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Research & Publications

Avera eCARE Research and Publications

Avera eCARE makes vital contributions to advancing the national research and literature on telemedicine services. We collaborate with institutions such as the University of Iowa, University of Pittsburgh and the University of North Dakota, among others.

You’ll find our medical professionals as primary authors and co-authors on key research studies, and our work is cited by diverse publications. Explore these peer-reviewed journal articles, abstracts and related sources to learn more about Avera eCARE’s contributions to important telemedicine topics.


Funding Agency: Health Resources & Services Administration (HRSA)
Grant Award: Evidence-Based Tele-Emergency Network Grant Program
Award Period: 9/1/2014 – 8/31/2019 (3 year award, 1 year additional funding, 1 year no cost extension) 

Grant Purpose: Evidence-Based Tele-Emergency Network Grant Program (EB TNGP): The EB TNGP is a competitive grant program that supports implementation and evaluation of broad telehealth networks to deliver 24-hour Emergency Department consultation services via telehealth to rural providers without emergency care specialist. The purpose of the EB TNGP is to support a range of TeleEmergency care programs that will allow for the analysis of a significant volume of patient encounters to allow for detailed study and analysis of patient outcomes in rural areas. 

eCARE Focus Areas: Sepsis, Chest Pain, Stroke, Trauma, Airway, emergency Behavioral Health

Publication Synopses:

  1. MacKinney, A. C., et al. (2015). "The Business Case for Tele-emergency." Telemed J E Health 21 (12):1005-11. doi: 10.1089/tmj.2014.0241
  2. Potter, A.J., et al. (2016). “Perceptions of the Benefits of Telemedicine in Rural Communities.”
  3. Mohr, N. M., et al. (2017). "Emergency Department Telemedicine Is Used for More Severely Injured Rural Trauma Patients, but Does Not Decrease Transfer: A Cohort Study." Acad Emerg Med 24(2): 177-185. doi: 10.1111/acem.13120.
  4. Mohr, N. M., et al. (2017). "Serum anion gap predicts lactate poorly, but may be used to identify sepsis patients at risk for death: A cohort study." J Crit Care 44: 223-228. doi: 10.1016/j.jcrc.2017.10.043     
  5. Mohr, N. M., et al. (2018). "Telemedicine Use Decreases Rural Emergency Department Length of Stay for Transferred North Dakota Trauma Patients." Telemed J E Health 24(3): 194-202.  doi: 10.1089/tmj.2017.0083.
  6. Mohr, N. M., et al. (2018). "Emergency Department Telemedicine Shortens Rural Time-to-Provider and Emergency Department Transfer Times." Telemed J E Health. doi: 10.1089/tmj.2018.0013
  7. Natafgi, N., et al. (2019). "The Association Between Telemedicine and Emergency Department (ED) Disposition: A Stepped Wedge Design of an ED-Based Telemedicine Program in Critical Access Hospitals." J Rural Health. doi: 10.1111/jrh.12370
  8. Natafgi, N., et al. (2018). "Using tele-emergency to avoid patient transfers in rural emergency departments: An assessment of costs and benefits." J Telemed Telecare 24(3): 193-201. 
  9. Vakkalanka, J. P., et al. (2019). "Telemedicine is associated with rapid transfer and fewer involuntary holds among patients presenting with suicidal ideation in rural hospitals: a propensity matched cohort study." J Epidemiol Community Health. doi: 10.1136/jech-2019-212623.
  10. Van Oeveren, L., et al. (2017). "Telemedicine-Assisted Intubation in Rural Emergency Departments: A National Emergency Airway Registry Study." Telemed J E Health 23(4): 290-297. doi: 10.1089/tmj.2016.0140.
  11. Ward, M. M., et al. (2018). "Use Of Telemedicine For ED Physician Coverage In Critical Access Hospitals Increased After CMS Policy Clarification." Health Aff (Millwood) 37(12): 2037-2044.
  12. Ward, M. M., et al. (2016). "Tele-emergency utilization: In what clinical situations is tele-emergency activated?" J Telemed Telecare 22(1): 25-31. doi:10.1177/1357633X15586319
  13. Potter, A. J., et al. (2014). "Effect of tele-emergency services on recruitment and retention of US rural physicians." Rural Remote Health 14(3): 2787.
  14. Weigel, P. A., et al. (2019). "Paediatric tele-emergency care: A study of two delivery models." J Telemed Telecare: 1357633X19839610.  doi: 10.1177/1357633X19839610. 

