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If you would like anytime, anywhere online access to your health records through the Mankato Clinic's MyHealthInfo, please fill out a form and to ensure your privacy and security, return in person to any Mankato Clinic location or at your next appointment. Because we have to verify your identify when you return the form before we enroll you, we can only accept forms that are returned in person; please do not mail sign-up forms.

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Thanks to the Mankato Clinic Foundation, over 35 area organizations received grants and funding totaling nearly $160,000 in 2011. Organizations supported include; Feeding our Community Partners – Backpack Program, Lake Crystal Area Recreation Center, YMCA,VINE, YWCA – Walking in Two Worlds, Greater Mankato Diversity Council, Creative Play Place in St. Peter , Children's Museum of Southern MN, Special Olympics, Greater Mankato Early Learning Initiative, area school districts, and several other organizations including scholarships for the nursing programs at both South Central College and Minnesota State University- Mankato.

The physicians at the Mankato Clinic provide the majority of the Foundation funding as a means to give back to the community by providing support to organizations which strive to improve health and wellness. The Mankato Clinic Foundation has given $914,148.00 to area organizations over the past six years in an effort to support the health and well-being of local communities.

Mankato Clinic Foundation president, Marcia Bahr said, “The Mankato Clinic Foundation is thrilled to be able to support the areas we serve by providing local organizations with funds that enhance the health and wellness of the community.”

The Mankato Clinic Foundation provides resources to organizations and endeavors that effectively promote and improve community health and wellness. Since the primary focus of the Foundation is to support the health and well-being of the community, projects and programs supported include education and scholarships, initiatives focused on health care, health education and wellness.

Grants are awarded on a quarterly basis and are considered only through the application process. Applications and more information can be obtained by clicking here. The next grant application deadline is March 1, 2012.

Take these everyday steps to avoid getting the flu:

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. You can also use an alcohol-based hand cleaner.
• Avoid touching your eyes, nose or mouth. Germs spread this way.
• Try to avoid close contact with sick people.
• Stay home if you are sick until at least 24 hours after you no longer have a fever (100°F or 37.8°C) or signs of a fever (without the use of a fever-reducing medicine, such as Tylenol®).
• While sick, limit contact with others as much as possible to keep from infecting them.

The Mankato Clinic is honored to receive the MACQ Corporate Quality Award for our service improvement efforts geared toward achieving better clinical outcomes, service, and overall patient satisfaction. The health care industry is undergoing significant transformation and the Mankato Clinic is proud to be recognized by the MACQ for its leadership in bringing about positive change for the benefit of our patients.

The Mission of the Mankato Clinic is “To improve the health of the people in our region through compassionate, patient-focused care and education.

Flu IQ

Our classes cover all kinds of issues surrounding childbirth including breathing techniques, pain management, vaginal birth, and cesarean birth. They can help prepare you for many aspects of childbirth: for the changes that pregnancy brings, for labor and delivery, and for parenting once your baby is born. Mankato Clinic Childbirth Educators are highly trained and knowledgeable and have proven to be a reliable resource for expectant parents.

Typically, new parents take birthing classes during the third trimester of the pregnancy, when the mother is about 7 months pregnant. Each "Prepared Childbirth" class is four sessions- one session per week. You do not need to be a Mankato Clinic patient to participate in these classes.

Benefits of Taking a Childbirth Class
At our childbirth class you will be provided with a great forum to ask lots of questions and you will learn more about topics such as:

•how your baby is developing
•healthy developments in your pregnancy
•warning signs that something is wrong
•how to make your pregnancy, labor, and delivery more comfortable
•breathing and relaxation techniques
•how to write a birth plan
•how to tell when you are in labor
•pain relief options during labor
•what to expect during labor and delivery
•the role of the coach or labor partner
Many of our classes also address what to expect after the baby is born, including breastfeeding, infant care, and dealing with the emotional changes of new parenthood.

If you have questions or would like more information please call 507-385-4089.

Click here for the 2012 Childbirth Education Class Schedule

Just 25 years ago, a diagnosis of Type 1 diabetes in adolescence meant a life expectancy of around 40, and a diagnosis of Type 2 diabetes in adulthood meant limb amputations, blindness, kidney failure or even early death. But, times have changed. Today, thanks to advances in research, education and technology, better diabetes health can be attained. One way Mankato Clinic is working to help its diabetic patients attain better diabetic control is with a new initiative at its’ North Mankato Family Practice Clinic called iD5. iD5, or Initiative Diabetes 5, seeks to improve diabetic control by pinpointing five target goals. The program benefits both Type 1 and Type 2 diabetics.

