Brian Skow, MD, MBA, CPE, FACEP and Troublemaker at Avera eCARE

How do you save a patient who fell into a den of rattlesnakes, received anti-venom, then suffered a severe and life-threatening reaction and is not physically anywhere near you? Dr. Brian Skow can tell you.

That’s because Dr. Skow, Chief Medical Officer of Avera eCARE, and his colleagues are experts in telemedicine. But not the kind of telemedicine that we’ve heard about recently in the face of the Coronavirus pandemic. Rather, these practitioners in all fields of medicine are experts in providing myriad services to critical access hospitals and their patients across the country.

The Backstory

Critical access hospitals are necessary for the survival of communities. They are usually rural hospitals lacking the resources of their urban counterparts. To fill the staffing and patient needs of these hospitals in areas such as 24-hour emergency medicine and specialties like intensive care, Avera Health, a 35-hospital system based in Sioux Falls, South Dakota, started Avera eCARE in 1993 to provide those services.

Avera eCARE telehealth services reach more than 500 facilities across 32 states and have interacted with more than two million patients since its founding.

Dr. Skow joined Avera eCARE originally as Medical Director of Avera eCARE Emergency and has logged more than 15,000 hours of direct patient telehealth care. He came to the telehealth services side after serving as an Avera Emergency Physician for 17 years. “What drew me into this really was that we found a need, a problem, and we innovated our way into it,” he says.

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The Solution

To say that the entire organization came about because of one patient isn’t a stretch. According to Dr. Skow, the very first patient treated was a judge in a rural community who needed to see an oncologist. The judge wasn’t able to drive the three hours to get to the facility for the evaluation. Instead, they were able to do the full evaluation over the camera.

“As you can imagine, the technology was quite a bit different 27 years ago than it is today, but it really made a difference in caring for this cancer patient,” he said.

How is that Troublemaking?

Two things set Avera eCARE apart from others like it: Ease of use and depth of services.

Avera eCARE makes it easy for those who need the services by removing all of the barriers to connectivity. “Imagine that you’re in a small, critical access hospital; a three-room emergency department. There’s an e-Emergency button on the wall. At the push of the e-CARE button, in about 15 seconds, you’ll see the faces of an emergency medicine physician and a critical care nurse. At that point is when the collaboration starts,” Dr. Skow explains.

Avera eCARE is among the most comprehensive telehealth service providers in the nation. In addition to emergency care, they provide ICU, pharmacy, hospitalist, senior care, school health, direct to consumer, prison health, specialty clinic, Indian Health Services, and behavioral health services. Uniquely though, while the patients may not be physically in the same place as the providers, the providers are co-located.

Avera eCARE has a full virtual hospital that is staffed 24/7 with physicians and other medical professionals who can collaborate with ease. “It’s that collaboration that really makes a difference. I can be seeing a patient over e-Emergency, and maybe I have a question on a ventilator. I can walk a few steps over to the e-ICU area, run it by one of our critical care physicians. If I have a suicidal patient and I have a question, maybe on medications, I can pull in a pharmacist or just walk down the hallway and ask our psychiatrist. That’s really what makes Avera eCARE somewhat unique in the marketplace,” Dr. Skow said.

It’s this combination of services, ease of use, and a ceaseless desire to provide the highest quality care that enables them to save lives, like that of the unlucky walker. Or Delores, a COVID-19 patient that they followed and treated in every setting. He tells that story, too, in our podcast. Give it a listen and you’ll agree that Delores is fortunate that this Troublemaker is at the medical helm of Avera eCARE.

Learn more about Avera eCARE

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