Publications Pending:

  1. Rural Telehealth Research Center T-PART Sepsis
  2. Rural Telehealth Research Center T-PART Stroke
  3. Rural Telehealth Research Center Averted transfer
  4. Rural Telehealth Research Center T-PART Cardiac
  5. Psychiatric Emergency Telemedicine Consultation Is Associated with Increased Hospital Admission Among Patients Presenting with Suicidal Ideation or Attempt: A Propensity Score Matched Cohort Study
  6. Pediatric Tele-Emergency Care: A Study of Two Delivery Models


  1. Davis, TM., Barden, C, Dean, S, Gavish, A, Goliash, I, Goran, S, Graley, A, Herr, P, Jackson, W, Loo, E, Marcin, JP, Morris, JM, Morledge, DE, Olff, C, Rincon, T, Rogers, S, Rogove, H, Rufo, R, Thomas, E, Zubrow, MT, Krupinski, E A and Bernard, J. (2016). American Telemedicine Association Guidelines for TeleICU Operations. Telemed J E Health, 22(12), 971-980. doi:10.1089/tmj.2016.0065
  2. Ward, M., Ullrich, F., Potter, AJ, MacKinney, C., Kappel, S., Mueller, K. (2015). Factors affecting staff perceptions of Tele-ICU service in rural hospitals. Telemedicine & e-Health, 21(6), 1-8. doi: 10.1089/tmj.2014.0137
  3. Davis, T. M., Barden, C., Olff, C., Aust, M. P., Seckel, M. A., Jenkins, C. L., Deibert, W., Griffin, P., Herr, P., Hawkins, C. and McCarthy, M. (2012). Professional accountability in the tele-ICU: the CCRN-E. Crit Care Nurs Q, 35(4), 353-356. doi:10.1097/CNQ.0b013e318266bef4
  4. Edward T. Zawada Jr., David Kapaska, Pat Herr and Michael Heisler (2011). Avera eCARE®, a Comprehensive Telemedicine Program for the Rural North Central Region of the United States, Advances in Telemedicine: Applications in Various Medical Disciplines and Geographical Regions, Prof. Georgi Graschew (Ed.), InTech, doi: 10.5772/13941.
  5. Zawada, E.T., Jr., Herr, P., Larson, D., Fromm, R., Kapaska, D., & Erickson, D. (2009). Impact of an intensive care unit telemedicine program on a rural health care system. Postgrad Med, 121(3), 160-170. doi: 10.3810/pgm.2009.05.2016.
  6. Nichols, R., Zawada, E., Johnson, T., Aaronson, M. L., Herr, P., & Casanova, J. (2008). Implementation of an insulin protocol using a multiplier-based calculation for determining infusion rates in critically ill patients. SD Med, 61(7), 247, 249-253. PMID: 8717292
  7. Zawada, E. T., Jr., Kapaska, D., Herr, P., Aaronson, M., Bennett, J., Hurley, B., Avera eICU (2006). Prognostic outcomes after the initiation of an electronic telemedicine intensive care unit (eICU) in a rural health system. SD Med, 59(9), 391-393. PMID:17058472


  1. Alexander, E., Butler, C. D., Darr, A., Jenkins, M. T., Long, R. D., Shipman, C. J., & Stratton, T. P. (2017). ASHP Statement on Telepharmacy.
    Am J Health Syst Pharm, 74(9), e236-e241. doi:10.2146/ajhp170039

Senior Care

  1. Hofmeyer, J., Leider, J. P., Satorius, J., Tanenbaum, E., Basel, D., & Knudson, A. (2016). Implementation of Telemedicine Consultation to Assess Unplanned Transfers in Rural Long-Term Care Facilities, 2012-2015: A Pilot Study. J Am Med Dir Assoc, 17(11), 1006-1010. doi: 10.1016/j.jamda.2016.06.014.
  2. Suzanne M. Gillespie MD, RD, CMD a, b, c, Andrea L. Moser MD, MS, CMD d, Murthy Gokula MD, CMD e, Thomas Edmondson MD, CMD f, Joseph Rees DO g, Dallas Nelson MD, CMD b, Steven M. Handler MD, PhD, CMD h, i.(2019) Standards for the Use of Telemedicine for Evaluation and Management of Resident Change of Condition in the Nursing Home. Journal of the American Medical Directors Association
    Volume 20, Issue 2, February 2019, Pages 115-122.

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