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Sioux Falls nurse helped Avera Health abandon using pagers

December 8, 2018
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In this Nov. 29, 2018, photo, Candice Friestad, Avera Health's director of clinical informatics, holds up her phone with the app Voalte displayed in Sioux Falls, S.D. (Loren Townsley/The Argus Leader via AP)

SIOUX FALLS, S.D. (AP) — Pagers might still beep at the hips of TV show doctors, but they have no place at Avera Health.

The way doctors and nurses communicate at Avera is different.

It’s more comprehensive. More connected to Avera’s other communication networks. And it’s far more appropriate given the capabilities of modern technology and the life-and-death scenarios that play out daily in clinics and hospitals.

Avera’s evolution beyond beepers might not seem like a major step, but it’s a departure from an industry that still by and large relies on the 1960s technology.

For Candice Friestad, it was more about helping the nurses. They were being overwhelmed by pagers and giant wireless phones. She wanted an alternative that wouldn’t make them feel like “Tim ‘The Tool Man’ Taylor,” Friestad said.

“The nurses came up to us and said, ‘stop this,’” said Friestad, who worked as a nurse in Avera’s critical care units for 17 years.

Friestad led the charge when Avera first made the switch in 2014 from Motorola alphanumeric pagers to smartphones and agreed to sign a contract with Voalte, a growing medical technology company out of Sarasota, Florida.

She dumped the beepers into boxes and orchestrated a technological evolution across the hospital system, departing from an industry norm with a gusto that only comes with a clear sense of purpose.

Friestad knew it would be better for patients.

Her vision for the future earned her a special nod from Voalte. The company named her “Innovator of the Year” in October at its 2018 user conference in Sarasota.

“Our entire customer base has benefited from her hard work,” Oscar Callejas, co-founder and vice president of services for Voalte. “Anybody that’s around her is just totally captivated by her and they immediately get the vision.”

Nearly 8 in 10 clinicians in the United States still use pagers for patient care-related communication, according to a 2017 report in the Journal of Hospital Medicine.

Hospitals resist change because it comes with the upfront costs of installing a new telecommunications network, throwing away already paid-for pagers and buying enough smartphones to equip the entire staff of providers, Friestad told the Argus Leader .

When she first started looking for an alternative, Voalte was one of a few tech firms creating software for using smartphones in patient care-related communication.

Voalte offered three things she was looking for: encrypted security, a variety of alarms and something that would work on any device — iPhones or Android, Friestad said.

Voalte founder and CEO Trey Lauderdale was working in health care tech for Emergin when he first realized the potential benefits smartphones to patient care-related communication.

“He saw the frustration from the nurses first hand,” Callejas said. “They were saying ’why is it we’ve got all this sophisticated equipment that can save lives and do all of these really advanced things but at the end the day, the output is the pager.”

Instead of relying on one-way beeper and the availability of a phone on both ends, doctors can communicate instantly with a team of providers by using text messages and file sharing. Friestad heard of one instance where providers shared a photo of a patient’s heart monitor reading and then immediately took action to save the person’s life.

“All I have to do is go for the patient, pull them up by name or by room number and then I see, oh here’s the nurse who’s caring for this person or the pharmacist,” Friestad said.

Friestad digs through her desk, looking for an old Avera beeper.

“At one point I had saved them as a relic,” she said. “As in, ‘oh, this used to be a pager.’”

Friestad speaks with a no-frills authenticity, softened by a dry sense of humor.

She jokes about the floral-pattern couch across from her desk — a secondhand piece of furniture she inherited from a retired physician and now feels obligated to keep. She tells a story about bringing the Voalte award through airport security, how its pointy top drew extra attention from TSA.

Behind it all is a deep sense of purpose for the task she is carrying out from her office on Avera’s main campus in central Sioux Falls. She came up in the system working as a nurse in critical care.

A lot of people in informatics have a background in critical care, Friestad said. Working in a unit like that impresses upon one the value of time.

Friestad grew up in Long Beach, California, and moved to South Dakota with her parents when they opened a laundromat in Colton.

She almost went to The Julliard School to study piano and music, but stayed in Sioux Falls and studied nursing at Augustana University. Already carrying an offer from A&M Records in Los Angeles, she thought working as a nurse at night would give her a chance to work on a career in music during the day.

Her plans to move away and make music professionally were sidelined when her father died. Friestad stayed in Sioux Falls to take care of her mother.

Her first day as a nurse was in Avera’s critical care unit.

“It was more like trial by fire,” Friestad said. “We were a burn unit, we did open hearts.”

Nurses came to her in 2013 expressing concerns about all the hardware they needed to carry. Supervising nurses at the time were lugging around three pagers and a Cisco mobile phone.

It only took a year before Avera was piloting the Voalte system on iPhones in a single unit on Avera’s main Sioux Falls campus. Avera went live with smartphones in October, 2015, and Friestad hasn’t looked back.

She continues to manage Avera’s adoption of the technology across a five-state network of hospitals and clinics.

In addition to Sioux Falls, smartphones programmed with Voalte have replaced pagers at Avera locations in Yankton, Mitchell, Platte, Parkston, De Smet and Wessington Springs. Avera has also introduced the technology at its hospital in Creighton, Nebraska, and plans to go live in January at its location in Marshall, Minnesota.

More than just an advocate of the technology, Friestad now serves on the board at Voalte. She has collaborated with other hospitals and Voalte leadership to improve the system so Avera can improve its ability to serve patients.

“They are the poster child for Voalte and for a communication system like this,” Callejas said. “It’s really difficult to connect all of those providers across such a wide distance.”

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Information from: Argus Leader, http://www.argusleader.com

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