Recently, St. Charles athletic trainers visited Lava Ridge Elementary in Bend as part of the Train Your Brain program.
Using a fun and interactive approach — see the beloved melon drop demonstration, pictured below — trainers taught third graders how to protect their brains and why it’s important to wear a helmet. Students also got to take home a free helmet properly fitted by our volunteers.
As part of Train Your Brain, which became a St. Charles program upon the integration of The Center, our trainers will visit dozens of schools, train thousands of kids and give away about 1,000 free helmets.
We are excited to continue keeping Central Oregon kids safe while they bike, skate and play this summer and beyond.
Recent upgrades to the MRI machine at St. Charles Bend are hidden away, out of sight, in the basement of the hospital.
But patients who experience them will certainly notice them, said Director of Imaging Scott Nelson, who has worked in the field for 22 years.
“We used to have to lower the resolution of our images to get a faster scan for claustrophobic patients and patients in pain, or we could achieve higher resolution images, but scan times were longer. There were always tradeoffs with time and resolution,” he said. “With this new technology, we can speed up the scan time and still keep hi-res images, which makes for an overall better patient experience.”
Faster, higher resolution scans are largely the result of computing advances over the years, said Alex Boggs, MRI Technologist Manager at Central Oregon Radiology Associates (CORA), who is overseeing the upgrades. More recently, integration of Artificial Intelligence has further improved the MRI experience, he said.
“The software has been shown thousands and thousands of images, so it learns the difference between quality signal and noise,” Boggs said. “Once it’s learned that, you can scan faster.”
For a variety of reasons, there is no easy way to quantify how much faster scans will be with the upgrades, Boggs said, but many scan times will drop significantly. And higher resolution scans often mean a clearer look inside the body for physicians, which can lead to earlier diagnoses, quicker treatment and better outcomes for patients, Nelson said.
CORA partners with St. Charles to provide the Bend hospital’s MRI, or magnetic resonance imaging, which uses a strong magnetic field and radio waves to create detailed images of the body’s organs, bones, muscles, blood vessels and other internal structures. MRI is used for many different fields of medicine, including stroke evaluation, examination of masses and ruptures of tendons and ligaments. It’s very versatile and it’s safer than CT scans because it doesn’t use ionizing radiation, Boggs said.
The improvements to the Bend hospital’s MRI extend beyond its imaging capability, too. The new machine is more comfortable, Boggs said, and the hole through which patients pass is 70 centimeters across — a 17% increase over the previous machine.
“There’s quite a bit more elbow room in there, so it’s more comfortable for everyone, and especially for people who are apprehensive about tight spaces,” Boggs said.
In recent years, Bend hospital caregivers have had to transfer some patients to Redmond because of size and weight constraints. That won’t be an issue anymore, Boggs said.
“We’ll be able to care for more people in Bend, which means they’ll get the service they need where they are,” he said. “Transferring them is expensive, it’s logistically complicated and it comes with added risk. With this new scanner, there’s virtually no reason for us to ever have to send a patient elsewhere, and that’s a good thing.”
When a piece of hardware – like a screw – needs to be inserted into a patient’s spine, it’s important that it is placed in precisely the right spot.
“The margin for error is very, very small when inserting instrumentation into the spine. One to two millimeters can make a huge difference as to where you put a screw into the spine,” said neurosurgeon Dr. Raymond Tien.
Now, thanks to donors to St. Charles Foundation, spinal surgeons in Central Oregon are the first in the state to have access to a new, state-of-the-art spinal navigation system to help ensure that spinal surgeries performed at St. Charles are incredibly accurate. The Seaspine 7D spine navigation system arrived last fall and it allows surgeons to see the spine in three dimensions while inserting a piece of hardware.
Tien just used the system for the first time to place hardware in the spine of a patient.
“The procedure went perfectly and faster than it would have gone previously. It’s eye opening how accurate this system is and how easy it is to use,” said Tien.
Patients may need this kind of procedure due to a degenerative or congenital condition or medical trauma, like a fall or car crash. When placed correctly, hardware can help stabilize an unstable spine.
