December 2018 MED Cover Story

As the regional leader in medical community news, MED is devoted to bringing you in-depth coverage of the projects, research, initiatives, expansions, and clinical advances that are consistently putting our region on the map and earning us recognition for some of the highest quality, highest value healthcare in the US. We do it by seeking out the interesting, intelligent and innovative personalities behind these stories.

As we wrap up our publication year and look back at 2018, we are devoting this article to highlighting some of our top interviews in each category. We hope that it inspires you to feel proud of the extraordinary work you and your medical colleagues are doing here and that it sparks some ideas that could help direct MED’s coverage in the coming year.

Leadership

This year, after more than four decades at the helm of Avera Health, and on the brink of his 70th birthday, President and CEO John Porter retired. In a March interview we asked him to name the accomplishment he was most proud of. “The fact that we were able to take these two disparate Catholic groups who had been engaged in their own separate ministries for 100 years and bring them together,” said Porter. “At one time, they saw each other as competitors. To have them come together and share a vision of a system that could be stronger and bigger, that was significant.” Read More »

The system that Porter helped unite took center stage in April/May when we featured The Presentation and Benedictine Sisters of Avera Health on MED’s Cover. System Member chair, Sister Mary Kay Panowicz of the Yankton Benedictines - Sacred Heart Monastery told MED, “We are the premier eHealth system in the country. Telemedicine has helped us not only save money and improve the quality of care in rural areas, but it has also made it easier to recruit providers into these areas. It’s about Christ serving the world through us.”
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MED’s September interview with Jill Fuller, recently-retired President/CEO of Prairie Lakes Healthcare System in Watertown, contained this nugget of wisdom for anyone beginning a journey in healthcare administration: “I think it is important to really learn the culture of your organization,” advised Fuller. “ In our case, our culture is very unique and we have been successful because of it. You need to listen and learn, which is going to help you build your relationships. When you understand the context, you don’t try to apply cookie cutter solutions. Read More »

Regional Health’s new President/CEO, Paulette Davidson, who worked her way to the top from hospital housekeeping, was our cover feature in November. “Community healthcare is vital for industry. It is the economic engine of the community,” Davidson told MED as she detailed the health system’s 5-part ‘roadmap’ for the future. “Our intention is to be here to take care of our grandchildren and our grandchildren’s grandchildren. That means we have to make good decisions so that we can support the other four missions.”
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Sioux Falls Surgeon Gary Timmerman, MD, became the second South Dakota physician to serve on the American College of Surgeons Board of Regents. Timmerman is one of 23 regents that direct the 80,000 member ACS, considered one of the world’s foremost medical organizations. A professor and chair of the USD Sanford School of Medicine department of surgery, Timmerman has been active with the ACS for more than 20 years. Read More »

MED loves to share the insights and experiences of regional healthcare leaders. Are you a leader with something to share? Contact us any time at info@MidwestMedicalEdition.com

Research

Sanford Health gave a boost to its global brand and fostered new connections with the announcement of the $1 million Lorraine Cross national research award covered in MED’s January/February issue. “Sanford already has a national and international reputation for developing treatments and innovations,” David Pearce, PhD, executive vice president of Sanford Research said. “Our idea was, let’s see if we can find and reward others like ourselves who are pushing the limits. The process will probably bring more individuals to us that need someone like us to help push their project across the finish line.” Read More »

Sanford’s second trial of adipose-derived stem cells began this year with Sioux Falls plastic surgeon Bradley Coots, MD, at the helm. Coots was a sub-investigator on the first stem cell trial for rotator cull injuries. The new trial is focused on non-healing leg ulcers. “Wounds are a huge burden on our healthcare system, in the billions of dollars,” Dr. Coots told MED in January/February. “If we can speed up the healing process, it is going to save money, improve lives, and get more of these patients back into society.”
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Regional Health radiation oncologist, Daniel Petereit, MD, graced the MED cover in March for his groundbreaking work in addressing cancer disparity among Northern Plains American Indians through the Walking Forward program which he started in 2002. Early this year, Bristol-Myers Squibb Foundation approved a 3-year 1.6 million dollar grant for the next iteration of Walking Forward— Increasing Lung Cancer Screening for High Risk Smokers in a Frontier Population project—a low-dose CT screening project which began in May. “A big part of the program was just gaining the trust of the tribal community,” Petereit told MED. Read More »

