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Essentia partners with Sioux Falls' Avera to treat liver disease

FARGO - Patients battling liver disease treated by Essentia Health here now can see a team of specialists visiting from Avera Health in Sioux Falls, S.D.

The partnership means Essentia patients, including those who are waiting for a liver transplant, no longer must travel for specialist consultations or evaluations in places like the Twin Cities or Rochester, Minn.

The team from Avera in Sioux Falls includes a surgeon, nurse practitioners and nurses who travel once monthly to see patients at Essentia Health in Fargo.

"It's a whole team evaluating patients," said Dr. Fadel Nammour, a gastroenterologist who is involved in the collaboration.

For patients, that obviously saves time and money by avoiding trips for medical centers elsewhere.

"It provides better care right here," Nammour said. "I know these patients and I get the opinion of the specialists immediately, instead of one or two or three days."

But it also means that Nammour has a direct connection to specialist consultations, which he said is good for continuity of care.

The Avera team, aided by a hepatologist, a doctor specializing in the liver, pancreas and gallbladder, has a partnership with Aurora St. Luke's Medical Center in Milwaukee.

Liver disease has been rising, Nammour said, in large part because of the obesity epidemic. The accumulation of too much fat can damage the liver, which can develop into cirrhosis.

In fact, non-alcoholic fatty liver disease now is the third leading cause of liver transplants, and rapidly rising.

In 2001, the condition accounted for 1.2 percent of liver transplants. By 2009, the proportion had risen to 9.7 percent.

"I think it's going to be more common, more prevalent than alcohol," as a cause of cirrhosis, Nammour said of liver disease caused by fat.

Essentia's collaboration with Avera to treat liver patients in Fargo is not a precursor to a possible merger, administrators at both health systems said.

Both health systems have Catholic connections. Avera, which once managed the Essentia Health hospital in Fargo, is a rival of Sanford Health in cities including Sioux Falls and Aberdeen, S.D.

"There are no discussions with Avera related to a merger or affiliation or such," said Kevin Pitzer, Essentia Health's chief administrative officer in Fargo.

"It really is an unmet need within the market," he said, referring to the liver treatment partnership. "It's just to assure that our patients can get good consultative services without going out of town."

Essentia Health in Fargo has other partnerships. For example, pediatric cardiologists from Children's Hospital in Minneapolis provide outreach for patients in Fargo.

Dave Fliecek, chief administrator for Avera Medical Group, said the health system provides clinical outreach for many communities when asked.

"We have a cordial relationship with Essentia," he said. "This is really an outreach relationship."

Readers can reach Forum reporter Patrick Springer at (701) 241-5522