Box Elder patients often rely on care pathways that involve more than one site—urgent care visits, follow-up with a primary provider, imaging or lab testing routed through regional networks, and referrals that may take days (or longer) to complete.
When a diagnosis is wrong or delayed, the harm can be amplified by:
- Gaps between visits (abnormal results not clearly communicated or acted on)
- Follow-up timing issues (the “we’ll call you” problem)
- Handoffs between departments or facilities (records not fully integrated)
- Time-sensitive test interpretation (imaging/lab findings that should have triggered escalation)
And when AI or automated systems are part of the workflow—whether for triage, imaging support, risk scoring, documentation, or routing—the question becomes not just “what diagnosis was ultimately correct,” but whether the earlier steps met South Dakota’s standard of reasonable medical care for the information available at the time.


