmakeourorganization,”saysDianaBerkland,Sanford’sChiefNursingOfficerforSiouxFalls.“Wecelebratetheworktheydoandwearehappytoofferthemadvancementandeducationalopportunitieslikethissymposium.”■

RETIRED SIOUxLAND NURSE TO RECEIvE pRESTI-GIOUS SpELLMAN AWARD /LONGTIME SIOUxLAND

NUrSING LEADEr VErNA WELTEwillbetherecipientofthepresti-giousDr.GeorgeG.SpellmanAnnualServiceAwardfromtheMercyMedicalCenterFoundation.TheawardwillbepresentedtoMs.WelteattheMercyFoundation’sannualgalaonSaturday,November3inSouthSiouxCity.WelteretiredfromMercyMedicalCenterin1997

astheVice-PresidentofPatientCareServices.ShewasoneofSiouxland’sfirstfemalehealthcareadministratorsandpavedthewayforotherwomenintheindustry.

Weltebeganhernursingcareerin1955aftergraduatingfromBriarCliffwithaBSinnursing.ShejoinedSt.Vincent’sHospitalin1957asaninstructorintheSt.VincentSchoolofNursingandwasoneofthekeyplayersinthe1977consolidationofSt.VincentandSt.JosephHospitals.

In1972,WeltewasnamedtheDirectorofNursingatSt.Vincent’sandfromthereassumedavarietyof leadershiproles inhospitaladministration,emergingasoneofSiouxland’sfirstfemalehealthcareexecutives.Herselectionasthe2012SpellmanhonoreetakesonanaddeddimensionbecauseofherprofessionalrelationshipwithDr.Spellman.WelteandDr.SpellmanspearheadedtheestablishmentofthesecondCriticalCareUnitinthestateofIowaandshealsoisresponsible,alongwithformercolleagueConnieSpain,forcreatingthecity’sfirstinpatientsubstanceabuseunitatSt.VincentHospital.■

Darilee Waddell received the July daIsy award for Extraordinary Nurses & Kimberley Weyer received the June daIsy award at rapid City regional Hospital (RCRH.)Wad-dellisanRNintheCardiacInterventionalUnitandhasworkedat thehospitalfor15 years.A patient’s family recognizedWaddell for her calm demeanor and fortakingthetimetoanswertheirquestions.WeyerisanRNintheEmergencyDepart-mentandhasworkedatthehospitalfor11years. A patient’s family acknowledgedWeyerforstayingwiththeirlovedonefromthetimeheenteredtheEmergencyDepart-mentasapatienttowhenhewaslife-flightedto another facility,which occurredwellafterWeyer’sworkshifthadended.RCRHhonorsoneextraordinarynurseeachmonthwithacertificate,pin,totebag,andaHeal-er’sTouchsculpturehand-carvedbyartistsoftheShonaTribeinAfrica.■.

meRcy medIcal centeR’s Debra Twyford has been named Worksite Wellness rN. Inhernew role,Twyfordwill helpdevelopworksitehealthandwellnesspro-gramsandwillassistinadministeringtheonsitenursingservicesprovidedbyMercyBusinessHealthtoareaemployers.

As an Occupational Health Nurse andWellnessCoachatMercyBusinessHealthSer-vices,Twyfordhasprovidedonsiteoccupationalhealthnursing,wellnesscoachingandcorewell-nessscreeningstovariouscompanies.

TwyfordreceivedherAssociateDegreeofNursingfromWesternIowaTechCom-munityCollegeinSiouxCityandcompletedthe12-weekIntrinsicCoachingDevelop-ment Series for health and wellnessprofessionals.SheisaCertifiedOccupa-tionalHearingConservationist,acertifiedFreedomfromSmoking facilitator,CPRInstructorfortheAmericanRedCrossandaNationalExerciseTrainersAssociationCertifiedGroupExerciseInstructor.■.


SD Joins action Coalition to Support nursing excellence AvERA SACRED HEART HOSpITAL AND YANKTON RURAL AREA HEALTH EDU-CATION 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.

