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April 30, 2018
This piece is presented by Avera.
At any given moment, an emergency physician is guiding a procedure in Plentywood, Mont.
A pharmacist is helping prescribe for a patient in Keller, Texas.
A nurse is assessing a student in Velva, N.D.
The care is being provided virtually, delivered through digital connectivity from a nondescript building surrounded by other offices in northeast Sioux Falls.
At its helm is a health care leader who has taken an equally low-profile approach in her rise to national success.
Few in Sioux Falls likely realize the breadth of Avera eCare. But from its base at 4500 N. Lewis Ave., its reach is worldwide. It has recorded more than 1.4 million patient visits. And this month, eCare CEO Deanna Larson was named the first American Telemedicine Association Woman of the Year.
“I was shocked,” she said. “You feel humbled because you know there are a lot of people who could receive awards.”
For those who know her well, though, Larson is a natural fit to lead this industry.
Growing up on a Howard farm without running water or central heat, she followed her mother into health care and became a nurse’s aide at age 17 at a local nursing home and worked as a night caregiver at a home for developmentally disabled adults while in nursing school.
Her work as a nurse then took her from frontline roles to leadership, including time as clinical director of cardiac surgery at Mayo Clinic Hospital St. Mary’s in Rochester, Minn., and nursing director of emergency, flights, critical care and adult services at Avera McKennan.
It’s a career path that took her into communities of all sizes, giving her “the opportunity to understand the variances that go on in delivery of care based on the resources available to you,” she said.
And that set a foundation for her leadership of eCare, where geographic boundaries don’t exist, where sophisticated services can be provided regardless of population size and where her work ethic would be required to build a new way of providing care.
“This just feeds me. It fills my cup up,” she said. “I see the ability to help so many patients on a large scale.”
When Larson came to eCare in 2006, it primarily was seen as a function of IT and offered ICU and specialty clinic services.
They were successful, but Larson saw the opportunity to do more.
She saw eCare as a clinical quality initiative – a way to leverage technology to improve patient outcomes and customer service while decreasing the cost of care.
But that would take funding. And Larson secured it. First came grants from the state and federal government to serve rural hospitals. It helped, but not enough to create the 24/7 operation Larson envisioned.
In 2009, a grant from the Leona M. and Harry B. Helmsley Charitable Trust helped launch eCare emergency and eCare pharmacy. By 2012, the eCare hub Larson envisioned launched, creating a virtual hospital with centers for intensive care, emergency, pharmacy, senior care and correctional health.
Today, it is the country’s largest virtual health network, with 10 service lines serving more than 400 hospitals, clinics, long-term care facilities, schools and prisons in 16 states, with four more coming online this year.
Avera eCare added a hub last year in San Antonio, Texas, strategically positioned to provide eCare pharmacy services to Emerus, the nation’s first and largest operator of micro-hospitals with locations in Texas, Oklahoma, Nevada, Idaho and Colorado.
“Telemedicine is just a vehicle of health care delivery,” Larson said. “Everyone needs to integrate it into their practice models. The consumer wants it. It reduces costs, and it addresses workforce issues. This is a delivery model.”
In rural communities, physician recruitment can be difficult and physician burnout can be prevalent. Connecting providers to peers virtually provides a sense of support and camaraderie that makes a huge difference, she explained.
“Rural physicians have been able to collaborate and gain confidence and competence in what they can deliver to patients. There’s less burnout. And it enhances the adoption of current evidence-based practices.”
There are 275 employees dedicated to eCare. But all newly recruited Avera physicians and nurse practitioners are introduced to it.
“We’re setting them up as a provider or receiver of virtual health,” Larson said. “We have numerous physicians tell us they come here for that reason, to be part of telemedicine, and we have physicians choosing to work in those communities because of telemedicine and physicians extending careers in rural communities because of telemedicine, which is very impactful to communities.”
From the eCare hub, Larson works with health care providers nationwide, from Texas to New Hampshire and many places in between.
Her experience has made her “a trusted and knowledgeable partner” for the federal government on telehealth issues, according to Thomas Morris, associate administrator for the Federal Office of Rural Health Policy.
“She continues to be at the cutting edge of how to leverage this technology to meet the needs of rural and underserved communities,” he said.
“When the White House Rural Council wanted to hold a national telehealth stakeholder meeting, they turned to Deanna. When the National Advisory Committee on Rural Health and Human Services wanted to focus on telehealth, it turned to Deanna. In short, she continues to be a sought-after resource for those interested in telehealth policy and the deployment of this technology to improve patient care.”
The Helmsley Trust, which was instrumental in scaling eCare, has become a sustainable model thanks to Larson’s leadership, said Shelley Stingley, director of the trust’s rural health care program.
eCare has built a team that includes outstanding female leaders, Stingley noted.
“Deanna has been instrumental in guiding and mentoring these leaders as the organization grew rapidly,” Stingley said, calling Larson “a role model committed to help women excel in the workplace and health care.”
It’s estimated eCare so far has saved almost 2,000 lives and reduced health care costs by $200 million.
“We could tell story after story,” Larson said. “Rural customers come in and say, ‘This saved my life. This saved my career.’ I’ll never know them, but to hear those stories certainly makes you feel like you had a role impacting their lives.”
It’s a story told almost daily to visitors who come from pre-eminent health care organizations around the world to “look behind the curtain,” as Larson describes it.
“Some will say, ‘Why are you showing them?’ First of all, there will never be enough care. Competitively, it would be extremely hard to get where we are in a short amount of time. But I believe health systems need to do more of this if we’re really going to reduce costs.”
At eCare, evolution is constant. This year will bring an enhanced focus on providing behavioral health services, including help for those battling opioid addiction, and obstetrics, where e-services could include assisting clinical providers in births and treating patients with gestational diabetes.
“I love it. It’s just great work,” Larson said. “I can honestly tell you, come out any day of the week and talk to anybody. People who work here love this work. They see the impact it has and the opportunities that are ahead. How can you not love this job?”
When Deanna Larson became the first American Telemedicine Association Woman of the Year recently, it capped an incredible career in health care.