The five goals for living well with diabetes are:
1. Control blood pressure - High blood pressure makes the heart work too hard. It can cause heart attack, stroke and kidney disease. Ideal blood pressure in a diabetic patient is less than 130/80.
2. Lower bad cholesterol – LDL, or bad cholesterol, can build up and clog blood vessels and can cause heart attack and stroke. HDL or good cholesterol helps remove cholesterol from blood vessels. Diabetics should strive for LDL less than 100.
3. Maintain blood sugar - High blood glucose levels (too much sugar in the blood) may harm the heart, blood vessels, kidneys, feet and eyes. Hemoglobin A1C, which measures the average blood sugar level over a three to four month period, should ideally be less than 7 percent in diabetic patients, which is equivalent to a daily average blood sugar of 154 mg/dL.
4. Be tobacco-free - Smoking doubles the risk of heart disease. It may also damage the blood vessels in the legs, increasing the risk of amputation. Smoking increases the cardiovascular complications associated with diabetes including heart disease, stroke and peripheral vascular disease.
5. Take an aspirin daily – Taking aspirin every day can help to reduce the risk of heart disease and stroke.

Christie Nelson, registered nurse and chronic care coordinator at Mankato Clinic-North Mankato Family Practice, works with the clinic’s diabetic patients and tracks their well-being. “Following and meeting the iD5 goals is important for patients managing diabetes long term,” said Nelson. “There is evidence-based data that shows following these goals helps reduce the risk of heart attack and stroke in individuals with diabetes. Because diabetes is a chronic disease and individuals with a chronic disease will never be cured, those who manage their disease in a healthy way have a good chance of living a long, quality life.”

Nelson is part of a team including the provider, the primary nurse and the department specialist that provides a medical home to coordinate all of the patient’s diabetic needs. She says patients sometimes need a little extra motivation, like a phone call to keep them on track. “The team keeps a registry of diabetic patients and if any of them do not meet any of the five targeted goals, we ask to see them back within a certain amount of time,” said Nelson. “The electronic registry alerts us if any patients are overdue and we give them a call to check in and schedule an appointment. I serve as a patient contact and inquire about side effects, make changes to medications per the patient’s provider, motivate patients in their efforts to achieve weight loss and healthy eating goals, and coordinate with medical specialists and community resources to support patient needs.”

Shirley Zimpritch, a 74-year-old Type 2 diabetic from Elysian, began working with Nelson and the medical staff at North clinic over six months ago after experiencing dangerously high blood sugars as a result of taking prednisone prescribed by another medical facility. She began taking insulin to control her blood sugars and Nelson, in conjunction with the physicians at North, began following her two to three times a week to make sure she was staying on track.

“My experience with the medical staff at North Mankato Clinic has been super,” said Zimpritch. “It makes me comfortable knowing that Christie is going to call and check in on me to see if my needs have changed and that I can call the medical team at any time when I need them. They simplify what I need to do in order to stay in good diabetic health and encourage me to stay under control. I am feeling better as well as seeing on paper that my complications are improving.”

Dr. Andy Miller, family practitioner at Mankato Clinic-North Mankato Family Practice, says that the iD5 concept stemmed from the health care home model and is part of the clinic’s team approach to diabetes care. “iD5 came from the idea of getting a nurse coordinator involved to keep better track of diabetic patients and in the end, get more patients to reach their goals and achieve better control overall,” said Dr. Miller. “Our medical home team is able to spend extra time with patients who need a little more attention which provides a team approach to medical care. Patients seem appreciative of the extra time and follow-through.”

Stacy Hogan, a Type 1 diabetic for 20 years, uses an insulin pump to help control her diabetes and has additional diabetic complications to manage. She says iD5 has helped make her goals more understandable and taught her how to implement the five goals into everyday life. Her blood pressure and A1C have both come down since she started following the goals.

“iD5 helps simplify what I should be shooting for to get better control of my diabetes,” said Hogan. “The last 15 years I was in denial about having diabetes and I blew it off thinking I was invincible. I really thought it would be a long time before I would start seeing complications. But because I didn’t do the things I needed to do to keep my diabetes in control, I am now suffering from kidney disease, neuropathy, seizures and visual problems. Christie follows me closely, coordinates my specialty care and actually breaks down my condition and needs into one summary so I can better understand it all.”

Dr. Miller says having specific goals to shoot for makes diabetic control more manageable for many patients. “iD5 helps clarify for the patient what we think is important for living healthy with diabetes,” said Dr. Miller. “It is geared toward the diabetic patient who is not at goal but is helpful to any diabetic patient to make sure they are sustaining goals. Meeting these five targeted goals, helps lead to successful diabetic control.”