N A N E T T E F I T zG E R A L D HAS RECEIvED THE 2011 GEORGE S. MICKELSON AWARD

FOR NURSING ExCELLENCE AT RApID CITY REGIONAL HOSpITAL (RCRH.)FitzgeraldworksasaCertifiedLactation Consultant and has beenemployed at the hospital for 26 years.Fitzgeraldisrecognizedasadedicatedandcaringmemberofthehealthcareteam.Shedemonstrates excellent interpersonalrelationship skills with staff members,physicians,patientsandtheirfamilies.Sheisdescribedas“arolemodelfornursing,demonstratingenthusiasm,knowledgeandrespectforothers.”RCRHmanagersnomi-natenursestoreceivethishonor.Allnurses,exceptnursingadministratorsandmanag-ers,areeligibletoreceivetheaward.■


The mission of the Cnos foundation is at onCe simple and profound.

OriginallycreatedbyCNOSandtheSiouxlandSurgeryCenterasanot-for-profitvehicleforprovidingsportsmedicineservicestoareaschools,theFoundationhasevolvedintosomethingmuchbroader.Today,itsstraightforwardbutfar-reaching

missionis‘ToImproveHealth’.“Ithasbeenexcitingtowatchthisfoundationevolvefromonewhichfocusedprimarily

onsportsmedicineandperformancetoanorganizationwhoseentirefocusisnowonimprov-ingthehealthofourcommunity,”saysMikeHurlburt,CEOoftheDakotaDunes-basedfoundation.

Inkeepingwithitssports-centeredbeginnings,the5-year-oldCNOSFoundationhasjumpedintoitslargermissionwithbothfeet.Throughateamof13certifiedathletictrainersandanother10to12specially-trainedVelocitySportsPerformancecoaches,theFoundationismakinganameforitselfacrossSiouxlandoffering

♦ sportsmedicineservicesandperformanceprogramstohighschoolsandcolleges♦ sportstraining,campsandhealtheducationforchildrenandyouth♦ symposiumsandsocialsforareamedicalproviders,trainersandcoaches♦ summersciencecamps♦ communitywellnesseventsandscreenings♦ partnershipswithotherhealth-focusedorganizations♦ communitysportingevents“Oneofourbiggestchallengesistryingtochangepeoples’definitionofwhat‘sport’

is,”saysSuziGausman,ExecutiveDirectoroftheCNOSFoundation.“Webelievethatlife issport.So,asourwayofgivingbackto thecommunity,wewant toreallycomealongsidepeopleandsupportthemintheirhealthandwellnesspursuits,whateverformthosepursuitsmighttake.”

SponsoredFeature

CNOS Foundation

Broadens its Mission

in Siouxland

to improve health

Dr. ralph reeder, CNOS neurosurgeon, interacting with CNOS Foundation Science Classic campers

CNOS orthopaedic

surgeon ryan Meis, MD,

practices sports medicine

on the side lines.


Brian Fink, Velocity Sports

Performance Trainer, in the weight

room at Briar Cliff University.

sports mediCine & performanCeAlthoughitisbranchingout,thereputationof the CNOS Foundation is still firmlyrootedinitsqualitysportsmedicineandperformanceservices. SevenSiouxlandareahighschoolsandtwolocalcolleges(BriarCliffandMorningside)havecontractswithCNOSFoundationcertifiedathletictrainersforfull-timesportsmedicineser-vices. This can range from hands-ontraining and advice during practice, totapingupanklesandicinginjuriesatgamesto recommending the appropriate ‘nextsteps’fortreatment.Another40areaschoolstakeadvantageofthesekindsofservicesonaweeklybasisthroughtheFoundation’soutreachprograms.

Asthearea’sonlyVelocitySportsPer-formancefranchise,theCNOSFoundationalsooffershigh-levelperformancetrainingdesignedtoimprovecorestrength,power,speedandagility.CertifiedVelocitySportsPerformance coaches conduct 8-weeksummerprogramsforhighschoolandcol-legestudentsandspreadtheirknowledgefurtherthroughauniqueprogrammodel.

“UnlikeotherVelocityfranchiseswhichoffer trainingonsite,wearea‘hubandspoke’program,”explainsGausman.“Wearecommittedtoreachingoutintothecom-munitybytrainingcoachesandthensendingthemoutintoschools.Doingit thiswaymeansthatSiouxlandstudentsareabletotakeadvantageofthiskindofhigh-leveltraining(Olympicgold-medalistAllysonFelixisanotableVelocitysuccessstory)atafractionofwhatitwouldotherwisecost.”Anestimated1200SiouxlandareachildrenenjoyedthebenefitsofVelocitySportsPer-formancetrainingthissummer.

