Avera Health is providing care to patients far from its Sioux Falls, S.D., base and, in many instances, far from its 38 hospitals — as far away as New Hampshire, in fact. The system is one of the many Most Wired health care systems riding a wave of growth in the use of telehealth and has arrangements to provide e-consultation to 235 sites through its telehealth subsidiary, eCare.


“We are now in 10 percent of all critical access hospitals across the U.S.,” says Deanna Larson, senior vice president of quality and eCare. In addition to the 125 sites in which it provides emergency e-consultation, Avera serves 80 clients for e-pharmacy, a number soon expected to grow to 100 based on signed contracts. The system provides services to 130 intensive care unit partners, a number that quickly could double, Larson says.

Avera’s leadership has learned some lessons in the electronic world that may have applications to traditional medicine: A variety of clinical specialists work together in eCare’s offices, a practice that some argue would improve care if followed in the physical world.

Most_Wired_Veline_Jim.jpg “The operation has been very successful at capitalizing on synergy,” says Jim Veline (pictured right), senior vice president and chief information officer of Avera Health. “All of the clinical personnel are essentially within spitting distance of one another. If a doctor needs a pharmacist or a pharmacist needs a doctor or either one of them needs a geriatrician, they can access one another. Capitalizing on that multidisciplinary environment is critical.”