Clinic services expand
In the past few years, the face of health care in Detroit Lakes has undergone some extensive changes.
Besides the changes in name — St. Mary’s Regional Health Center merged with Dakota Clinic and is now Essentia Health St. Mary’s, while MeritCare has become Sanford Health — there have been big infrastructure and personnel changes to both local organizations as well.
Essentia Health St. Mary’s
In 2008, St. Mary’s completed a 40,000-square-foot addition to its campus that encompassed both a new, integrated Therapy Center and an expanded nursing home — with the name of that nursing home being changed as well, from St. Mary’s Nursing Center to Oak Crossing.
In May 2011, St. Mary’s EMS completed a construction project of its own, which included 10,939 square feet of space for a garage, office, two conference rooms and a kitchen.
And in August 2011, work was completed on a 49,315 square foot remodeling and expansion project at the Essentia Health St. Mary’s Clinic, which includes 90 exam rooms, nine procedure rooms and seven registration desks.
There is now one main entry for the hospital and the clinic, which is located off Frazee Street, along with new patient and visitor parking on the east side and a drop off lane at the main entrance.
There is also a retail pharmacy, complete with drive-through, and Urgent Care is open from 8 a.m. to 8 p.m., seven days a week.
A remodeled lab and gift shop were included in the project as well, along with additional office and locker room space. But the renovations still aren’t complete.
“This year, we are embarking on a project to expand and renovate our imaging (radiology) and emergency departments,” said EHSM President Peter Jacobson. “The construction on that will begin in April, with the first phase slated to be completed in the fall of 2013 and the final phase to be completed in the spring of 2014.
“We are also just completing our new clinic in Frazee, which will open on April 15, with our grand opening set for April 23.”
Another clinic was opened in Pelican Rapids in October 2011.
Besides all these infrastructure improvements the hospital also made several equipment upgrades in 2011-12, such as adding a new MRI machine, OB fetal monitors and ultrasound units, new urology instrumentation, EKG units and pulmonary function testing equipment.
And that’s just the physical changes.
“This last year we’ve added a number of physicians to our organization, including two pediatricians, two in internal medicine and an additional family practice physician,” said Jacobson. “Those are all local positions. We’ve also expanded outreach services in Detroit Lakes to include an orthopedic physician specializing in treatment of hands, and we will shortly be adding a position that specializes in the treatment of chronic pain. This summer, we’ll be adding dermatology as well.
“We also have three urologists who come in from Brainerd to work with our DL urologist, who’s here full time. We now have urology coverage at the clinic four days a week.”
In all, Essentia Health-St. Mary’s employs about 850 people in the Detroit Lakes, Lake Park and Frazee area, both full and part-time, Jacobson said.
EHSM has also made a significant investment in information technology the past couple of years.
A new electronic health record system went online at both the hospital and clinic in January 2012. This system, known as Epic, is used in all Essentia Health facilities, which means a patient’s records are fully transferable between those facilities, in a matter of minutes.
“Regardless of where a patient is being treated in our system, those people who are taking care of them will have access to all of their information,” Jacobson said. “It was a lot of work bringing it online, and now we’re really starting to see the value of using it for patients both in terms of service and quality (of care).”
Now that the function known as “My Health” has been fully enabled, patients themselves are able to access their own medical records electronically, send messages to their physicians electronically and even schedule their own medical appointments, Jacobson said, adding that he recently took advantage of this function on a Sunday morning to schedule an appointment with his physician the next day.
“It took about 45 seconds (to schedule the appointment),” he said. “I also had my lab work done that Monday and was able to access my results two hours after I had the test done.
“It (the Epic system) will help us in lots of ways — it just helps tie everything together as a system,” he said.
Recently, EHSM also completed the requirements for becoming an accredited accountable care organization — one of only six in the U.S. that has received such accreditation thus far.
“It means we’re accountable for both quality of care, and cost,” Jacobson said.
Ultimately, Jacobson noted, the vision of EHSM is “to continue to position ourselves for the future of health care, which is focused on improving the health of the overall population, improving individual patient experience, and doing it at a lower cost per capita.
‘Everything we’re investing in now is to position us to do those things in the future, by being part of an integrated health system,” Jacobson added.
Not to be outdone, Sanford Health announced plans in 2009 for a 33,000 square foot expansion and 28,800 square foot remodeling project at its existing Detroit Lakes clinic — to the tune of about $15 million.
The expansion was announced just days after the local clinic’s merger with Sanford Health was finalized.
Completed in October 2011, the clinic’s 60,000 square feet of total space now encompasses a Surgery Center with two operating suites and an endoscopy suite; expanded imaging and lab services; expanded and relocated physical and occupational therapy spaces; outdoor space for mobile medical units with over-head canopies on the south and north entrances; and expanded clinic space for future growth of up to 36 providers, both primary and specialty care.
“Our pharmacy and optical shop got completely redone as well,” said Sanford Director of Clinic Operations Breanna Adams.
The newly updated optical shop celebrated its 25th anniversary in 2012, she added.
One of the biggest moves was bringing behavioral science, which was down the block from the main clinic, under the same roof.
“It’s integrated care, because they work so close with family physicians already,” said Adams.