TheFoundation’ssportsmedicineandperformance services don’t stop withschool-aged athletes.CNOSFoundationcertifiedathletictrainersofferfreeinjuryevaluationstothepublic,bothonsiteattheCNOSClinicandatinjuryscreeningclinicselsewhereinthecommunity.

eduCation Education is a major component of theCNOSFoundation’sevolvingmission.TheFoundationsponsorsthreemedicalsympo-siumsayearinNeuroscience,OthopedicsandSportsMedicineforhealthcareprovid-ers throughout the region.CNOSClinicprofessionalsandguestspeakersprovidehalf-daytrainingdesignedtosupportareaprofessionalsintheevaluationandtreatmentofpatientswitharangeofneurologicalororthopedic disorders or sports-relatedissues.CNOSFoundationsymposiumsareaccreditedbytheIowaMedicalSocietytoprovidecontinuingeducationcredittophy-sicians, physician assistants, nurses andathletictrainersandcertificatesofcomple-tiontoNPs,PTsandOTs.

“These symposiums are a way ofimprovingcommunityhealthbyimprovingthestrengthofthemedicalcommunity,”saysHurlburt, echoing theFoundation’sbelief thatgoodhealthencompasses thebrainaswellasthebody.

Ontheotherendoftheacademicspec-trum is the CNOS Foundation SummerScienceClassic,offeredforthefirsttimethissummer.Duringtheseweek-longcamps,areacertifiedteachers,CNOSFoundationstaffand CNOS Clinic rehabilitation expertsguidedmiddleschoolstudents throughahands-onexplorationofthechemistry,phys-ics,anatomyandphysiologyofmovement.

TheCNOSFoundationalsosupportscommunity health events such as theYMCA’s annual Healthy Kids Day andtheHyVeeKidsTriatholonandworksinconjunctionwithnon-profitagenciessuchasGirls, Inc.,BigBrothers,BigSisters,CampHighHopesandtheBoysandGirlsHomestoofferavarietyoftailoredhealtheducationprograms.

“Wearetryingtoexpandourfocustoencompass total health and wellbeing,”saysGausman.

sporting events ThousandsofSiouxlandareaathletesandsportsfanshavecometoknowandappreciatetheCNOSFoundationthroughitsannualClas-sicsportingevents.TheFoundation’sannualFootballClassic,GolfClassic,BaseballClas-sicandBasketballClassichavebecomestaplesofthelocalsportscommunity,providinglivelyentertainmentforattendeesandarareoppor-tunityforyoungparticipants.

“OurClassiceventsprovideanoppor-tunityforsomeoftheathletesthatweworkwithtocompeteatahigherlevelandatahigh-end facility, like theTysonEventsCenter,”saysGausman.

Forthefirsttimein2012,theFoundationsponsored‘CreatingCaptains”,acharacter-buildingcampforelementaryandmiddleschoolstudentsthatteachesdisciplineandcharacterqualitiesalongwithfootballknowl-edgeandskills.TaughtbyformerNebraskafootballplayerMattDavison,thecampwasthelargestCreatingCaptainshaseverhadwith105kids.CNOSFoundationsupportallowedcamperstoattendforjust$10.

TheFoundation’scommunityfocusevenextends to themakeup of its governingboard. The board of directors includesCNOS and Siouxland Surgery Centeremployees,aswellascommunitymemberswhoarenotaffiliatedwitheitherorganiza-tion.InanefforttoremainfocusedontheFoundation’smission,thevarietyofper-spectivesfromboardmemberskeepstheFoundationsociallyaccountabletoprovidetruecommunitybenefit.

“Wetakeourresponsibilityseriously,”saysHurlburt.“Wearedevelopingourkeycurriculaaroundthepillarsthatsupportourreasonfordoingwhatwedoeverysingleday.Themessageisthateverypersonisanathlete;itcannolongerbedefinedbysports.Itneedstobedefinedbylife.”