Diabetes Mellitus is a condition in which a person has a high blood sugar (glucose) level as a result of the body either not producing enough insulin, or not responding to the insulin that is produced. Insulin is a hormone produced in the pancreas which enables body cells to absorb glucose and convert it to energy. If the body cells do not absorb the glucose, the glucose accumulates in the blood leading to hyperglycemia and various potential medical complications.
Most people have heard of diabetes, but many may not realize that there is more than one kind. The two most common types of diabetes are:
Type 1: Type 1 results from the body's failure to produce insulin, and requires a person with diabetes to inject insulin to move sugar from the bloodstream to survive. This type of diabetes is an autoimmune disorder, which may be triggered by a virus or other factors. Type 1 can start at any age but many cases begin in childhood, adolescence or early adult years. It is usually diagnosed before age 40. Only 5 to 10 percent of people with diabetes have this form of the disease.

Type 2: Type 2 is the most common form of diabetes. It results from a relative deficiency of insulin and insulin resistance, a condition in which cells fail to use insulin properly. Type 2 diabetes occurs when insulin that the body produces is less efficient at moving sugar out of the bloodstream resulting in a high blood sugar. Experts once considered Type 2 diabetes as the adult onset type of diabetes. However, many children are now being diagnosed with Type 2 diabetes as the obesity epidemic grows. Diet, exercise, weight loss, and, in some cases medications and insulin, are the treatment for this type of diabetes. This type is often associated with physical inactivity and obesity.

For more information about iD5 or to schedule an appointment with a member of the medical team at the Mankato Clinic please call 507-625-1811.

One in four Americans lives with a mental health condition that is treatable. Studies show that one of the best ways to treat and live well with a mental health condition including bipolar disorder is with the love and support of family and friends. Mankato Clinic is helping to make a difference in the lives of bipolar sufferers and their loved ones by providing the support they need by hosting bipolar disorder support groups twice a month. Mary Beth Trembley, registered nurse in the department of psychiatry at Mankato Clinic, facilitates the support groups on the first and third Wednesday of every month, from 6:30 p.m. - 8:00 p.m., in the Mankato Clinic conference room, located at Madison East Mall in Mankato. Sessions are free and open to the public, age 18 and older. Reservations are not required.

“There is evidence-based data that shows people who attend support groups for illnesses have better overall health outcomes and gain valuable insight and information from others,” said Trembley. “Support is vital. One of the most powerful things a person can hear or say is that they have been there and understand what another is going through. Bipolar can be an isolating illness and support groups break down barriers and stigma.”

The ups and downs in life can be hard to tolerate for both the bipolar sufferer and their loved ones. Therefore, Mankato Clinic bipolar support groups give hope to not only those who suffer from the illness but to those whose lives are affected by the illness of another. Thirty percent of bipolar support group attendees are there as part of a support system including children whose parents are bipolar, parents whose kids are bipolar, spouses, family, friends, neighbors, work colleagues and even students from Minnesota State University looking to learn more. The groups are there for anyone who wants to learn more about illness and wants to receive support or give support. About half of attendees come alone and half are accompanied by friends or family.

“Those whose lives are touched by bipolar disorder need support from people who have been there and who understand the bipolar journey,” said Trembley. “Our support groups offer an opportunity for others to share their experience, provide ideas and meet other people in the community who can relate to their experience in a confidential setting.”

Sessions are facilitated by Trembley and are completely confidential. The group is open for sharing dialogue and ideas, seeking validation and information, asking questions and finding comfort and direction. “The sessions are very dynamic and upbeat,t and offer practical ideas for managing illness,” said Trembley. “It is common for attendees to bounce ideas off of each other and get feedback from group. I provide education about treatment and diagnoses. I have 25 years of psychiatric nursing experience which is unique to a peer-facilitated group.”

Those attending the bipolar support groups are finding that it is making a difference in their lives. One bipolar sufferer said “because of the support groups, I now have a better relationship with my spouse because he has more knowledge about bipolar disorder and I have a better understanding for what he is going through living with my illness.” Another says “I have found it helpful to hear others’ perspectives and experiences and it is comforting to know that I am not alone.”

Carole Milner, a support group attendee who has been living with symptoms of bipolar disorder since childhood, says the support groups have helped her manage her illness through education and insight. Milner also says the support of others helps keep her on track when she begins to go off course. “When I am having a bipolar episode and feeling depressed, others at the meetings remind me of what has worked for me in the past because I tend to isolate and forget,” said Milner. “A simple reminder from a peer to journal is an effective way to work through the episode.”

She says it is also therapeutic for her to help others. “I attend the support groups both when I am feeling well and when I am struggling,” said Milner. “When I am feeling well, it makes me feel good to go to the meetings and see what kind of support I can provide to another. It gives me a feeling of self worth to provide my insight and help someone else who is struggling with bipolar.”

Bipolar disorder, formerly known as manic depressive illness, is a medically diagnosed and treatable disorder marked by extreme changes in mood, energy, thought and behavior. The disorder causes a person’s mood to alternate between the highs of mania on one extreme to the lows of depression on the other.