For the past 20 years, surgeons performed spinal surgeries using an X-ray unit in the Operating Room to help them visualize the anatomy. Tien says surgeons took many X-rays of the spine to create as complete a picture as possible. However, he says, the two-dimensional images are not as accurate as 3D images – and the process exposed everyone in the room to a lot of radiation.
With the new system, patients get a high-resolution CT scan prior to surgery. That scan is uploaded to the computer as a reference. Surgeons then place a marker on the patient’s spine that a camera can see. The navigation system has an array of lasers and light-emitting diodes that take a flash photo of the marker exposed in the spine. With those images, surgeons then have an accurate 3D model of a patient’s spine.
“We can see directly on the computer where we are touching and see in very high fidelity where we are inserting the hardware and make adjustments on the fly,” said Tien. “This tool provides us an incredible level of accuracy and precision.”
St. Charles Foundation Executive Director Jenny O’Bryan says this piece of equipment is the largest investment the organization has made in 2024 – spending nearly $700,000 to bring the Seaspine 7D spinal navigation system to Central Oregon.
“Our donors want to ensure that Central Oregonians are receiving the best care possible from the best providers, utilizing the best equipment available. If you or your loved ones need spinal surgery, you want to know that your surgeons have the best equipment on hand. Thanks to our donors, that’s the case,” said O’Bryan.
In addition to its precision, Tien says the new tool also helps save time for patients. He also believes it will allow for surgeons to take on more complex cases.
“There is a real tangible value in the level of patient care that we can provide now that we weren’t able to prior to this,” said Tien. “Without a doubt, we are very grateful for what the donors to the Foundation have been able to do for the hospital and for the community.”
Physician Associate Mandi Bryson went into family care medicine because she wanted to help people. “I love building relationships with patients,” said Bryson, who works at St. Charles' Bend East Family Care Clinic.
But in recent years, Bryson found herself tied to her computer more and more, due to increasing documentation requirements, inbox messages and phone calls to return. “There was a mental burden of all the stuff that you have to do that’s not taking care of the patient in front of you,” said Bryson. She found herself leaving the clinic about 6 p.m. and then spending an additional hour or two at home every night completing required documentation on the computer.
Last spring, the stress became so overwhelming that Bryson considered leaving the profession all together.
“I was desperate. The demands were so heavy, I was looking for other jobs. I knew I couldn’t continue to do this to myself. What was a life-giving job had become too much. I thought, ‘Either I get something that helps me, or I have to leave this work that I love,’” she said.
Bryson got help with the burdens of technology from an unlikely source - new artificial intelligence software called DAX. Not only has this technology cut charting time significantly, but it has also allowed Bryson and other physicians to better connect with patients during exams. That’s because the technology completes the documentation, allowing providers to focus all their attention on their patients.
“This has been a game changer. I’ve stopped applying to different jobs,” said Bryson, who says she is now leaving work by 5:30 p.m. with notes done and an empty inbox. “I love my work. There are still challenging aspects, but documentation isn’t one of them. I can focus more on the parts that bring me joy.”
She is one of approximately 55 primary care providers at St. Charles now using DAX and there are plans to bring the service to other clinical areas.
“DAX allows providers to get to do what called them to medicine in the first place – caring for patients,” said Dr. Matt Clausen, ambulatory chief medical informatics officer, who led the effort to bring DAX to St. Charles.
DAX is more than a transcription service; it uses artificial intelligence to summarize and provide accurate notation within a patient’s electronic health record. Physicians using DAX first get permission from patients to use the service – then, they pull the app up on their phone as they walk into a patient’s room. The provider conducts the exam with the patient as usual – but there is no need to take notes or sit by a computer. Instead, the physician can focus entirely on the patient while DAX listens in the background and fills in the patient’s chart. Providers review the notes to ensure accuracy, but it significantly cuts down the time spent charting.
Clausen says burnout among physicians has increased in the past few years and he believes that is directly linked to the demands of documentation. This AI tool was brought in specifically to help with burnout and the results have been overwhelmingly positive.
Before using DAX, 47% of St. Charles primary care providers said they were “definitely burning out” and experienced more than one symptom of burnout. After implementing the DAX program, that dropped to just 7 percent of providers. Physicians using the technology also reported higher job satisfaction (88%), that they are more likely to continue practicing medicine (75%), that they have better documentation quality (88%) and better work-life balance (75%).