THE rALLy BY THE NUMBERSHOSPITALS 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 under700 rally-relatedvisitstotheiremergencyroomsduringthisyear’srallyweek,August6to12.Thetotalof696ERvisitduringthe2012rallyweekwasupbyabout50fromtheyearbefore,butstillafarcryfromthepeeknumberofERvisits–1044–recordedduringthe2006rally.Day-to-dayinpatientnumberswerecomparable topreviousyears.

Asinpastyears,mostoftheERvisitshappenedatSturgisRegionalandRapidCityRegionalHospitals.RegionalHealthspendsmonthspreparingforrallyweek,whichmorethandoublesthearea’spopula-tion,withstrategicmeetingsandplanningsessions,similartothewayotherfacilitiesmightpreparetohandlenaturaldisasters.

Althoughthefinalfigureswerenotinatthetimeofprinting,earlyestimatessuggestthatmorethan500,000peopleattendedthisyear’sSturgisrally.Ninepeoplewerekilledinrally-relatedaccidents.■


THIS SuMMER, A DOzEN COLLEgE students studyinghealthcareers gotafirst-handlookattheupsdownsofhealthcareinruralSouthDakota.ThestudentswerepartoftheRuralExperiencesforHealthProfes-sions Students (REHPS)SummerExperi-ence, a collaborative effort between stateuniversities and the communities selectedas“BestPracticeModel”sites.

AprogramoftheYanktonRuralAreaHealthEducationCenter(AHEC),REHPSconnects interprofessional studentsenrolled inmedical,physicianassistant,doctorofnursingpractice,andpharmacyprograms through theUniversityofSD(USD)andSDStateUniversity (SDSU)withhealthcareprofessionalspracticinginsixruralSDcommunities.Since2011,theprogramhasexpandedfromthreesites:Redfield, Parkston, and WessingtonSprings, tosixsiteswith theadditionofWinner,PhilipandWagner.

“We were able to see a time-lapsepictureofhowthefamilypracticeclinicfunctions, something that is difficult toaccomplishonthemorningpreceptorshipsthatwehaveinmedicalschool,”saysmedi-calstudentAnthonyLoewen.Inadditiontothereal-lifecareerexperience,studentswere involved in community projectsdesignedtoprovideinteractionoutsidetheclinicalsettingandimmersethemincom-munitylifeduringtheirfourweekstay.

“Studentsaremorelikelytoreturntofacilitiesandcommunitieswheretheyhavehadrich,positiveexperiencesearlyintheir

training,” saysKassyYoumans,REHPSProgramManager.“TheREHPSprogramisdesignedtoallowcommunitiesandstudentstomakethishappen.”TheREHPSProgramalsoprovidesaframeworkforcommunityleaderstofollowinanefforttosuccessfullyrecruitandretainhealthcareprofessionals.

Student participants are asked tocompleteasurveybeforeandafter theirexperience.Resultsofthe2012surveywereencouragingforthosecommittedtotack-ling theproblemofhealthcareaccess inruralareas:v 92% of students strongly agreed oragreed that their four week ruralexperiencemadeitmorelikelythatthey

wouldconsiderruralhealthcarefortheirfutureprofession

v 100%ofstudentsfelt theyhadabetterunderstandingofruralhealthcareandfeltmorecomfortableintheruralhealth-caresetting

v 75%ofstudentssaidtheystronglyagreedor agreed that the facility they wereplacedinwouldbeaplace theywouldconsiderforfutureemployment.

Communitiesinterestedinbecoming2013sites for the program can contact theYankton Rural Area Health EducationCenter(AHEC)[email protected].■

THE DIFFERENCE IS SERVICE“I live, work and play in South Dakota. Being local means I get to be proactive with my customer’s requests and respond to their needs right away. Cassling designed it that way, and it’s a service mentality I’m proud to support.”

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Every day, we strive to respond to our customers’ equipment service needs quickly and efficiently. That’s why we’re proud to report that Cassling customers, on average, receive phone fixes or on-site support on a critical down system in just 52 minutes.

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Grape Expectations

the Chicken and the egg

IRECENTLY HAD ADISCuSSIONwith a friend of mine about the“chicken and egg theory of wine”.Wearebothinthewineindustryand

liketoshareinformationwithoneanother.Ifindherinformationveryvaluableassheis on the restaurant side of the businesswhileIamontheretailside.