The cycles of bipolar are more than just a temporary good or bad mood and may last for days, weeks and months. And unlike ordinary mood swings, mood changes associated with bipolar disorder are so intense that they may disrupt the ability to function in daily life. It may affect work and school performance as well as personal relationships.

The mood swings between mania and depression may be very abrupt or subtle. During a manic episode, a person might feel refreshed and energized after only a few hours of sleep and impulsively engage in erratic behavior like spending sprees. On the other hand, that same person may feel like sleeping all day, feeling hopeless and worthless.

The signs of bipolar vary largely from person to person by pattern, severity and frequency. The first episode generally occurs in late adolescence or early adulthood although the initial presentation may occur in childhood.

General symptoms of bipolar disorder include patterns of sleep disturbances, variations in energy like having restless energy one day and no energy the next. A manic state may include racing thoughts and an abundance of ideas at once which are hard to sort through. Depressive states reflect lack of creativity and spontaneity. There are four types of bipolar episodes including mania, hypomania, depression and mixed patterns. Each type has its own unique symptoms.

Symptoms of mania or “highs” of bipolar
• Heightened mood and exaggerated optimism
• Little need for sleep
• Excessive agitation or irritation
• Inflated self-esteem and self-confidence
• Noticeably elevated moods including hyperactivity, increased energy, racing thoughts and lack of self-control
• Reckless behavior including impaired judgment, reckless spending, sexual promiscuity and binge eating and drinking
• Tendency to be easily distracted
• Delusions and hallucinations

Symptoms of depression or “lows” of bipolar
• Low moods daily
• Difficulty concentrating, remembering or making decisions
• Fatigue, loss of energy or listlessness
• Prolonged sadness or unexplained crying spells
• Persistent thoughts of death or suicidal thoughts
• Changes in appetite or sleep patterns
• Withdrawal from friends and activities normally enjoyed
• Feelings of worthlessness and guilt and loss of self esteem
• Unexplained aches and pains

Please visit the bipolar alliance website at dbsalliance.org or call Mankato Clinic at 625-1811, for more information.

Mankato Clinic Foundation Awards $2,000 Scholarship

The Mankato Clinic Foundation has selected Jamie Schlarbaum, a senior at LeSueur Henderson High School as the fourth recipient of the J. Scott Sanders, M.D. Memorial Scholarship. Dr. Sanders’ sound character was recognizable in all aspects of his life and positively impacted others. Applicants of the award provided an essay describing how character has been important in achieving their accomplishments and how it will be a key cornerstone in their future. The winner is selected solely on this personal statement of character, academic standing has no bearing.

“Character can be elusive in its definition. Jamie gave it life in his perception of the quality of choices, personal awareness of those around him and in his own journey”, commented Barb Sanders, wife of Dr. Sanders.

Stacy Carpenter, counselor at LSH High School says “Jamie is an exceptional student, a thoughtful learner, and an articulate young man. Jamie is known at our school for being a hard-worker. His friends and teachers know they can count on him to not just meet expectations, but to exceed them. Jamie is goal-oriented and responsible. He makes thoughtful decisions, and he is a student who will easily find his place at college. I have consistently been impressed with Jamie.”

LSH High School Principal, Kevin Enerson, describes Jamie this way, “"Jamie has always pushed himself to excel in whatever he does, be it academics, fine arts, or speech. He has achieved at some of the highest levels, but that is not as important as the character he demonstrates in his friendships or through his demonstration of respect and caring for others. Jamie is a truly good person and has made his family, friends, and community proud by all of his accomplishments."

Jamie is the son of Steve and Sue Schlarbaum. During his high school career, Jamie has participated in Speech, Fall/One Act Play, LifeSmarts, and Knowledge Bowl. He has volunteerd for Habitat for Humanity, Red Cross, and was a Junior High Knowledge Bowl Volunteer Coach. Jamie has been accepted for admission to Georgetown, University in Washington, D.C.

Effective immediately, Mankato Clinic will unite with Open Door Health Center (ODHC) and begin providing low income, uninsured patients in the Mankato area with high quality, much needed specialty health care services. With this partnership, Mankato Clinic will offer ODHC patients a complete array of medical assistance beyond the primary care services currently available at the ODHC facility.

“The Open Door Health Center is a safety net in the region for those who do not have access to medical services,” said Sarah Kruse, CEO of Open Door Health Center. “While we see patients with insurance, the vast majority of our patients are uninsured or underinsured. For those without insurance, financial barriers frequently result in difficulty accessing specialty care. Our collaboration with Mankato Clinic helps eliminate those barriers. Patients who don’t have the resources to get the specialized treatments they need now have access to these services at Mankato Clinic and may get the complete care they need.”

