How Leona Helmsley Is Revolutionizing Health Care in the Midwest

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Avera McKennan Hospital

A technician at the Avera McKennan Hospital and University Health Center studies screens showing images with data about a patient in a remote location.

Panzirer lives near Sioux Falls and owns and operates a hunting lodge north of Pierre, where he spends a lot of time with his wife and five kids. But his philanthropic role is now a full-time job. He’s up to his elbows in the details of the $108 million that the Helmsley Trust has granted so far to projects in the Upper Midwest — of which eCare is but one.

Three million dollars went to the Abbott House, a home for troubled girls in Mitchell, and $8 million to the Good Samaritan Society for a program that puts sensors in the homes of elderly people. The sensors track movements at all hours, reporting how often a homebound senior takes a shower or wakes up in the middle of the night. Compare $750 a month for the sensors to $80,000 a year for a nursing home, “and you see the savings,” said Panzirer. “And it lets people stay in their own homes.”

Helmsley money has also purchased digital mammography equipment for isolated corners of the Dakotas — the goal is to make sure that a high-quality scan is no farther than an hour by car from every woman. Another initiative will equip every ambulance in the Dakotas — where ranchers and Native Americans have some of the deadliest heart attack rates in the nation — with a 12-lead electrocardiograph machine. Those ECGs let first responders know whether a patient is having the most lethal of attacks, so they can administer clot-busting medicine or dispatch a medical helicopter to get the patient to a hospital that can perform an angioplasty.

Dr. Elliott Antman, a cardiologist at Harvard Medical School, says the Helmsley grant serves as a potential game-changer. When first responders know what they’re doing, it helps reduce the all-important “door-to-balloon time” — that is, the time it takes from the moment a heart patient rolls through the ER bay before the completion of an angioplasty or stent to open up the heart valve and lessen damage to the heart muscle.

“Time is muscle,” said Antman. The national median door-to-balloon time was 96 minutes in 2005; last year it was down to 64 minutes. The more ambulance services are equipped with life-saving tools such as those purchased by the Helmsley grant, Antman says, the more lives will be saved. “Foxhole by foxhole, we can get there,” Antman said.

Whether it’s a heart attack or a gunshot wound, the red buttons, likewise, are adding precious moments. According to Panzirer, ongoing reviews of eEmergency facilities show that when a patient arrives in a rural ER in the middle of the night and no doctor is on site, a trauma specialist in Sioux Falls can be on the case 12 minutes faster than the local physician, who has to be rousted out of bed. “Twelve minutes can save a life,” he says, adding, “there’s no reason why a rural person shouldn’t get the same care as someone in a big city.” The Trust estimates as much as $2.3 million has been saved in unnecessary transfers since it started expanding into more ER sites two years ago.

Panzirer’s passionate conversation with TIME about rural health care took place in a blandly understated conference room. He is as demure and self-effacing as his famous grandmother was self-promoting. Where she starred in the advertising campaigns for Helmsley hotels, he will hardly let himself be caught in the frame at ribbon-cutting ceremonies. Most folks in the Dakotas have never heard of Panzirer and have no idea that a trustee of one of the world’s wealthiest charitable trusts is in their midst.

He is the type of person who neglects to mention that the antique partner desk of his multibillionaire step-grandfather, Harry Helmsley, Leona’s late husband of 25 years, is in his office. Walter uses the desk daily, tending to the charitable work made possible by the shrewd man who started out as a $12-a-week errand boy and ended up a mogul. (Harry Helmsley once told a reporter that the biggest accomplishment of his life was marrying Leona.)

Panzirer seems puzzled when asked about the desk. No, he doesn’t know if it’s oak or walnut. “They were renovating the office in New York, putting furniture in storage,” he explains. “I took it to be thrifty.”

Correction [2:50 p.m.]: Due to an editing error, the original version of this story misstated that a judge deemed Helmsley mentally unfit when she executed her will, and granted $10 million originally bequeathed to Trouble to two of Helmsley’s grandchildren. In fact, Helmsley was deemed fit and the money went to her charitable trust.

Karen Ball is a former AP national reporter who now occasionally contributes to TIME.com from Kansas City.

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