Dowinedrinkers lookforwhat theyhavepurchased ina retailestablishmentwhentheygoouttoeat,ordodinerscometoaretailestablishmenttobuysomethingtheyhaveconsumedwhileeatingatares-taurant?Thisisthe“chickenandeggtheoryofwine”.Doyoufindthatyoudiscovermorewineinrestaurantsorinwineshops?Oncetheyarediscovered,thenwhatdoyoudo?Searchthemoutinshopsoraskyourfavoriterestaurantstoaddthemtothemenu?Ireallyhopethatitgoesbothways.Ioften“find”newwinesbecausetheyarebroughttomebypeoplewhohavehadthem,lovedthem,andwanttogettheirhandsonmore.

Oversharedbottlesofwine,withcus-tomers and friends weighing in on the

matter,myfriendandIhavedecidedthatthequestionwillneverbesolved.Bothofuscannotcounthowmanytimescustomershavecometousaskingforawinetheyhavehadsomewhereelse.Dowealwayssucceedinthequestofhavingtheperfectwineforall of our customers?Unfortunately theanswerisno,butfortunatelywehavebothcometotheconclusionthatwiththeenor-mousamountofchoiceswecanoffer,wecancomeprettydarnclose.Betteryet,wecanoftengivecustomerssomethingunex-pectedandevenbetterthanwhattheywereactuallylookingfor.

Americanslovewine.In2011,theUnitedStatessurpassedallotherwinedrinkingcountries includingFrance, Italy,Spain,AustriaandGermanyinpercapitaconsump-tionofwine.Wearenumberone!Whatthismeansforallofusisthatourchoicesarebecomingmoreandmoreabundant.Becauseweloveourwine,wearenowseeingprod-uctsthatwe’veneverbeenabletogetfromothercountries.Thesedays,everyonewantstoselltheirwineinAmerica.

IwasrecentlyabletopouraBeaujolaisBlanc (yes, theFrenchdon’t like toputanythingontheir labels thatwill telluswhat isactually in thebottle,but in thiscaseBlancmeansChardonnay)atoneofourwinedinnersandwhatawonderfulexperience!TheFrenchregionofBeaujo-laisiswellknowforitsGamayBeaujolaisbutvery little isknownabout thewhitewinesproducedthere,withgoodreason.Lessthan2%oftheentireregionproduceswhite wine and almost none of it isexported.Only400casesofthiswinewereproducedbythislittlewineryandweman-agedtosecureasmallamount.

I’veneverhadaBeaujolaisBlancbeforesoIwasveryexcitedtotrythiswine.Whatabeautiful littlewhitewithbrightcrispnotesonthepalateandwonderfulpurityofthechardonnaygrapeflavoritselfhavingnotbeenobliteratedwithoakaging.Betteryet,evenwithitsrarityintheU.S.market,itcameatapricethatastonishedme:Itwasunder$20!

Asforthe“chickenandeggtheoryofwine”,myfriendgotafewcallsandrequestsfor thisamazingBeaujolaisBlancatherrestaurantandshecalledmetoaskifI’veeverheardofit.Unfortunatelyforher,inthiscaseI wasthechickenandshewastheegg.I’msavingherabottleofitsothenexttimewegettogether,wecanshare.■

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Quarter Page Horizontal 3.875 x 5.275 SEPT 2012 ISSUE20120821_Layout 1 8/21/2012 11:20 AM Page 1


MANY OF YOu HAVEprobably heard of the oldadage,“Wherethere’sawill,there’s a way”. While this

sayingwasn’tintendedtoapplytoanactualestatedocumentsuchasatrust,todayitcan.Formanyyears,thegeneralrulewasthatifatrustwasirrevocable,theonlywaytochangeitwasbygoingtocourt;andeventhen,thecourtswerereluctanttomakechanges.Overthepastfifteenyears,thisrulehaschangedand many states have modernized andupdatedthetrustlawstoreflectwhatisnowreferredtoas‘moderntrustlaw’.However,stateshavenotuniformlymodifiedthelawsinthesamemannersoitisveryimportanttocomparison shop since you are NOTrequired to create ormodify a trust in thestatewhereyouresideorwherethetrustwasoriginallyexecuted.

