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We’ve completed the new Annex dining room where residents can enjoy a more private, but still sociable dining experience. Both dietary staff as well as residents are excited about the new space:

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You can take steps today to lower your risk of heart disease and heart attack. Heart disease is the leading cause of death for both men and women in the United States.

To help prevent heart disease, you can:

• Eat healthy and get active.
• Watch your weight.
• Quit smoking and stay away from secondhand smoke.
• Control your cholesterol (“koh-LEHS-tuh-rahl”) and blood pressure.
• If you drink alcohol, drink only in moderation.
• Take steps to prevent type 2 diabetes.
• Manage stress.

Find out more here: Healthfinder.gov

We have been working hard to expand our Pharmacy to include a new IV preparation hood. The new hood will greatly reduce the possibility of contamination and could allow us to offer additional services like Total Parenteral Nutrition, or TPN. TPN is often ordered for patients that cannot, or should not, get their nutrition through eating. This is just another way Columbia County Health System is elevating the quality of care we give our community.

I recently had the opportunity to provide some information for NoaNet’s ENewsletter that they produce. I’m sure that the format will require that they edit the content of my responses greatly, I thought I would share the full response here. A little background: NoaNet was selected to build out a fiber optic network into rural communities throughout Washington State, including Dayton. By extending their already expansive network, they will be able to provide critical telecommunications services to communities like ours that have traditionally lagged behind many of the larger cities surrounding us.

Hi Shane,

Thanks again for your time. As I mentioned the goal is to include a short section (a paragraph or two) on how high-speed broadband access benefits local hospitals like Dayton General in the next NoaNet Enewsletter. If you’re interested, you can see previous Enewsletters here: NoaNet ENewsletters.

Here are the interview questions we were hoping to ask you. Any information is helpful.

Is Dayton General Hospital currently connected to NoaNet broadband fiber service? If not, when do you believe it will be connected?

We are not currently connected, the fiber has been delivered to the buildings and we believe that services will be up first quarter of 2013.

How will high-speed broadband Internet benefit the Dayton General Hospital?

Both the Federal and State governments have established policies and incentive programs to encourage healthcare organizations to invest and adopt systems that will support Electronic Healthcare Records. These Meaningful Use initiatives require, among other things, electronic communication to update Immunization Databases, transfer syndromic surveillance data to Public Health, and the secure, electronic transmission of key clinical information among providers of care and other patient authorized entities. In addition to these government incentive programs, we’ve also established interfaces to our reference lab, radiology service provider, and Inland Northwest Health Services (INHS) for telehealth opportunities. All of these services are in addition to the direct connections we maintain to our Rural Health Clinic in Waitsburg and our local pharmacy. We’ve struggled to maintain communications integrity and performance, under the demand of all these competing needs, while utilizing older telecommunications technologies that are both expensive and highly restrictive. NoaNet’s broadband services will allow us to better fulfill the requirements of a modern day Electronic Medical Records System in an ever increasingly interconnected industry.

How will this service enable patients to receive better, faster or more efficient care? Can you give any specific examples?

One of the largest hurdles that rural healthcare facilities faced, with the delivery of healthcare in a modern age, was the electronic and telecommunications infrastructure, enjoyed for years, by facilities located in metropolitan areas. Healthcare facilities in Spokane have had access to fiber optic based telecommunications mediums since the late 90’s. High speed interconnection and the subsequent ability to quickly share diagnostic information with specialists truly elevates the quality of care and the responsiveness of that care. At the same time that images from Spokane Hospitals were being electronically transmitted to radiologists, in Dayton, Washington, diagnostic images were placed on a public transportation bus and driven to radiologists in Walla Walla so that they could be read. Thankfully that solution evolved to one where images are transmitted over a T1 line to the Radiologist electronically, but larger studies often take quite a bit of time to send before they can finally be read. It can be said that broadband services delivered over NoaNet’s infrastructure is the next evolution of this example and that it finally closes the gap between solutions available to healthcare facilities in larger metropolitan areas and the facilities in the more rural areas of the State. If NoaNet hadn’t built it, who would have and how many more years would the rural areas have struggled with outdated telecommunications technology?

Any other information you’d like to share on the Columbia County Hospital District or Dayton General Hospital?

In the coming years we expect to see many changes in the healthcare industry as we all work to accommodate a greater number of patients. I would say that Columbia County Health System is a model for the future of Healthcare. While the Federal and State Governments work to make their “Healthcare for All” initiatives become reality, healthcare facilities are looking for ways to accommodate a greater influx of patients in an age of increasingly shrinking margins. Hospital Districts and Critical Access Hospitals have been serving our underserved communities for years and have learned to operate on razor thin margins. We often find ourselves working hard to do more with less without compromising patient outcomes. We are compassionate, have great practitioners and caregivers, and we are increasingly becoming more technologically advanced after a long period of time when it wasn’t financially viable nor available. There may have been a time when the quality of care in a rural setting was not on par with that found in larger hospitals, but today we have to meet the same quality indicators, we rely on the same specialists practicing in the larger institutions, we have electronic medical records systems, transmit diagnostic images to radiologists in Walla Walla and Spokane, interface electronically with large reference laboratories, and will soon be able to do this even more effectively with increased communications capacity. By all measures, we are reducing the once large disparity between the quality of healthcare received in a large institution to that which is delivered in a smaller environment. There will always be a need for specialists and specialized care, but a large percentage of routine care can be delivered efficiently, and cost effectively without sacrificing quality, in our rural healthcare systems as we have gained access and adopted tools and resources not previously available.