The ODHC mission is to increase access to quality, affordable, culturally appropriate, patient centered health care, and to maximize the overall well-being of its patients. As a Federally Qualified Health Center, ODHC provides a full gamut of primary and preventive health services to the medically underserved in south central Minnesota. Now, a patient who visits ODHC whose medical needs extend beyond primary care services may turn to Mankato Clinic for help. These services include specialty care, advanced lab work and radiology.

For example, primary care services at ODHC may manage a patient with diabetes on a regular basis but if that diabetic patient begins to have foot complications, a podiatrist at Mankato Clinic will be available to consult the patient. And, that patient will have access to specialized lab work or radiology services if necessary.

“We feel the Open Door Health Center’s mission is an important one,” said Randy Farrow, CEO of Mankato Clinic. “We applaud their efforts. It is an important obligation on our part to support their efforts and provide complete medical access for patients with financial challenges. Our collaboration is the perfect fit. It is a win-win for everyone.”

Mankato Clinic and ODHC hope this collaboration will improve outreach in the community. Many of ODHC patients are poor and less likely to receive preventive care, such as immunizations or cancer screening, or to avoid hospitalization for serious conditions by receiving regular office-based care. These patients often end up with a disease that could have been managed and now need emergency care or advanced care that could have been prevented.

“We hope that by being proactive, we will help underserved patients in the Mankato area get a better handle on their medical needs and live a better quality of life,” said Farrow. “Many times, due to financial constraints, these patients choose not to access the care they need and let their conditions get out of control. We want to eliminate the emergency room as their last resort when their condition worsens. This puts stress on the system as a whole and is not in the best interest of anyone.”

“We are delighted that Mankato Clinic has a heart for our mission and a strong commitment to the community for the health-related goodness of all,” said Kruse. “Out of compassion, their physicians sought to serve the needs in the area and stepped up to the plate to offer their services in the best interest of the community.”

Thanks to the Mankato Clinic Foundation, over 30 area organizations received grants and funding totaling more than $160,000 in 2010. Organizations supported include Children's Museum of Southern MN, Feeding our Community Partners – Backpack Initiative, Lake Crystal Area Recreation Center, YMCA, Open Door Clinic, Greater Mankato Diversity Council, St Peter Early Childhood Initiative, American Red Cross, Special Olympics, ECHO Food Shelf, area school districts, and several other organizations including scholarships for the nursing programs at both South Central College and Minnesota State University- Mankato.

The physicians at the Mankato Clinic provide the majority of the Foundation funding as a means to give back to the community by providing support to organizations which strive to improve health and wellness. The Mankato Clinic Foundation has given $915,152.00 to area organizations over the past six years in an effort to support the health and well-being of local communities.

Mankato Clinic Foundation president, Marcia Bahr said, “The Mankato Clinic Foundation is thrilled to be able to support the areas we serve by providing local organizations with funds that enhance the health and wellness of the community.”

The Mankato Clinic Foundation provides resources to organizations and endeavors that effectively promote and improve community health and wellness. Since the primary focus of the Foundation is to support the health and well-being of the community, projects and programs supported include education and scholarships, initiatives focused on health care, health education and wellness.

Grants are awarded on a quarterly basis and are considered only through the application process. Applications and more information can be obtained at www.mankatoclinic.com.

Mankato, Minn. (Jan. 11, 2011) – The Mankato Clinic Foundation’s J. Scott Sanders, M.D. Memorial Scholarship is available to area seniors. Recipients will emulate Dr. Sanders’ unforgettable character, his kindness and his passion for helping others. To be eligible high school seniors must reside within the Mankato Clinic service area, which includes Mankato, North Mankato, St. Peter, Lake Crystal, Mapleton, and the surrounding area. Students must plan to obtain secondary education after graduation.

Student selection is based solely on the content of the students’ 1,000 word personal statement. Academic standings will have no bearing on selection. . The application deadline is March 1st. Applications for this $2,000 scholarship are available from area high school guidance counselors or can be accessed by clicking here.

The physicians at the Mankato Clinic provide the majority of the Foundation funding as a means to give back to the community by providing support to organizations which strive to improve health and wellness. The Mankato Clinic Foundation has given $915,152.00 to area organizations over the past six years in an effort to support the health and well-being of local communities.

Mankato Clinic Foundation president, Marcia Bahr said, “The Mankato Clinic Foundation is thrilled to be able to support the areas we serve by providing local organizations with funds that enhance the health and wellness of the community.”

The Mankato Clinic Foundation provides resources to organizations and endeavors that effectively promote and improve community health and wellness. Since the primary focus of the Foundation is to support the health and well-being of the community, projects and programs supported include education and scholarships, initiatives focused on health care, health education and wellness.