SouthDakotaisnationallyrecognizedashavingthemostflexibletrustlawsinthenation.Infact,SouthDakota is theonlystateinthenationwithaGovernor’staskforcedesignedtoreviewandkeepabreastofthemostrecentdevelopmentsintheareaoftrustssothatourstatecanremainaleaderinattractingclientswithwealth.Since1986,SouthDakotahasbeenafavorablestatefortrustadministration.Onereasonisbecauseoftheeasebywhichatrust–evenanirre-vocableone–canbemodifiedandupdated.

Forexample,ifyourancestorcreatedatrustthatdirectsthepaymentofnetincome,andthosedistributionshavedwindledtoalmost nothing in the current economicenvironment,thebeneficiariesofthetrustmaybeabletomodifythetrusttoenablemoregenerouspayouts.Other reasonsafamilymaywanttomodifythetrustaretoaddressachangeincircumstances,toallowmorefamilyinvolvementininvestmentanddistributiondecisions,ortosavetaxes.

UnderSouthDakotalaw,anirrevocabletrustcanbemodifiedwhenallbeneficiaries

consent.Thelawdoesnotrequireanapprovalbythecourt;but,itissometimespreferabletogetacourtorderforIRSclarification.Whathappensifthetrustwaswritteninanotherstate?Youstillmaybeabletohavethetrustadministered in SouthDakota. The Statewherethetrustisadministerediscalledthe‘situs’.Withconsentofallbeneficiaries,mosttrustscanbemoved toanewsitus.Oncemoved,thelawsofthenewstategovernforamendingorreformingatrust.Oldertrustsareoftensilentabouttheabilitytomovethetrusttoanewlocation.Asageneralrule,thesetrustscanbemovedandthenmodified.

Decantingisanothermethodofamend-inganirrevocabletrust.Decantingatrustissimilartodecantingawine.Essentially,

itmeanstodistribute theassetsfromtheexistingtrusttoanewtrustwiththesamebeneficiariesbutwithamendedandupdatedterms.Statelawsvarywidelyonthetypesofchangesthatcanbeincludedinthenewtrust.OnlyahandfulofStateshaveapro-cedurefordecanting.Again,SouthDakotaisrecognizedashavingthemostflexibleandbroadpowerwhendecanting.

Bottomline,therearewaystomodifyanirrevocabletrust.Formoreinformationonhowatrustcanbemodified,reformedordecanted,youshouldconsultwithanattorneywhospecializesinthisarea.■

Alice rokahr is the Wealth Planning Officer at

Bankers Trust Company of South Dakota.

tRust modIFIcatIon… But what if it says irrevocable?By Alice Rokahr, JD

We protect your peace of mind. It’s what we do for

medical professionals. We know your work challenges

are unique. And so are we.

Sure, we provide medical liability insurance. But we’re

also focused on your personal wellness. We want you to feel

as groovy as possible, because if you’re at your best, you’ll

deliver your best. It’s a Peace of Mind movement, and we’d

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Contact your independent agent or broker or check out

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Be protected, stay cool.

MMIC has earned the AM Best industry rating of “A” (Excellent) for 20 consecutive years.


Congratulations!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.

17787-0712

Regional HealtH

Recognized for Best Practices

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”susan mcKinney, rn, eICU Quality CoordinatorRapid 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 DirectorSpearfish 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

BuILDINg ON THE POPuLARITY OF ITS VOLuNTEER LABOR doulaprogramlaunchedlastfall,BrookingsHealthSystemisnowofferingpatientsaccesstocareafterthebirththroughvolunteerpostpartumdoulas.Itisthefirstorganizationinthenationtooffertheseservicesatnocharge.

“We’vehadapositiveresponsefromparentsregardingourvolunteerdoulashelpingthemduringthedeliveryprocess,”saidChiefNursingOfficerTammyHillestad.“Ourvolunteerdoulasarepassionateabouttheentirechildbirthexperience,includingtakingcareofmother,babyandfamilyafterdelivery.Theyareeager toprovidephysicalandemotionalsupport tonewmomsandtheirfamilies.”

Labordoulasarewomenwhoprovidecontinuouslaborsupportduringchildbirth,worktogetherwiththemotherandherpartnertoassistwithemotionalandphysicalsupport,anduserelaxationtechniquessuchaspositioningandmassage.