Last week we officially began using the new, remodeled space. Medical staff is discovering how to be more efficient every day and feel that our patients have a much more personal experience in the private exam rooms. We could not have done this without the efforts of our valued staff, community support, and some great tradesmen.

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Casework is up! The rooms really are looking great. We will be excited to see how the floors look at the end of next week.

The cabinetry is installed in the exam rooms and the ceiling grid has been installed. We will have floors and a bulk of the electrical done next week! Thanks greatly to Blue Room Architecture, Walla Walla Electric, Leone & Keeble, and Apollo Heating.

Things are progressing rapidly with the sheetrock crew finishing up as well as the fire alarm and sprinkler crews finishing up. We will have cabinets and flooring starting next week and hope to be moving in the week of the 23rd.

Pertussis, or “Whooping Cough”, has reached epidemic levels in the State of Washington. According to the Washington State Department of Health, as of June 9th 2012 there have been 2,325 cases reported statewide, compared to 171 reported cases, over the same time period, in 2011. Infants and children have been hit hardest, both in number and in severity of the illness.

The majority of these cases have been in counties with larger cities. Walla Walla County has reported 20 cases to date. Most of these cases have been in the City of Walla Walla, but recently there have been cases reported in Prescott and Waitsburg. We have seen 2 cases, so far, in Columbia County, both cases were reported in May.

The Washington State Department of Health (http://www.doh.wa.gov/) has issued recommendations to help battle this epidemic. Columbia County Health District (CCHD) would like to inform the local community of these recommendations.

Pertussis is a highly contagious bacterial infection that causes a long-lasting cough which is often severe. Pertussis is spread by coughing or sneezing with symptoms usually starting 7-10 days after exposure, although symptoms may take up to 21 days to develop. The cough can last for weeks.

The bacterium that causes pertussis, Bordetalla pertussis, is sensitive to antibiotics. Unfortunately the damage done to the airways persists even after all the bacteria are killed; this is why the cough lasts so long. Therefore, prevention is the best defense against pertussis.

The illness usually starts with mild upper respiratory symptoms, similar to a cold. A cough develops, but as the other symptoms resolve the cough persists and may become more severe. The cough tends to come in spells or “paroxysms,” which are often associated with gagging or vomiting. The cough is sometimes associated with a “whoop” sound as the patient tries to catch their breath between coughs.

Anyone exposed to the bacteria can get pertussis, although immunization is very effective at preventing the spread of pertussis. Younger children and infants have smaller airways and often have less immunity and are at higher risk of complications. These complications include difficulty breathing, pneumonia, convulsions and even death.

While immunization is very effective at preventing the spread of pertussis, immunity wears off over time, so booster immunizations are necessary to maintain immunity.

An entire community can be protected against the spread of an illness if a sufficient number of the community are immunized. This “herd immunity” only works to prevent the spread of pertussis if 9 out of 10 of us are immune. Older children and adults not only protect themselves against pertussis by being immunized, but we also protect the infants and other at risk patients in our community.

Children are routinely immunized against pertussis by the DTaP vaccine, which immunizes against Diphtheria, Tetanus and Pertussis. DTaP is usually given at 2, 4 and 6 months of age, with booster immunizations between 15 to 18 months and between 4 to 6 years of age. If your child has not received five DTaP immunizations by age 7, or, if you are not sure about their immunizations, contact your child’s health care provider.

In the past only children were vaccinated against pertussis. Adults and older adolescents received Td booster shots, which immunized against tetanus and diphtheria, but not against pertussis. In 2005 a new vaccine, Tdap (not DTaP), became available in the U.S. for use in older adolescents and adults. Tdap immunizes against all three infections, tetanus, diphtheria and pertussis. In 2006 the U.S. ACIP (Advisory Committee on Immunization Practices) recommended that adults and adolescents receive Tdap instead of Td for their next routine “tetanus” booster, which is usually given every 5 to 10 years. However, Tdap may be given to adults regardless of the time interval since the previous Td dose. If you are an adult who has not yet received a Tdap booster, especially if you have close contact with infants, consider having a Tdap shot, even if you recently had a have had a Td (tetanus) booster.

Women who get Tdap before or during pregnancy pass the immunity against pertussis to their babies. The ACIP therefore also made a new recommendation that pregnant women get Tdap during their pregnancy (after 20 weeks gestation) unless they have previously received a Tdap vaccination.

To summarize, the current recommendations for pertussis immunization are:

1. Children should receive five doses of DTaP before age seven according to the routine immunization schedule.

2. Children age seven to ten who did not receive all 5 doses of should follow the ACIP “catch up” schedule, with Tdap given as the first “catch up” dose.

3. Adolescents age 11 to 18 years (preferably at age 11 or 12) should receive one Tdap. If not fully immunized earlier in life, additional “catch up” doses may be given.

4. Adults over the age of 19 should receive one dose of Tdap vaccine instead of Td for their next routine booster. However, Tdap can be given regardless of the interval since the previous Td dose, especially if the adult has close contact with children, i.e. parents, child care providers, health care workers, etc.

5. Pregnant women who have not received a dose of Tdap should receive one dose after 20 weeks gestation.

The Columbia Family Clinic and the Waitsburg Family Clinic have plenty of Tdap available, and are making efforts to immunize all appropriate patients. We encourage you to protect yourself, your family, and your community by making sure your immunizations are up to date.

Dr. Kyle Terry, MD
Waitsburg Clinic

Booker’s Getting a new roof! Thanks to Janean, Nick, Brian, Mike, Kevin for the help on stocking the roof. Amazing team, amazing teamwork!