Image courtesy of Avera eCARE

Based in Sioux Falls, South Dakota, Avera eCARE has established a fine-tuned network of remote care providers to bring advanced medical resources to communities in 32 states around the country. For 25 years, Avera eCARE has supported patients and clinicians with their team of medical experts through their robust communication and video infrastructure.


Avera eCARE conducts specialty consults out of their Sioux Falls Hub, primarily servicing rural health care facilities. In 2004, Avera evolved to begin providing 24/7 on-demand services. While this service initially began with intensive care unit (ICU) services, they were one of the earliest adopters of telemedicine to support rural clinicians and began to see how those hospitals were using the services in unique ways. The ICU and rural hospital use cases helped to inform Avera about new ways to think about telemedicine and have since evolved to provide remote emergency care to rural emergency rooms, behavioral health clinics, critical access needs, correctional health needs, senior care, and many others.

In rural communities, oftentimes there are only a handful of clinicians who are not only in charge of general hospital services, but also emergency services, senior care, and all other health needs for the community – at times overwhelming clinicians. In these overstretched medical environments, eCARE is extremely beneficial to on-site clinicians who are then able to bring in specialty healthcare providers through Poly video endpoints.

Poly recently had the opportunity to speak with Mandy Bell, Innovation Officer at Avera eCARE to learn about how their advanced remote medical network uses Poly.



When choosing a provider to power their network, the primary emphasis was placed on sourcing solutions that deliver consistent audio and video to facilitate virtual consultations with ease in place of on-site services. This is because in emergency scenarios it is crucial that minimal training is required for any of the technology. It has to be easy to use and it needs to work every time. “Poly has been highly reliable; it’s there when we need it most. The Poly technology is seamless to use across our network and we know that it’s easy and intuitive to use right from the start,” said Bell.

Additionally, the technology needed to provide lifelike video to allow clinicians and patients to feel as if they are in the room together and facilitate proper evaluation of patients. In essence, the key to the success of telehealth is that the technology must be seamless for all to use and bring high-quality professional care to anyone, anywhere via a Poly device. When it comes to how these attributes come together to create an experience that is similar to being in-person, Bell explained, “We’ve relied on Poly technology to make sure that we can zoom in and evaluate patients, support emergency airway intubations, and communicate effectively with the bedside team. All of this is set up using any reliable, hi-def technologies so that the end-user doesn’t have to lift a finger when they are taking care of the patient in front of them.”

So, what happens when technology is easy to use and provides high-definition video and audio? You forget it’s there.

“One of the best things about working with Poly technologies is that the technology works so well, it actually fades into the background, we no longer had to have conversations about what technology to use, but more about how to deliver the care. It works so well we almost take it for granted that the tech will just work so we can do our jobs,” explained Bell.

Image courtesy of Avera eCARE


In addition to ease of use, Bell noted that another important variable is durability. “We chose Poly (then Polycom) as our standard primary vendor in 2005 and we feel amazingly fortunate. The units we bought nearly 16 years ago are still in service – which is amazing if you think about it. That’s a really good run for any kind of technology that’s deployed and used that heavily. We’re big fans and we’re currently installing the next generation [of endpoints] across hospitals and in our corporate headquarters,” said Bell.


With technology at the core of how Avera eCARE operates, the ability to remotely manage their vast deployment becomes crucial to ensuring endpoints are running on the latest updates and device issues flagged. Avera’s infrastructure relies on Poly RealPresence Resource Manager, a collaboration device management platform that provides advance provisioning and management of Avera’s entire deployment. 


Avera’s eHelm is set up for all services offered, each service station with its own video unit and computer documenting systems so that doctors and nurses can huddle up and take calls together. Rather impressively, care providers can have up to ten calls simultaneously across the network of 200+ facilities.

Image courtesy of Avera eCARE

On an average month, Avera eCARE supports 1,400 emergency video consults calls and 1,000 specialist consults, receiving patients from their 380+ Poly Group Series 500 units deployed to emergency rooms, state correction facilities, and long-term care facilities and have over 900 Poly Group Series codecs deployed. In addition to video, nearly 90 percent of Avera’s clinical and clinical staff use Poly headset at their desk every day.

At the end-user sites in the ER, Avera has Poly video devices hung on the hospital room wall so that the patients can easily be seen by the practitioners, and boom mics are hung over the hospital beds to pick up conversations with patients. In one case, Avera worked closely with Poly engineers to design devices to assist in video laryngoscope needs – most often used for intubations which can be a scary, lifesaving procedure, that most practitioners do not do very often. Using Poly video, doctors and clinicians can see the airway very clearly and help guide the bedside clinician through the procedure.


In the NICU (newborn intensive care unit), Avera uses the Poly Group Series 500 connected to a GoPro camera mounted to a flexible arm on the NICU warmer. After the baby is born, the GoPro is mounted above the infant to be monitored by a remote physician. The doctor communicates with on-site physicians and nurses to advise proper care. The dual-camera system allows the remote NICU team to collaborate and communicate effectively with bedside caregivers during the intense period of care just after delivery.


Avera’s eRadiation and Oncology programs are brought to rural locations using the Poly Group Series 700, allowing physicians to provide quality accessible care. Poly engineers came into the hospital to test mount cameras in oncology lead-lined vaults to ensure cameras, control rooms, and supporting technology could provide this level of remote expertise. The multi-camera setup allows the remote specialist to get multiple views of the patient and linear accelerator as well as the staff and systems in the control room.


During the first month of the COVID-19 pandemic, Avera deployed 500 endpoints via the Poly RealPresence Desktop solution to respond to the high-demand for telehealth visits. Remote diagnosis and monitoring have been hugely beneficial in relieving on-site nurses from being required to go into every room and potentially risk contracting the virus. Additionally, this saves nurses time – allowing them to treat more patients. This rapid deployment of Poly solutions ensured that operations continued to run smoothly and helped Avera feel as if they were prepared ahead of time because of the strong technology backbone they already had in place.

Poly also worked with Avera to increase the number of live sessions, allowing them to have an additional 600 video sessions per day to allow staff to remotely check on COVID-19 positive patients – this limited the need to use precious PPE (personal protective equipment), and expedited care for patients. The increase in live sessions also allowed Avera eCARE to ramp up other telehealth services to hospitals in need through a quick install via the RealPresence Desktop App.

In some cases, clinicians who were exposed to COVID-19 were outfitted with the RealPresence Desktop App on their laptops or iPads and they were able to work from home while still seeing patients in the hospital. 


During the pandemic, the vast majority of routine and non-urgent medical visits have been relying on telemed to safeguard patients and healthcare workers from illness. This mode of care is something Bell predicts will have staying power long after the pandemic, explaining, “This is that watershed moment for telehealth. We’re just at the tip of it. But now that more people have been exposed to telehealth, it’s going to be difficult to go back to pre-COVID times. Patients are going to demand it – why would you want to go to the hospital when you can stay in the comfort of your home or office?”

We are living through a time with so much at stake when it comes to health and the ways in which technology has enabled so much of our lives to turn virtual is astounding. And as time goes on, it’s only becoming more difficult to imagine things going back to the way they were before COVID-19. As Mandy Bell said, this is truly a pivotal moment for telemedicine. Healthcare systems such as Avera eCARE that have been embracing technology and driving innovation to provide quality care remotely have been at the forefront of reshaping the medical space.

For more information about Poly’s solutions for healthcare, contact a Poly representative.


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