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Avel eCare, based in Sioux Falls, South Dakota, has been providing telehealth services since 1993.

Avel provides this service to 43 mostly rural and small-town hospitals across five states and is expanding to Indian Health Service hospitals in the Great Plains.

Jen Canton, who oversees Avel’s teleSANE program, said arriving at a local hospital and being referred elsewhere can be devastating for sexual assault survivors.

Taking a break from a recent busy morning in the emergency department, nurse Lindee Miller rolled out the mobile teleSANE cart and colposcope device from Avel eCare.

Avel Ortiz, 55, put the final touches on a window message in front of his business in Ulvade on Sunday.