Also announced in March, another researcher with expertise in health disparities, Amy Elliott, MD, and members of her research team joined Avera Research Institute as the Center for Pediatrics and Community Research early in the year. Dr. Elliott has been a principal investigator on several NIH-funded research projects including an initiative to reduce infant mortality in American Indian Communities. In August, her lab secured a $17.1 million NIH grant for its work on a children’s health study called ECHO. “We are the only site in the middle of the country,” said Dr. Elliott. “This is great opportunity for us to represent rural populations and the Midwest.” Read More »

In a discussion of the challenges of including more women in clinical trials in March, Sanford researcher and USD Sanford School of Medicine clinical instructor Lora Black told MED, “It’s not just about equal representation. Men and women differ at the cellular level. Women have different organs and different hormones. Sometimes even cycles can affect medications and dosages, etc.” NIH no longer funds projects that do not include a gender breakdown in animal trials and report on the sex, race, and ethnicity of the people enrolled. Black says it is incumbent upon providers to invite eligible female and minority patients into clinical trials. Read More »

In the April/May issue, MED announced that The Sanford Project: T-Rex Study, a Phase 2 clinical trial on diabetes in children, enrolled the last of its 110 trial participants. The project is studying the potential of a cell therapy developed by Caladrius that uses each patient’s own regulatory T cells, or Tregs, to fight type 1 diabetes. “It is still a long way from having the answer, but reaching full enrollment essentially tells us that we are going to get there,” said Kurt Griffin, MD, PhD, director of clinical trials for The Sanford Project. Read More »

In the same issue, MED reported that Children’s Hospital & Medical Center and the University of Nebraska Medical Center (UNMC) would take part in one of the nation’s first large-scale trials of clinical whole-genome sequencing (cWGS) in the neonatal and pediatric intensive care unit (NICU and PICU) environments. “In the next 10 years, we will see a dramatic shift in the implementation of precision neonatal medicine, coupled with improvements in areas such as ventilation, nutrition and pharmacogenomics,” said Luca Brunelli, MD, PhD, Children’s Specialty Physicians, Division Chief of Neonatology at Children’s.
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The KEYNOTE trial on the immunotherapy drug pembrolizumab (Keytruda) at Sanford Health, which wrapped up in 2018, had important implications for non-small cell lung cancer patients in the region. Thanks to Sanford’s involvement, patients with an illness that is often fatal within a year, had access to a promising new treatment long before they might otherwise have even heard about it. “Now we can run any National Cancer Institute trials, we get to pick from pharmaceutical trials, and some of the universities are even contacting us,” lead investigator Steven Powell, MD, told MED in June. “It is great to be able to offer cutting-edge trials to our patients.” Read More »

Sanford Health and medical technology company Inanovate have launched a clinical trial to confirm the accuracy of a breast cancer blood test developed by Sanford researcher and breast cancer survivor Kristi Egland, PhD. Egland says it was her diagnosis that drove her to develop the new test. “I was thinking, I want to be able to make a test that can monitor patients during treatment and after that would hopefully be sensitive enough to detect recurrence,” Dr. Egland told MED in September. “That could give us a shot at curing more patients.”
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When the winners of 2018’s Nobel Prize for Medicine were announced in October, we turned again to Sanford Researcher Steven Powell, MD, an immuno-oncology researcher to share his thoughts in the November issue. “These guys found a piece of the puzzle that was integral to making immunotherapy work,” said Dr. Powell. “We now have about a half dozen trials looking at other immune checkpoints, besides the ones identified by Allison and Honjo. We are also trying to learn how to use immunotherapy with chemotherapy, radiotherapy and other treatments to get the most out of it.”  Read More »

 Are you a researcher (or know one) doing something extraordinary? We want to know about it. Contact us at info@MidwestMedicalEdition.com.