“We are early adopters for this technology and we are already seeing it help us with recruitment and retention,” said Clausen.
But perhaps the most significant aspect of this technology is its impact on patients. Eighty-nine percent of patients said that their provider was more focused during their visit when they used DAX and 100% said their provider spent less time on the computer.
Dr. Nathan Thompson, a family care physician in Redmond, says doctors have a choice: Do I chart in the room and look at my computer or do I give my attention to the patient and try to remember everything they are saying to document later? “It’s a horrible tension,” he said.
Now, with DAX, that tension is gone.
He said documentation used to take him up to 20 minutes per patient before DAX. Now it’s down to minutes of review. For Thompson that means he now has time to volunteer coaching soccer at a local high school and he is more able to be present mentally, physically and emotionally to his family.
Thompson worried that some of his patients might be skeptical of the technology. “I worried a lot of people would not go for it, but it’s been the complete opposite. I am very grateful to our community for accepting it. I want them to know this is only something we use to be more present as humans. It’s allowing us to be more human in the room.”
Bryson agrees that her patients have also been very supportive of the technology.
“I’m hearing from patients, ‘you were really listening; it felt like you weren’t rushed; I’ve never had an appointment like this.’ It’s so nice to not have a computer between me and them,” she said. “St. Charles really offered something that helped me where I needed it most. Day-in and day-out, this is making a difference and I am very grateful for that.”
As a physician and as a parent, I’ve never seen a case of measles. I’m not alone. The World Health Organization declared measles eliminated in the United States in 2000, thanks largely to an extremely effective vaccination program.
Because of the Centers for Disease Control’s recommended childhood immunization schedule, measles has been an afterthought for decades in America — if families thought about it at all. For many, receiving the MMR vaccine, which stands for measles, mumps and rubella, has been as routine as getting dressed in the morning and brushing teeth at night.
However, measles remains a serious disease: Airborne and extremely infectious, it can cause severe illness, complications and even death. Before there was a widely available vaccine, an estimated 48,000 people were hospitalized and 400 to 500 people died of measles in the U.S. each year.
Because it is so contagious, measles is a significant community health problem, and I firmly believe community challenges require collective solutions. With that in mind, I hope you’ll watch this video:
Our Central Oregon health care community is small, but strong. Our providers often work across organizations on important issues that impact us all. A handful of local pediatricians meet regularly to discuss emerging public health concerns for our kids. When Dr. Suzanne Mendez, a pediatric hospitalist at St. Charles, said this group was concerned about measles and wanted to work together on messaging that would encourage curiosity and conversation between parents and providers, we jumped at the chance to help.
I want to personally thank Dr. Julie Ansbaugh of Central Oregon Pediatric Associates, Dr. Michelle Mills of Summit Health and Pediatric Nurse Practitioner Ellie Millan of Mosaic Community Health for joining Mendez and her fellow St. Charles physician, Dr. Carey Allen, in the video. And I want to thank COPA, Summit and Mosaic for their vital partnership as we all work together to ensure Central Oregon is a safe and healthy place to live.
Community challenges require collective solutions. Here it is in action.
Just one day old, Gracie Abbott was swaddled and cozy, taking turns snuggling in the arms of her dad, Brennan, and her mom, Teagan, in a private room in the Family Birthing Center at St. Charles Bend. These tender early moments were particularly sweet for the Abbotts, as Gracie came close to spending her first days of life in the hospital’s Neonatal Intensive Care Unit.
When Gracie was born, she had fluid in her lungs, struggled to breathe and her oxygen level was low. But thanks to a newly implemented treatment called Interpulmonary Percussive Ventilation (IPV), respiratory therapists were able to remove the fluid and Gracie was able to safely stay with her parents.
“Without that machine Gracie would’ve been in the NICU. It was pretty scary; it felt like we almost lost her,” said Brennan Abbott, a Prineville resident.
Gracie is one of 116 infants who received IPV therapy since the treatment was implemented at St. Charles in March of 2024. The treatment is now available for infants born in Bend and Madras. Of those 116, 60% (70 infants) were able to stay with their parents and avoided the NICU.
