Britton Journal 
Marshall County Healthcare Center is proud to have a rural hospital with state of the art technology, according to hospital CEO Nick Fosness.
Avera eCARE, centered in Avera McKennan in Sioux Falls, is a collaborative effort in which physicians at Avera’s eHelm serve as back up to on-site medical staff in rural facilities. It provides 24-hour access to specialty care providers and pharmacists through advanced tel-communication technologies.
Avera McKennan has installed three electronic service (eService) stations at the Marshall County facility. One is located in the emergency room. The second, up and running since October 2011, is in the cardiac room; and the third is at the clinic for outreach appointments. These stations include web cameras, big screen monitors, hand-held cameras, stethoscopes, and oral airway equipment.
When a patient arrives at the ER, Marshall County Healthcare staff can connect to Avera McKennan through eEmergency with the push of a button. The monitors allow them to interact verbally and visually with the staff in Sioux Falls, and eEmergency doctors can advise the nursing staff until the local provider is on the premises.
Specialized equipment attached to the station includes a hand-held camera to provide a close-up look at the affected area, a stethoscope allows the eEmergency staff to hear the lung sounds or heartbeat and a laryngoscope with a camera allows the eEmergency staff to see the esophagus and offer advice during difficult intubations.
“The nurses and doctors from eEmergency are fantastic to work with. When we have a critical patient, they can take transcription, provide advice, calculate medication dosages, make transfer arrangements and so much more,” Director of Nursing Toni Bray said. “The ability to have a consulting ER doctor and nurse at the push of a button provides a sense of security to our nurses, providers, and patients.”
Walt Roehr knows first hand the importance of those services because he had the misfortune to need them this past summer on June 20.
Roehr flooded his John Deere Model B tractor and being in a hurry, decided to drain the gas right away. It sprayed out of the engine and ignited causing an explosion and a fire.
“I was on fire from my waist up, so I dropped and rolled,” he said. “Part of the fire would go out, but it immediately ignited again. I was on fire from the waist up, so I pulled off my t-shirt, ran 50 feet to a water faucet and turned it on me.
“While running I just kept telling myself how lucky I was to be running and breathing. I got my phone out but my left hand was too badly burned and was useless and my right was blistering.
“I used my thumbnail and pushed 911. I asked them to call the fire truck and my wife Patty so she could come get me. I grabbed my fire extinguisher and put the fire out using tools to break the pin open because I couldn’t use my hands. I called 911 and cancelled the fire truck and asked them to call my brother Randy so he could come and make sure the fire was out.
“I put the dog in the house, grabbed a bucket and filled it with ice water, stuck my hands in it and waited for Patty. But two deputies from the Marshall County Sheriff’s Department drove up first and took me to the emergency room,” Roehr recalled.
As the staff was giving Roehr oxygen and checking his vitals, the television monitor in the ER came on and Roehr was talking with the doctor in Sioux Falls who immediately told the nurses the care needed.
Helicopter services in Aberdeen couldn’t respond because of a storm there, but Avera had a fixed-wing plane between Fargo, ND, and Sioux Falls and they immediately sent it to the Britton airport. The Britton EMT staff met it and brought needed equipment to the hospital, loaded Roehr and flew him to the St. Paul Regional Burn Center.
“My call went in at 4:11 and three hours later I was in the Burn Center,” Roehr said. “Unbelievable service! In two hours, I used our 911, law enforcement, fire department, ambulance crew, and the new eServices. We are such a fortunate community to have top notch crews in all of those areas who do a tremendous job working together. I can’t thank them enough.
“One misfortune of my accident was that I had to shave my beard, which I hadn’t done in 43 years. My family hardly recognized me,” he concluded.
Emergencies are a fairly common occurrence to the Britton facility.
“We had over 100 patients in our emergency room in January and over 1000 in a given year,” Fosness said. “Although we have immediate support in our ER, eServices supports our providers in providing excellent medical care. In the clinic, follow-up appointments can be conducted here so people do not need to spend the time or money driving to another area. It’s a great service.”
Medical Assistant Laurie Nelson is the contact for eServices in the clinic. She pushes a button to connect with Avera’s staff a couple of times a week.
“While I’m taking a patient’s blood pressure and heart beat, they receive that information, also,” she said. I use the hand-held camera to zoom in and out of a wound or any problem we have. We’ve been busy with the infectious disease specialist there. It’s a terrific new resource for us.”
Marsha Block is one of the many Registered Nurses on duty at Avera McKennan.
“We are connected with 102 hospitals in South and North Dakota, Iowa, Minnesota, Nebraska, Montana, and Wyoming,” Block said. “We assist staffs with all medical emergencies, transfers, and just about anything a patient needs. We have specialists in many areas to lend top medical care to rural settings.”
The eHelm plan is named after Leona Helmsley, a New York real estate tycoon, known as the “Queen of Mean.” She earned her nickname for the way she treated employees. She repaired some of the negative image when she paid for all the start-up costs for eServices for Avera centers through the Helmsley Foundation. This is one of many excellent rural healthcare initiatives that this foundation has assisted to fund.
“Our challenge is to continue funding the expensive program,” Fosness said. “We have been able to find the money so we can keep patients here and save lives.”
Fosness is quick to add that eServices does not take over the case. “They are there for support and counseling,” he said. “They research our problems and have expertise we could not afford. It allows us to better meet the needs of multiple and critical ER patients. We are excited to be able to offer this valuable service to our community.”