Expansions and Initiatives

Sioux Falls Specialty Hospital opened its first urgent care facility just over a year ago in Sioux Falls. In January/February, CEO Blake Curd, MD, talked to MED about what makes this facility different from other area urgent cares. “For one thing, it was built from the ground up to be an urgent care facility,” said Dr. Curd. “Secondly, a significant portion of the building will be dedicated to occupational medicine. We are the first facility to put these two things together.” Curd says the facility was designed without a central waiting area to make patient flow more streamlined and efficient. Read More »

In March, Rita Blasius, President and CEO of Avera St. Benedict in Parkston, spoke with MED about the pervasive problem of housing medical workers in rural areas. “Many times, we have had the chance to hire someone but couldn’t find a place for them to live in our community,” said Blasius. In partnership with Avera and the Parkston Area Development Foundation, the hospital helped fund a four-plex housing unit specifically for healthcare workers. Meanwhile, SDAHO has established a website dedicated to supporting facilities like Avera St. Benedict in their efforts to create more workforce housing. Read More »

The American Hospital Association invited physicians to “Lead Well. Be Well. Care Well” as part of a new initiative to support well-being and encourage leadership among medical professionals. AHA Senior Vice President and Chief Medical Officer Jay Bhatt, MD, told MED in the April/May issue, “As healthcare delivery changes from fee-for-service to a value-based system, it is incredibly important to have physicians shaping the future along with administrative leadership.” The initiative provides tools and resources for senior physician leaders at AHA member institutions as well as frontline employed physicians. Read More »

In the spring, Prairie Lakes Healthcare System in Watertown became the only independent hospital in the region to make the iVantage list of Top 20 Rural Community Hospitals. In June, MED asked then President and CEO Jill Fuller how this hospital in a town of just 22,000 people made the cut. “Our board made a strategic decision in 2003...that we were going to better serve the 90,000 people in our 10-county service area by expanding our services,” said Fuller. The hospital recently built a $32 million dollar specialty clinic and offers more than 10 specialties including cardiology, nephrology, and wound care. Read More »

The Sioux Falls VA Health Care System was recognized once again this year as a leader in LGBT Healthcare Equality by the Human Rights Campaign Foundation, the educational arm of the country’s largest LGBT civil rights organization. The VA is the only healthcare facility in South Dakota to receive the honor, which is awarded to facilities that meet key criteria for equitable care, including nondiscrimination policies and LGBT health education for staff. “It is not just about having policies in place that say we’re LGBT friendly,” says VA primary care social worker Tammy Reiff. Read More »

In the July/August issue, we highlighted LSVT Big & LSVT Loud, programs that are allowing Parkinson’s Disease patients at Sanford facilities in Vermillion and Canton to make major strides in their ability to move and speak more normally. “Having them concentrate only on being loud improves not only volume but articulation, pitch range, and even swallowing,” said Speech-Language Pathologist Candace Zweifel, MA, CCC-SLP. LSVT Big adopts the same concept to improve slow walking and small movements. 100% of LSVT Loud patients report improved communication while LSVT Big patients walk faster and have better balance. Read More »

The Sioux Falls VA Healthcare System is in year two of a bold experiment integrating physical therapy into primary care. Since 2016, patients who visit the VA’s primary care clinic for a musculoskeletal issue see a PT first, cutting out the time and delay involved in getting a referral first. “We are meeting the veteran’s needs comprehensively and providing better care while simultaneously saving time for the primary care doctor,” said Brandon Peterson, DPT, Cert. MDT, who heads up the project. “Our VA is setting a model for other VAs as well as private sector hospitals.” Read More »

As MED told you in September, Regional Health Heart and Vascular Institute has reduced the number of patients who seek care for heart failure in the ED, as well as the number of patients who are readmitted for HF. Through a combination of education, interventions such as IV diuretic therapy, and monitoring, the multidisciplinary Heart Failure Clinic provides both an alternative to the emergency room and peace of mind for HF patients and their doctors. “If their heart function is less than 35 percent and no one is keeping a close eye on them, they may end up with a defibrillator down the road,” said the clinic’s Jessica Tvedt, CNP. Read More »

Avera Cancer Institute’s sixth location, the Helmsley Center in Pierre, held a grand opening in September. The 57,000 square foot facility connects patients with radiation and medical oncologists, oncology nurses, and radiation therapists, as well as a physicist and dosimetrist. In a March interview, Pierre oncologist Sreekanth Donepudi, MD, said the center will help him and his colleagues deliver better care. “At least a third to a half of cancer patients need radiation therapy,” he said. “It is difficult to tell patients they have to go somewhere else for six to eight weeks of treatment.” Read More »