“We see this as a tremendous success,” said St. Charles neonatologist Dr. Sue Ann Smith. “When infants are able to stay with their mothers, there are so many benefits – I call it the ABCs. It helps attachment, breastfeeding and it helps keep costs down for families.”
It also keeps those NICU beds open for infants who are in greater need.
How IPV works
Blake Andrews, manager of respiratory therapy at St. Charles, explains that with IPV, a mask is placed on the infant and then a pulsating airflow is pushed into the lungs. These little jets of air help move fluid out of the airways.
“The small bursts of air get around and behind the fluid trapped in the lungs, forcing those secretions out,” said Andrews. “It’s a pretty short intervention for a pretty big outcome.”
IPV was already used with adult populations, but was rarely used on infants, explained Smith. After attending a training by a NICU doctor from Legacy Salmon Creek hospital, Smith thought it was worth bringing to St. Charles.
Smith says infants often get fluid in their lungs, as the womb is a fluid-filled environment. This is especially common with babies born via C-section, as the fluid is often pushed out of the lungs in the birth canal.
“Sometimes babies have trouble making the transition and retain fetal lung fluid or meconium,” said Smith. If a baby is struggling with fluid in the lungs, the first step is to use a CPAP machine, a device that uses mild air pressure and is commonly used to treat sleep apnea.
“We need to get the air in there to keep the lungs open between breaths,” said Smith.
If after 20 minutes the baby is still in distress, they used to be sent to the NICU, where they receive more intensive care and treatment by specialized caregivers. But now, respiratory therapists can use the IPV treatment. The treatment is used for 10 minutes and then if there’s no positive change, babies are moved to the NICU.
The therapy is also available at the Family Birthing Center at St. Charles Madras, which allows infants to stay in Madras rather than having to transfer to St. Charles Bend for the NICU.
“We really want our babies to get to stay with their mothers, so this is really exciting,” said Smith.
And for the Abbott family, keeping Gracie close by during her first few days of life meant the world.
“I wouldn’t have wanted to leave her. I’m so glad we got to stay together,” said Teagan Abbott.
It’s official: The Center Orthopedic & Neurosurgical Care & Research — a longtime provider of orthopedic, neurosurgical, occupational and physiatric care in Central Oregon — is now a part of St. Charles Health System.
Its new name is the St. Charles Center for Orthopedics and Neurosurgery, and about 250 people who worked for The Center — including 27 physicians and 29 advanced practice providers — decided to join our team. They work in clinics in Bend, Redmond, Sisters, La Pine and John Day, and the surgeons among them provide surgical care at the Bend and Redmond hospitals, Cascade Surgicenter and Bend Surgery Center.
I want to thank those folks for their patience as we’ve worked through this complicated integration process. We are excited to have them on our team and are making every effort to make sure they feel welcome at St. Charles.
I also want to thank the many St. Charles caregivers who worked hard over the past few months to make this transition as seamless as possible. We are stronger today because of their efforts.
The history of The Center and of St. Charles are deeply intertwined. The Center physicians and providers have always been essential members of the St. Charles medical staff, and over the years many served in St. Charles leadership roles, including on the boards of St. Charles and the St. Charles Foundation. And yet this integration is still a big change for all of us — providers, employees and patients. I believe it was absolutely necessary.
Over the past few years, Central Oregon experienced a rapid reduction in access to care across many different types of medicine, due in part to increasing costs to provide care and flat or declining reimbursements. The number of orthopedic, neurosurgery, physical medicine and rehabilitation providers in the region has decreased dramatically, making access to necessary care a significant burden for patients and their families.
The Center tried to fill care gaps as best they could, but as a stand-alone practice found it very difficult to recruit and retain providers at a pace fast enough to stabilize the service. Their leadership was concerned that without immediate financial support, more providers would leave the region, worsening the long delays patients are experiencing for care.
Like The Center, St. Charles is committed to providing the best possible care in the communities we serve. So, it made sense for us to step in and help shore up these critical services and ensure care remains locally owned and operated.
It’s the right thing to do, not just for St. Charles, but to ensure Central Oregonians continue to have access to a wide variety of health care services close to home.