Grants are awarded on a quarterly basis and are considered only through the application process. Applications and more information can be obtained at www.mankatoclinic.com.

The physicians at the Mankato Clinic provide the majority of the Foundation funding as a means to give back to the community by providing support to organizations which strive to improve health and wellness. The Mankato Clinic Foundation has given $915,152.00 to area organizations over the past six years in an effort to support the health and well-being of local communities.

Mankato Clinic Foundation president, Marcia Bahr said, “The Mankato Clinic Foundation is thrilled to be able to support the areas we serve by providing local organizations with funds that enhance the health and wellness of the community.”

The Mankato Clinic Foundation provides resources to organizations and endeavors that effectively promote and improve community health and wellness. Since the primary focus of the Foundation is to support the health and well-being of the community, projects and programs supported include education and scholarships, initiatives focused on health care, health education and wellness.

Grants are awarded on a quarterly basis and are considered only through the application process. Applications and more information can be obtained at www.mankatoclinic.com.

• November 2nd the Mankato Clinic was notified that a laptop computer belonging to an employee was stolen out of a vehicle sometime between November 1st and 2nd; the laptop contained a spreadsheet which included personal health information of 3,159 patients and is considered a breach of unsecured protected health information.

• Patient information involved includes; patient’s full name, date of birth, medical record number, healthcare provider’s name, encounter date, and diagnosis information. Fortunately, Social Security numbers and addresses were not included in the information. Log-in access to the computer was password protected. This breach did not include the Mankato Clinic’s electronic health record.

“The Mankato Clinic understands the importance of safeguarding our patients’ personal health information and takes this responsibility very seriously. We have safeguards in place to ensure the privacy and security of all patient health information. To further mitigate this situation the Mankato Clinic is implementing encryption software to all mobile computers, establishing a more stringent mobile computing device security policy and a mandatory staff education program related to improving privacy protection measures,” comments Randy Farrow, CEO of the Mankato Clinic. “The Mankato Clinic regrets that this incident occurred and we sincerely apologize to our impacted patients for this situation and are doing everything possible to rectify the circumstances”.

Patients impacted by this information breach will receive a letter by mail detailing the situation. The Mankato Clinic has trained staff available for those patients to call with any questions related to the data breach. Patients may call 1-800-657-6944 – extension 8633, or 625-1811 extension - 8633 during normal business hours, Monday – Friday from 8am – 5pm, the Clinic is closed on December 24th. No steps by the patients are suggested to protect them from potential harm resulting from the breach of this personal health information as the data involved in this breach did not included any financial information.

“Mankato Clinic and OFC’s collaboration to bring 3T Breast MRI to Mankato truly offers patients the best in breast imaging,” said Julie Johnson, supervisor of MRI at OFC. “We are striving to meet patient expectations by providing a comfortable environment that brings together the technology, imaging skills, expertise, responsiveness and excellent care that physicians require and patients deserve.”

Used in conjunction with mammography and ultrasound, breast MRI is fast becoming a powerful tool in the detection, diagnosis and management of breast cancer in select patient populations. Breast MRIs are more sensitive than traditional mammograms which use low dosage x-rays to image breasts. Breast MRI is generally used as a complement to diagnostic mammography and is not a replacement for traditional mammography screening.

American Cancer Society guidelines recommend breast MRI, in addition to mammograms, for women at high risk including:

• A strong family history of breast cancer including a mother, sibling or child
• A diagnosis with the BRCA1 or BRCA2 genetic mutation which gives them a 60 – 85 percent lifetime risk of acquiring breast cancer
• A previous diagnosis of breast cancer in one breast by mammography or ultrasound
• Radiation to the chest between the ages of 10 and 30
• Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalca syndrome or may have a close family history of one of these diseases in a first-degree relative

“Breast MRI is not recommended for routine screening or as a replacement for mammography, but is an important tool in clarifying inconclusive findings from a previous mammogram or ultrasound,” said Dr. Maureen Magut, radiologist at Mankato Clinic. “It is commonly used to evaluate for surgical planning because nearly five percent of women with breast cancer in one breast develop a new tumor in the opposite breast, even though nothing is found on a mammogram or physical breast exam at the time of original diagnosis. Finding these cancers earlier may help women make treatment decisions and may spare them from additional rounds of chemotherapy or radiation in the future.”

Because of its high sensitivity, breast MRI is useful in imaging dense breast tissue, which is often found in younger women, and in viewing breast abnormalities that can be felt but are not visible with conventional mammography or ultrasound.

MRI is also an effective tool for imaging the augmented breast, including the breast implant itself and the breast tissue surrounding the implant which may be obscured by the implant on a mammogram.

It is useful for staging breast cancer, determining the most appropriate cancer treatment and for patient follow-up after breast cancer treatment. MRI may be useful in determining whether breast cancer has spread into the chest wall which often requires the patient to undergo chemotherapy before breast cancer surgery.