Services now offered at the Detroit Lakes clinic include dermatology, diabetes education, dialysis, hematology, nutrition, obstetrics and gynecology, oncology, optometry, orthopaedic surgery, internal medicine, family medicine, psychology, physical and occupational therapy, occupational medicine, surgery and urology.
Staffing changes completed in 2012 included the addition of psychiatrist Dr. Morris Hund and family physician Dr. Ram Kafle in August; and Dr. Jeff Andersen joining Sanford’s walk-in clinic in February.
Another change coming in 2013 is the addition of Dr. Steven Glunberg at the walk-in clinic.
“Our goal is to have a physician on site at the walk in clinic five days a week — right now we only have one there Monday through Thursday,” Adams said. “We are very excited to have him (Dr. Glunberg) come aboard with us.
“In August, Dr. Nicole Cox will be joining our internal medicine department, and Dr. Nick Esala will join our family practice department.”
Like EHSM, Sanford has also made a considerable investment in updating its technology, and on April 4, Sanford will officially switch over to the OneChart system of maintaining electronic medical records, Adams said.
One Chart offers many advantages — the most important being that patients can visit any clinic or medical center across the Sanford health system and their medical information will be immediately available for the medical professionals caring for them. There will no longer be a need to have records faxed, photocopied or hand-transferred.
Patients will notice some changes, Adams said. Billing statements will look different. They will also be asked to validate their contact information and insurance coverage, have a photo taken for their online records.
“This going to require a little extra time up front for the patient but I’m very proud to offer this service because I know how much it will enhance the care I provide for them,” said Dr. Jon Larson, Sanford physician. “This service ensures our patient’s information is securely available anywhere in the Sanford health network.”
Another change that took place in December is that Sanford officially completed the process of being “Medical Home certified.”
The clinic now employs one full time RN strictly as a “health coach,” whose job is to coordinate patient care before, during and even after each clinic visit.
“We hope to have two RNs completely devoted to coordinating patient care within the year,” Adams said.
Medical Home is a program that offers team-based, coordinated care, focusing on the whole patient rather than one specific aspect of their overall health needs.
Patients are treated from a whole person perspective, rather than just looking at the specific medical issue that brought them to the clinic.
“It helps us be more prepared, and proactive,” said Colleen Bauck, RN, who serves as health coach for the clinic’s Medical Home program.
As an example, a patient enrolled in Medical Home might come into the clinic for acute care, such as for an injury or virus, but the doctor will also assess their progress in treatment of a chronic illness or medical condition as part of the same appointment.
“Our goal is to improve patient outcomes, to decrease acute care visits and increase preventive care visits,” Bauck said. “Ultimately, our goal is to keep them healthier … to keep them out of the hospital.
Under the Medical Home model, a team-based approach is taken to the patient’s health care.
Each patient’s care team includes at least one primary care provider, the RN health coach, specialty care providers, clinic staff and family members — with the patient as an active participant.
“Basically, we’re engaging our patients in their own health care,” Bauck said. Participation in the program is voluntary, she added, but candidates who are recommended for Medical Home by their primary care provider usually meet one of the following criteria:
- Multiple and/or chronic illnesses
- Unstable or newly diagnosed illness;
- Taking multiple medications;
- Special health needs.
“The patient always has a choice — they have to agree to participate,” Bauck said. “A patient can also request to be enrolled if they feel they are struggling with self-management or they do not have the support or resources (to manage their own health care) … a family member can request it too.”
What this means to the patient, Adams noted, is that they will be receiving additional care services outside the clinic, at no added cost.
“The patient doesn’t get billed for the care coordination services,” Adams said.
As part of becoming “medical home certified,” Sanford has also established a patient advisory board, whose task is to focus exclusively on patient satisfaction — things like reducing the time patients have to wait at the clinic before their appointments, and reducing the time they have to wait before they can actually schedule an appointment.
One other change that occurred in 2012 is that Sanford-DL occupational therapist Jane Leno became certified in two different intensive therapy programs, the LVST BIG program, which is used in the treatment of Parkinson’s patients; and another for the treatment of lymphedema, a chronic condition that causes swelling of a patient’s arms and legs.
“Some of the research they’re doing shows that it (BIG therapy) can slow down the progression of Parkinson’s at the brain level,” Leno said. “It has other benefits too — helping patients to move faster and increase their functional skills.
“It’s been working great. The patients love it.”
Leno also helps lymphodema patients in a couple of different ways: A massage technique that helps with drainage of the lymph from limbs and decreases swelling; and providing compression bandaging to help decrease swelling.
“We eventually transition to compression garments that they can wear at home and manage without me,” Leno said.
“I also do a lot of hand therapy, working with patients who have carpal tunnel, tendonitis and De Quervains syndrome (a form of tenosynovitis),” she added.
Back in August, Sanford also completed the process of being accredited by the Joint Commission for continuously providing “safe, high-quality care, treatment and services.” The accreditation is good for three years.
“It’s an exciting time here at Sanford,” Adams said. “We’re always developing, expanding and changing, but it’s all behind the scenes, while we still continue to provide the best possible care to our patients.
Ultimately, she added, the goal is to lower patients’ healthcare costs by keeping them healthier.