As a patient or visitor, your experience should largely remain the same as it has been in recent years. You may notice a new sign on the building, but once inside, you can expect to encounter great people and receive great care.
That’s what we do here at St. Charles. As always, I’m proud to be a part of it.
I’ve spent time meeting with many local business leaders in recent weeks and have been hearing many positive comments about our region, our community and how most local businesses produce goods and services closely tied to our quality of life. We have incredible local restaurants, recreational activities and so much more that make Central Oregon a place we are proud to call home.
These conversations have also led me to think more critically about the role St. Charles plays — not only as the largest provider of health care in the region, but as the largest employer. What benefit do our friends and neighbors receive simply by St. Charles continuing to exist as a nonprofit organization that is locally owned and where every dollar goes back into our people, programs and places?
We recently asked East Slope Economics, a Bend-based firm, to produce a report on the health system’s economic impact. Here are just a few highlights that I think are worth calling out:
Of the approximately 7,400 jobs directly and indirectly supported by St. Charles, 41% are health care clinicians or directly support clinicians. The rest work in information services, educational instruction, food preparation, community and social services, administration and other areas.
The vast majority of the nearly 5,000 folks directly employed by St. Charles live in Central Oregon. They account for nearly 4.7% of total employment in Deschutes County and around 3.5% of total employment in Crook and Jefferson counties. Roughly one in 20 jobs are St. Charles jobs – which means if you go a movie, a busy restaurant or a concert there is a high likelihood someone – or many people – in the crowd work for St. Charles.
Our average wage is more than $109,000 — 75% higher than the average wage in Deschutes County. In addition to our caregivers’ local spending at area businesses, we contribute an estimated $40 million in annual income taxes to the state of Oregon.
The economic impact of those 5,000 jobs is nearly $871 million. Meanwhile, the economic impact of St. Charles’ business spending is around $202 million, and the impact of our caregivers’ spending is about $377 million.
Add it all up and you have a total economic impact of approximately $1.45 billion — yes, billion. That’s roughly 5% of total economic output from the entire region.
It’s important to note that our economic impact doesn’t end with direct spending and jobs. There’s a ripple effect: Providing access to quality care and critical services leads to improved health outcomes for Central Oregonians, which leads to things like decreased spending on health services and increased workforce productivity.
Having this information has been helpful as I’ve also been listening to and learning from other local business operators over the past few weeks. In addition to the pride they feel in our region, I also hear concerns that Oregon has developed a reputation as a state that is unfriendly to business. These concerns were echoed and substantiated by Oregon Business & Industry in a recent and comprehensive report. This year CNBC gave Oregon an “F” for business friendliness.
These are concerns that we at St. Charles share. Our long-term sustainability relies on the same trends supporting, or hindering, all local businesses. Our vitality is intimately linked with our region’s overall vibrancy.
My big takeaway from East Slope’s findings and listening to the voice of our local businesses? Our health system is an essential engine for a lot of good in Central Oregon — good that starts in our clinics and hospitals and stretches out to the far edges of the region, touching every individual, business and organization along the way. To maintain it, it’s imperative that our region adopts a renewed and thoughtful approach to continued economic development.
For Erin Mackie, caring for the people of Crook County has always been a family affair.
Her mother, Kim Crofcheck, ran the Prineville Medical Clinic for 10 years — from 1997 to 2007, before it was a St. Charles facility — managing the practices of eight different doctors. And her grandfather, Thomas Matheson, was a family practice physician in town for four decades.
“I remember they used to do after-hours physicals for the community and we were always helping out with those and checking people in, giving them their paperwork, stuff like that,” Mackie said. “It was just a volunteer, small-town thing, but being there and seeing what they were doing for the community was really cool.”
When it was time for her to go off to college, Mackie thought she wanted to work in the health care industry, but she didn’t want to do clinical work. She ended up studying business management and eventually moved back to Central Oregon, where she has worked for St. Charles for the past seven years, first in operations for the health system’s professional development department and then doing policy work for the Quality team.
She lived and worked in Bend, and didn’t think she’d ever move back home. But last year, a position became available there: Manager of St. Charles’ Prineville Family Care Clinic — the same job her mom held a generation ago.