In addition to its superior diagnostic ability, researchers have been investigating whether breast MRI may be useful in screening younger women at high risk of breast cancer. Most women under 40 do not require any breast imaging. However, the American Cancer Society recently recommended that women at very high risk of developing breast cancer have annual breast MRI exams in addition to annual mammograms to increase the likelihood that breast cancer will be detected early, when the chances of survival are greatest.

The most useful MRI technique uses a contrast material called Gadolinium DTPA, which is injected into a vein in the arm during the exam to improve the quality of the images. This contrast agent helps produce a stronger and clearer image and highlights any abnormalities.

During a Breast MRI, a patient lies face down on an exam table, keeping still and breathing normally. A physician may prescribe a mild oral sedative to help the patient rest comfortably in the scanner and reduce any feeling of claustrophobia. Unlike mammography, the breasts are not compressed during the exam so there is no discomfort. The table then moves into a cylinder shaped machine with the magnet where the images are taken. The test does not use any harmful or dangerous radiation. The exam is performed at OFC and a Mankato Clinic radiologist interprets the images and sends a report to patient’s ordering physician.

“Because patients in Mankato can now receive the best in breast imaging care here at home, it is more convenient for the patient and her physician,” said Dr. Magut. “This allows for better coordinated care between a woman and her healthcare team.”

3 Tesla (T) MRI is the best in breast MRI imaging because of the strength of its magnet, a 3 Tesla, which is twice the strength of the more commonly available 1.5 Tesla. The magnetic field produced by the 3T yields exceptional anatomic detail and offers higher signal to noise ratio, better image resolution and faster scan times. It is the highest strength scanner currently available in the Mankato area.

“3T breast MRIs have been shown to improve patient outcomes due to its high sensitivity magnet,” said Dr. Magut. “MRI, coupled with mammography, detects almost all cancers at an early stage; therefore, a smaller size, which reduces the incidence of advanced stage breast cancer in high-risk patients.”

This system, with its 70 cm Open Bore, is one of the largest scanners available being at least 10cm wider than the average scanner. It is made for patients of all shapes and sizes and improves patient comfort and reduces incidents of anxiety and claustrophobia.

To find out more about breast MRI, contact a breast health nurse at Mankato Clinic at 507-389-8781.

Camp gives youngsters the

SWEET LIFE

Day camp for kids with diabetes to become annual event

Story and photos by John Cross

jcross@mankatofreepress.com
The day camp held Friday at the Norseland Scout Camp in Nicollet County was like most any other with youngsters hik­ing down the paths, playing camp games, geocaching and sitting around the campfire.

The only notable difference was that when lunch time rolled around, every one of the 27 campers took the time to check their blood sugar levels before lunch was served.

The campers age 5-13 were par­ticipating in the first- ever Camp Sweet Life, a day camp for young­sters with Type 1 Diabetes.

Youth from six area counties attended the camp sponsored by the Mankato Clinic Foundation and Medtronics.

And while they were participat­ing in outdoor camp activities, their parents were able to learn from rep­resentatives from the Juvenile Diabetes Research Foundation about support systems and resources they can access for help in dealing with their children’s disease. Camp Sweet Life Director Vickie Parsons, a nurse practitioner at the Mankato Clinic, said the camp will become an annual event.

“It’s all about kids having fun out­doors just like all the other kids,” she said. “ They shouldn’t be denied from enjoying the outdoors just because they have diabetes.”

Services offered by the Mankato Clinic at the new location will include urgent care and occupational medicine. The Clinic will continue to offer urgent care services at their Main Street location as well. “The addition of the Now Care location to the Mankato Clinic’s current locations will give our patients a convenient option for urgent care and occupational medicine services. Patient volumes at our Main Clinic urgent care have continued to increase over the past few years. The addition of a second urgent care option at the former Now Care location on Adams Street will allow us to improve access for our patients,” commented Randy Farrow, CEO of the Mankato Clinic. “The Now Care Clinic has filled a strong niche with convenient access to urgent care and occupational medicine services for many years and we are excited to maintain and expand these services as they become part of the Mankato Clinic. “ All occupational medicine services will now be housed out of the new Adams Street location giving current and new patients convenient access to walk –in services as appointments will not be necessary for most occupational medicine needs. Additional occupational medicine services not offered by Now Care will now be offered such an travel and immigration services. The new location will focus on walk-in health care services. No appointment will be necessary for all urgent care services and most occupational medicine services.

The Mankato Clinic will also be utilizing electronic health records at the new location which will assist in providing patients with continuity of care. Medical records can instantly be shared by multiple physicians simultaneously regardless if a patient is being seen by their primary provider or an urgent care provider. Important patient information regarding previous visits, lab and radiology test results, and current medications, are available within the electronic health record to assist the provider in delivering the highest quality of healthcare.