What expansions and new initiatives are going on where you are? MED wants to know! Send news our way at info@MidwestMedicalEdition.com

Clinical Advances

MED’s first cover story of 2018 focused on Warsaw natives and Sanford cardiovascular disease specialists Adam, Maria, and Tomasz Stys of Sioux Falls who are responsible for significant advances in heart care at Sanford. As director of the Women’s Heart Program, Maria Stys is active with AHA’s “Go Red for Women” and has worked to establish a clinic for pregnant women with heart disease. Her husband Adam helped establish Sanford’s cardiology fellowship and was a major force behind the Heart Hospital. His younger brother Tomasz, medical director of Sanford Cardiovascular Institute, counts the transcatheter aortic valve implant (TAVI) program among his proudest achievements at Sanford. Read More »

People with non-healing wounds in Aberdeen got easier access to hyperbaric oxygen therapy thanks to the installation of two hyperbaric oxygen chambers early in the year. “What was happening is that patients who needed this treatment just weren’t getting it,” Chief Nursing Officer Cory Geffre said in MED’s January/February issue. Before the new chambers were installed, the nearest hyperbaric chambers were in Fargo, Sioux Falls, or well into Minnesota and many patients were unwilling or unable to travel for treatment. Read More »

Prairie Lakes Urologist Chris Adducci, MD, brought transurethral radiofrequency thermal therapy with the Rezum system to qualified Watertown patients who either want to get off medication for BPH or avoid it altogether. “This represents the latest in-office procedure for BPH but it is one that is very, very tolerable,” Dr. Adducci told MED in March. Adducci says Rezum can be used for a wider range of patients than some other minimally invasive BPH treatments and does not cause incontinence or ED. Read More »

Cardiothoracic surgeon Ali Ibrahimiye, MD, of Children’s Specialty Physicians in Omaha introduced several complex cardiothoracic surgical procedures as part of the new Pulmonary Artery Rehabilitation Program at Children’s Hospital and Medical Center. One of the new procedures offered is unifocalization, a procedure to repair tetralogy of Fallot with pulmonary atresia and major aortopulmonary collaterals. “A surgeon has to do a lot of these operations to learn how to do it well and be comfortable performing it,” Dr. Ibrahimiye said in a March article. Read More »

Dakota Lions Sight and Health in Sioux Falls became one of just a few elite eye banks in the country to begin offering pre-loaded corneal tissue for transplant surgery. In the April/May issue, Fargo ophthalmologist Dr. Michael Greenwood of Vance Thompson Vision, told MED that the Descemet Membrane Endothelial Keratoplasty (DMEK) grafts make the corneal transplant procedure less stressful for everyone involved. “It not only saves me a step but it also means that I don’t have to worry about the possibility of making a mistake while I am preparing the tissue,” he said. Read More »

CNOS orthopedic surgeon Brian Johnson, MD, of Dakota Dunes has become a regional expert in a procedure that attempts to get around one of the problems inherent in a diseased or injured rotator cuff: the fact that it is unlikely to support a standard total shoulder replacement. Johnson performs reverse total shoulder replacements, which reverse the ball and socket of the shoulder joint. As MED reported in April/May, Johnson has performed more than 500 of these procedures over the past 11 years. “This procedure offers options for something that didn’t have options,” he said. Read More »

Avera gynecologic oncologist Luis Rojas, MD, is changing the way endometrial and cervix cancers are being treated in the region. Instead of removing as many lymph nodes as possible throughout the pelvis, which results in lymphedema in nearly half of patients, Rojas now dissects only the first set of lymph nodes — or sentinel nodes — into which the uterus drains. “We know that the sentinel nodes are the nodes with the highest likelihood of having metastatic disease,” says Rojas. In the first 20 test cases at Avera, the sentinel nodes were 100 percent accurate in predicting the presence of metastatic cells in other nodes. Read More »