“I said, ‘OK, let’s put our house in Bend on the market and see what happens.’ It sold in 48 hours,” Mackie said. “I looked at my husband and said, ‘Maybe we’re moving to Prineville.’”
Kim Crofcheck was thrilled, of course. She moved to Prineville when she was 6 years old, attended Lewis & Clark College in Portland and managed a medical clinic in Salem for 10 years before moving back to her hometown in 1997. Community health care work runs deep in the family, she said.
“My dad’s a doctor. My mom was a lab tech who did research on childhood leukemia. My brother’s a doctor. My uncle’s a doctor. Everyone’s in medicine,” she said. “I thought, ‘I’m going to do something different.’ So I got degrees in business and Spanish.”
After leaving the Prineville clinic in 2007, Crofcheck got her teaching degree and became a Spanish instructor at Crook County High School, where she still works. These days, she’s busy building the school’s business program.
“She’s just one of those people who always wants to learn and do things, and my grandfather was all about education, too. That’s just something that has been big in our family — growing and developing,” said Mackie, whose father Dan and sister Sarah are teachers. “I didn’t think I’d ever be in a management position and back in Prineville, but I think within the context of my family, it’s important that I take this next step.”
She’s ready for the job, according to someone who should know: Her mother.
“I loved that job because every day is different. There’s always something that needs your attention and needs to be fixed,” Crofcheck said. “That’s Erin’s personality. She and I are similar that way. So I encouraged her to go after it. I told her health care and education are two places where you can make a significant difference and give back to your community. And I told her, ‘You’ll be fine.’”
Nine months after accepting the position, Mackie is more than fine, actually. She distinctly remembers how much her mom loved the job, and she’s starting to see why.
“I’m really enjoying this, and it’s nice to be back in the community,” she said. “The older you get, the more you understand that your family and the place you grew up is as important as anything else in life.”
On Thursday, Nov. 14, St. Charles celebrated Native American, American Indian and Alaskan Native Heritage month by hosting a Native Market of artisan vendors at our Madras hospital and presenting the first physical installation of our organization’s land acknowledgment statement.
Posted prominently in the main lobby of the hospital, the land acknowledgment says:
We acknowledge that the St. Charles campuses are located within the 10 million acres ceded to the Federal Government, also usual and accustomed areas, when the 1855 Treaty was signed with the Confederated Tribes of Warm Springs of Oregon. We offer this acknowledgment to honor all Native Americans that live in this area and who are the original people of this land.
The journey to get to those 62 very important words was long, and it predates my work at St. Charles. For me, though, it started a couple of years ago, when one of our providers, Dr. Shilo Tippett — a member of the Confederated Tribes of Warm Springs, Wasco Tribe — spent a chilly fall day taking me around area, feeding me delicious luckame’n, touring the Warm Springs Health and Wellness Center, introducing me to tribal leaders and teaching me about tribal culture.
At the end of the day, I thanked Dr. Tippett for not just telling me about her history and the history of her family, but for taking time to show me how many people of the Confederated Tribes of Warm Springs live and so many places where their culture is rooted. She reminded me recently that as I thanked her, I also asked if there was anything I could do in return for the generosity she had shown me.
And that’s when she told me that about the land acknowledgment work that began before the COVID-19 pandemic and stalled as our St. Charles teams put all efforts toward saving lives for several years.
I am grateful for that day and for the work that came next, which resulted in the land acknowledgment now on the wall at our Madras campus. I’m also grateful for the many people — including members of the Confederated Tribes of Warm Springs — who worked hand in hand to develop its language and artwork, as well as our new land acknowledgment web page. I have learned so much along the way, and I view our acknowledgment as a standing invitation to each of us to be curious, to inquire, to reflect and to learn for oneself. To further extend that invitation, we will also install land acknowledgments at our other locations in the near future.
Land acknowledgments are a way for organizations to pay respects to the original inhabitants of the land upon which we reside and work and to recognize Indigenous people as the original stewards of said land. We hope that by acknowledging the past and working toward an inclusive future, we can aid in emotional healing and help set a positive tone for future generations.