When accidents, incidents, and illnesses arise, finding the best type of health care provider for your needs can be confusing. Primary care providers such as a family practice physician are a great place to start for most undiagnosed health issues. The Mankato Clinic suggests all patients have an
established primary care provider. If your primary care provider is not available and you need quick medical attention for a non-life-threatening problem, visit an urgent care center. No appointment is required at Mankato Clinic’s Urgent Care locations which are open extended hours for patient convenience: 8:00 am – 8:00 pm – Monday – Friday, 8:00 am to 5:00 pm on Saturday and 11:00 am – 5:00pm-on Sunday. Urgent care centers also provide a significant cost saving over care in an emergency department. A retail clinic such as the Mankato Clinic Express in the Riverhills Mall is another option for minor illnesses such as colds, ear infections, and pink eye for patients over 18 months old.

As part of Mankato Clinic’s commitment to its patient-centered healthcare home model, the clinic will take the model a step further by focusing on patients with depression and launching the DIAMOND initiative, at its North Mankato Family Practice and Wickersham Family Practice locations this month. Mankato Clinic is the only clinic in the region to offer DIAMOND services at this time.

DIAMOND, or Depression Improvement Across Minnesota, Offering a New Direction, is a new model for treating patients with depression in primary care by taking a team approach. It was developed in 2008 by the Institute of Clinical Systems Improvement (ICSI). ICSI is a non-profit organization that works with medical groups, hospitals, health plans, purchasers, policy makers and consumers to deliver patient-centered and value-driven health care services in Minnesota and its surrounding areas. Mankato Clinic is a member of ICSI and is part of the fourth group of clinics in Minnesota and Wisconsin to participate in the DIAMOND initiative.

“At Mankato Clinic, we sought a more effective way of providing depression care that takes the sole responsibility away from the primary physician and expands it to a team of care providers with the patient at the center,” said Julie Gerndt, chief medical officer at Mankato Clinic. “By taking a collaborative approach and integrating care managers and medical health professionals into primary care, outcomes of patients with depression are significantly improved compared to results seen under the standard care.”

DIAMOND helps overcome barriers to successful depression treatment in primary care clinics. It offers a scientifically-sound framework and training program to establish evidence-based, collaborative, measurable and actionable solutions.

There are six components of the DIAMOND model that distinguish it from traditional depression care including:
• A validated screening tool or checklist that helps the health care team detect and manage symptoms of depression
• A way for the care team to regularly track patient progress
• A proven medical guide with stepped-care approach for treatment modification or intensification
• A relapse prevention plan with tools to keep a patient who is improving from relapsing and move them out of the care management program
• A care manager to educate, coordinate and troubleshoot depression services and who serves as a liaison between psychiatrist, primary care provider and patient
• A consulting psychiatrist who reviews patient cases with the care manager and may consult with the primary care physician

Barb Anderson, CGRN, Quality Management specialist and DIAMOND initiative project manager at Mankato Clinic, says the use of a care manager is an important aspect of DIAMOND. “The involvement of the care manager is integral to the success of the initiative,” said Anderson. "The care manager has special training and works together with the patient to best support their depression treatment needs." Typically, a care manager has a nursing or mental health care background; and in collaboration with the entire health care team, is responsible for education, self management support, primary care mental health care coordination and relapse prevention.

The consulting psychiatrist collaborates with the care manager and reviews the clinic’s DIAMOND patient caseload weekly and recommends changes in treatment for patients not improving. The primary care physician makes all final treatment decisions and initiates changes in treatment plans. “If we are not getting desired outcomes and the patient is not making progress at certain steps, we get additional care providers involved,” said Gerndt. “It has proven effective just by changing the model of care.”

After tracking patients who followed DIAMOND care for 12 months, ICSI states remission rates were 49 percent surpassing goals by 19 percent and response rates, or the decrease in the severity of depression, were 72 percent exceeding goals by 22 percent.

According to ICSI, more than 37 DIAMOND trials have shown this method improves patient health. Patients had more depression-free days, fewer suicidal thoughts, stated they felt better physically and liked the care they received more. Employers benefited also because patients missed fewer days of work and were happier and more productive at work. And, health care costs decreased compared to costs under usual primary care.

DIAMOND also offers the Clinic an opportunity to enhance treatment models of other chronic diseases that are typically difficult to treat. “Depression is the first specific chronic disease that we have expanded our medical home model into,” said Gerndt. “We are excited and encouraged by the results of other clinics who have implemented DIAMOND. We hope to replicate those outcomes and expand the model to other Mankato Clinic sites as well as use DIAMOND to develop a model of care for other chronic diseases.”

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