Regional Health Rapid City Hospital began offering therapeutic plasma exchange or plasmapheresis for patients with autoimmune conditions such as lupus, Guillain-Barre, Goodpasture syndrome, and myasthenia gravis. “We can now treat them by combining a treatment like TPE to remove [immunoglobulins and antibodies] with immunosuppressive therapy to stop their production,” nephrologist Ebima Okundaye, MD, told MED in June. Before TPE was available, some patients declined treatment or took higher doses of immunosuppressants to avoid having to travel to get treatment. Read More »

As MED reported in July/August, Brookings Health System became the second facility in South Dakota to offer robotic-arm assisted total knee, partial knee and total hip replacements with Stryker’s Mako System. The Mako system negates the need for manual templates and cutting blocks, allowing for a truly personalized approach to surgery based on each patient’s diagnosis and anatomy. “Now, I can say, let’s take another ½ mm off of the end of the femur and then reassess,” said surgeon Mark Mayer, MD, who relocated to Brookings this year. “You can make that decision during surgery.” Read More »

Rapid City pulmonologist Muhammad Alsumrain, MD, brought a higher level of knowledge on a range of complex and rare lung disorders to Regional Health this year. Alsumrain has been fellowship trained in interstitial lung disease and pulmonary vasculitis at Mayo Clinic. “In the past, we often had to send patients for surgical lung biopsy to confirm the diagnosis,” Dr. Alsumrain told MED in July/August. “But with more understanding of the different radiographic findings and ordering the right blood tests, we have been able to decrease the likelihood of needing surgical intervention to make a diagnosis.” Read More »

In July/August, MED also introduced readers to the eye-opening power of UV photography and skin analysis with VISIA at The Body Garage Medical Spa in Sioux Falls. “With this tool, we can look for skin cancer, fine lines, do pore counts and, most impressively, perform a UV damage index,” said plastic surgeon Richard Howard, MD. Howard and his son Tom use VISIA to determine skin type, texture, special needs, etc., in order to recommend a product or procedure that may help prevent further damage. “It’s just like exercise,” says Dr. Howard. “If you quit taking care of your skin, you lose the effects.” Read More »

In November, we reported that interventional radiologist Charles Voigt, MD, had begun performing Selective Internal Radiation Therapy (also called radioembolization) at Regional Health Rapid City Hospital. The minimally invasive procedure involves injecting tiny resin beads filled with the radioactive isotope yttrium Y-90 into the blood vessels that feed liver tumors. The microspheres block the tumor’s blood supply while the radioactive isotope destroys cancer cells. “We felt it was important to bring this here because, once cancer happens inside the liver, systemic chemotherapy is not usually very effective,” said Dr. Voigt. Read More »

MED wants to know about the clinical advances happening at your institution. Send your suggestions our way at Info@MidwestMedicalEdition.com.

Interesting People

LifeScape’s Medical Director of Rehabilitation Services once swore she would never be a physician. In January/February, Kate Sigford, MD, told MED that watching her parents return to med school late in life convinced her that it was not for her. “I thought it just looked like an awful lot of work,” said the physical medicine and rehabilitation specialist. But she was eventually drawn to PM&R for its ability to deliver “whole person” care without what she saw as the downsides of primary care. “When I started doing my primary care rotation, I realized that I couldn’t do coughs and colds every day,” said Sigford.
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In March, Martin Digler, a PA at Regional Health Heart and Vascular Institute, told MED the story of his harrowing escape from violence, disease and poverty in his West African homeland of Liberia. Joel Swiesow, a Rapid City man on a two-week mission trip to Liberia in 1999, eventually arranged Digler’s move to the US, hosted him in his home, and helped him pursue a college education. After graduating from the School of Mines and Technology, Digler earner his PA at Long Island University and returned to the Black Hills to work. “God just opened up the doors for me,” he says. Read More »

Rapid City plastic surgeon Hunter Moyer, MD, was an established expert in breast reconstruction in Atlanta when his wife was diagnosed with breast cancer at the age of 35. His personal experience, along with his training in Emory’s large breast reconstruction program, have made him especially passionate about this area of plastic surgery. “The first goal is to eradicate disease,” Dr. Moyer said in a March interview with MED. “But a lot of studies and my personal experience has shown that the secondary goal of restoring form can have a huge impact on how women feel about themselves.” Read More »