Postpartumdoulashelpparentstransitionandadjusttohavinganewborninthechild’sfirstfewdaysoflife.Theyhelpparentswithissuessuchasinfantfeeding,emotionalandphysicalrecoveryfrombirth,mother-babybonding,infantsoothingandbasicnewborncareduringtheirpostpartumstayatBrookingsHealthSystem.

BrookingsHealthSystem’svolunteerdoulaprogramofficiallylaunchedOct.1,2011,inresponsetocommunityfeedbackfromthreebirthexperiencefocusgroups.Seventeentraineddoulasvol-unteerone,24-hourshiftpermonthtohelpareaparentsduringtheirbirthexperience.■

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

SMootH T r A N S I T I O N SBrookings Launches First-in-Nation

Free Postpartum Doula Program

MEDMagazine

2013 Call For noMinationS

Please include the following information:

Name of Nominee ______________________________________________________________________________________________________

Location of Practice _____________________________________________________________________________________________________

reason for Nomination __________________________________________________________________________________________________

______________________________________________________________________________________________________________________

your Name ____________________________________________________________________________________________________________

your Contact Information ________________________________________________________________________________________________

MED noMination ForM

Mail / Fax or email this form to: PO Box 90646 Sioux Falls, SD 57109—Fax 605-271-5486—email [email protected]

MED Magazine is seeking Nominations for Cover and Feature Article topics for 2013. MED is committed to focusing on pioneer-ing 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 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].

Learning Opportunities

September – November 2012September 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 Location: Sanford Information: [email protected]

September 14 .. .. .. .. .. .. .. .. Diabetes Care Conference8:00 am – 4:15 pm Location: Sanford Center, Dakota Room CNE/CME Credit available Information: 605-312-6971 Registration: [email protected]

September 15 .. .. .. .. .. .. .. .. American Heart Association Black Hills Heart Walk9:00 am Location: Main Street Square, Rapid City Information & Registration: Robin Albers, 605-754-6267, [email protected] For a personalized fundraising website: http://heartwalk.kintera.org/westcentralsd

September 17 – 18 .. .. .. .. .. .. Medical-Surgical Nurse Certification Review Course7:30 am – 4:00 pm Location: Sanford Research/uSD Sanford Center Information & Regisration: [email protected], 605-328-6377

September 19- 21 .. .. .. .. .. SDAHO 86th Annual Convention Location: Sheraton Inn, Sioux Falls Registration and information: www.sdaho.org Information: [email protected], 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: [email protected] or call 322-8950

September 26 .. .. .. .. .. .. .. .. perinatal Clinical Update8:00 am – 4:00 pm Location: Sanford Center Information: SanfordHealth.org

September 27 – 28 . .. .. .. .. .. 2012 Upper Midwest Regional pediatric Conference Location: The Marina Inn & Conference Center Information: www.umrpconference.com or (712) 279-3235

September 28 . .. .. .. .. .. .. .. .. Avera Transplant Institute Symposium8:00 am – 2:00 pm Location: The Prairie Center Information: www.AveraMcKennan.org; click on Events Calendar Registration: [email protected] or call 322-8950

September 29 .. .. .. .. .. .. .. .. First Annual Genomic Medicine Symposium Location: Sanford Information: [email protected]

October 4 .. .. .. .. .. .. .. .. .. .. Avera Rural Health Conference8:30 am – 4:00 pm Location: Sioux Falls Convention Center Information: www.AveraMcKennan.org; click on Events Calendar Registration: [email protected] or call 322-4645

October 10-11 .. .. .. .. .. .. .. .. CAE Health Simulation in Rural America Conference8:00 am – 5:30 pm Location: Sioux Falls Convention Center Information: Sandi Durick, 605-773-3366, [email protected]

October 12 .. .. .. .. .. .. .. .. .. .. CNOS Foundation Neuroscience Symposium7:15 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 Conference9:00 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 Symposium8:00 am – 5:00 pm Location: Sioux Falls Convention Center Information: www.northcentralheart.com Registration: [email protected], 605-977-5316

November 9 .. .. .. .. .. .. .. .. .. 5th Annual SD eHealth IT Summit8:00 am – 5:00 pm Location: Ramkota Inn, Sioux Falls Information & Registration: http://healthpoint.dsu.edu/summit2012

A few steps awayOur 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.

(605) 33-HEART

Sanford Heart Hospital

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MED-Midwest Medical Edition-September/October 2012

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