In the April/May issue, we brought you a profile of Allison Wierda Suttle, MD, MBA, Chief Medical Officer at Sanford. Suttle is the Daughter of a Sioux Falls radiologist who grew up around medicine. After a decade as an Ob/Gyn, Suttle earned an MBA at USF and, in 2015, became a full time administrator. “It is an amazing time to be in healthcare,” said Suttle. “It’s fascinating to think about our work as physicians and how that changes. We are now moving into more collaboration with patients.” Suttle keeps herself connected to the healing arts as a part time yoga teacher. Read More »

Sanford’s Chief Medical Analytics Officer, Sioux Falls Pediatrician Benson Hsu, MD, became one of 24 people chosen from a pool of 751 applicants to receive a 2018 Bush Fellowship. The fellowship provides up to $100,000 over 1 to 2 years. Dr. Hsu told MED he wants to use the money to find better ways of stopping preventable childhood illnesses and injuries. “I always have this lingering thought: Is there something we could have done to keep this child from needing care in the first place?” said Hsu. “My mind goes to immunization, nutrition, seatbelts, ect.” Read More »

Vascular medicine specialist Michael Bacharach, MD, spoke to MED this summer about the origins of the Avera Heart Hospital which grew from a program he helped to start at North Central Heart. “[The Heart Hospital] consolidated and improved heart care in the community and became a model for the future, too,” said Bacharach, who came to Sioux Falls from Cleveland Clinic in 1995 for what he expected to be a short-term stay. “Although Sioux Falls was a small community, it had skilled, well-trained subspecialists and offered advanced procedures,” he said. Read More »

Sanford geneticist Cassie Hajek, MD, told MED in July/August that she expected to have to leave her home state of South Dakota for good when she decided to move from primary care into complex genomic medicine. She had left the area twice before, first to pursue an engineering degree and later to do her primary care residency. But after her medical genetics fellowship at UCLA, Hajek found just what she was looking for in Sanford’s Imagenetics program. “What we are doing here at Sanford is very rare,” she says. “I knew it was a huge opportunity that I would be unlikely to find elsewhere.” Read More »

In September, MED gave readers a firsthand look at the impact of corneal transplant with the story of a Renner man who has been living with his for more than 20 years. Mike Nieman was just a teenager when he began to experience the effects of Fuch’s Dystrophy. Full thickness corneal transplants in the late ‘90s and laser surgery in 2005 eventually fully restored his sight. “Nieman’s transplant is special because he is among the 71 percent of PK transplants with 20/20 vision after 15 years,” said Marcy Dimond CEO of Dakota Lions Sight and Health. “I did not fully appreciate at the time what it really meant to receive donor tissues,” said Nieman, who now serves on the DLSH board of directors. Read More »

Our September cover story, CNOS Sports Medicine Specialist Ryan Meis, MD, of Dakota Dunes, has become a fixture on the sidelines of high school, college and championship sports events in the region. Meis has a passion for managing complex shoulder, knee, and elbow injuries and performs advanced procedures like arthroscopic shoulder surgery, multi-ligament knee repair and ulnar collateral ligament reconstruction. He told MED he felt “drawn” to the CNOS clinic, which integrates orthopedics and neurology. “We manage on the sidelines, provide care if there are injuries, and...have physical therapy to help them recover,” said Meis. Read More »

Family medicine physician Mark Ptacek, MD, of Lead-Deadwood Regional Hospital and Clinic, was first introduced to the world of aviation in medical school in Omaha. He earned his pilot’s license in his second year of residency and has even built his own plane. A long-time member of the Flying Physicians Association, Ptacek has this advice for healthcare professionals considering aviation: “I encourage young docs, especially if they are going to be in a rural area, to get a pilot’s license. If you are bitten by the ‘aviation bug’...it is a very good fit with medicine.” Read More »

Last month, we brought you the story of Thomas Asfeldt, RN, BAN, MBA, Director of Outpatient Cancer Services at Sanford who had a very personal experience with palliative care this summer. Asfeldt spoke to MED about the loss of his father-in-law and how palliative care helped to make his passing easier on him and his family by clarifying goals and making a plan. Asfeldt’s experience has made him an even more vocal advocate for palliative medicine. “It improve quality of life and decreases the cost of care. Why would be not want to use it for every appropriate patient?,” he said. Read More »