North Dakota

State Demographics
RUPRI Demographics & Economic Profile: North Dakota

Rural Assistance Center (RAC) State Profile

U.S. Census Bureau State & County Quick Facts

USDA State Fact Sheets: North Dakota

Legislation
HIMSS Legislation Tracker
The HIMSS State Legislation Tracker is a tool that provides key information on pending health IT legislation at the state level.

North Dakota Telemedicine Legislation
State telemedicine legislation addresses various providers, including physicians, dentists, chiropractors, nurses, and other health professionals. This site includes telemedicine-related laws; however, it does not include all appropriations bills that fund telemedicine initiatives.

Telemedicine
Dakota Telemedicine System

Delivering Cognitive Behavioral Therapy via Telemedicine
This is a randomized clinical trial evaluating the effectiveness of cognitive behavioral therapy delivered via telemedicine. The program is funded by an ROI (Regions of Interest) grant from the National Institutes of Mental Health.

Home Telehealth Programs

St. Alexius Telecare Network
Rural health care providers and their patients can meet face-to-face with St. Alexius physicians via two-way "live" television. The physicians are able to consult, examine, and implement patient care plans immediately and the patient never has to leave their rural community.

Telemedicine Information Exchange

Telepharmacy at North Dakota State University
Through the North Dakota Telepharmacy Project, a licensed pharmacist at a central pharmacy site supervises a registered pharmacy technician at a remote telepharmacy site through the use of video conferencing technology.

Health Information Exchange (HIE) and Regional Health Information Organizations (RHIO)
HIMSS HIT Dashboard
Click on your state to see a list of Health Information Exchanges (HIE) and Regional Health Information Organizations (RHIO) and other Health Information Technology related projects going on throughout the states.

Grant Funded HIT Projects
Blue Cross Blue Shield Rural Health Grant Program

Introduction

Keenly aware of the significant stress North Dakota rural areas face in providing for their local health needs, BCBSND seeks to support those communities who demonstrate an effective plan to successfully improve health care delivery to the rural population. The company desires to stimulate new thinking about what can be, as opposed to what has always been in the health delivery status quo. Financial support based on established criteria was awarded to those applicants whose proposals benefit rural North Dakotans and their emerging health needs in a society and industry undergoing accelerated change.

Attributes of the BCBSND Rural Health Grant Program

The BCBSND Rural Health Grant program rewarded three essential concepts, alignment, innovation and collaboration, whose measurable outcomes improve the triad of quality, access, and cost of health services to the population residing in rural North Dakota.

The continuing advances in HIT offer significant opportunity to improve the health care effectiveness and efficiency in rural regions. As in past years, proposed grant programs must address the high priority health needs of a rural population through the promotion, development, and implementation of an HIT infrastructure that proves to be cost-effective, improves quality of care, and/or improves access to care.

BSBSND Grants were awarded to the following:

Bowman- Southwest Health Care Services, 2006
This project will implement an Electronic Medical Records (EMR) system to improve the communication between professional health care staff and increase patient information for visiting specialists that travel to the facility.

Garrison- Garrison Memorial Hospital, 2006
This project is to purchase a computed radiography or CR system, which will allow images to be transmitted digitally to the radiologists in Bismarck. Patients will have final radiologist reading within hours, rather than weeks.

Hettinger- West River Health Services, 2006
The project will focus on access to, and timely transmission of client health information of home bound individuals through the use of telehealth technology.

Langdon- Cavalier County Memorial Hospital, 2006
This project is to purchase a Picture Archiving and Communications System (PACS) which will allow this facility to communicate all radiology results to St. Paul Radiology, in St. Paul, Minnesota, and other provider systems. The facility will have radiologist interpretation within hours at most and minutes at best.

Park River - First Care Health Center, 2006
This project will focus on the purchase and implementation of a computed radiography system or CR, which will allow images to be transmitted digitally offsite via a T-1 line and can be read 24 hours a day, 365 days a year. The individual patient images will remain in the rural facility for access by their local physician.

Dickinson- St. Joseph's Hospital and Health Center, 2005
This project will initiate an information and communications technology (ICT) web-based patient maintenance project which targets patients diagnosed with diabetes as a prototype -- with the idea that this web-based approach will be extended to other chronic conditions. The goal is to create a unique web interface model that will allow rural patients with diabetes to receive on-going diabetes care.

Fargo- Prairie land Home Care, 2005
The Prairie land Home Care is a not-for-profit home care agency. This agency will purchase additional telehealth units which will supplement the existing telehealth program located in Bottineau and will serve Harvey, Rugby, Carrington and Rolla.

Hettinger - West River Health Services, 2005
The project will use funds to further develop electronic health record for the ambulatory and outpatient service areas including rural health clinics in Bowman, New England, Mott, Scranton, Lemmon, Buffalo. The project goal is to improve decision making and quality care for patients in the service area, through the use of EMR which will improve the timely transmission and access to health care information.

Lisbon- Lisbon Area Health Services, 2005 This facility will purchase a computed radiography or CR, and a Digital Subscriber Line (DSL) line which will allow images to be transmitted digitally to the radiologist's in Fargo. Patients will have final radiologist readings within hours, rather than a week, sent to their personal physician.

Rolla- Presentation Medical Center, 2005
The project will include Presentation Medical Center, Rolla and St. Andrew's Health Center in Bottineau which will work together to research, analyze and select a Laboratory Information System (LIS). These facilities will share equipment and supplies in an effort to maintain access to services and reduce costs.

Williston- Mercy Medical Center, 2005
Mercy Medical Center is partnering with nine smaller rural communities. They are requesting funding to create a regional Picture Archiving Communication System (PACS) that assists rural communities in maintaining radiological access and services to ensure access to adequate care in their communities that is cost-effective and increases the quality of patient care.

Cooperstown- Cooperstown Medical Center- Coordinated Health Program, 2003
Four rural hospitals are working together to reduce service duplication, create administrative and clinical efficiencies, enhance technological connectivity, and improve the overall quality of life in the area.

Minot- North Dakota Emergency Medical Services (EMS) Association- Forge a Communications Network, 2003
The North Dakota EMS Association along with the state Division of Emergency Health Services, and rural health ambulance systems are working together to forge a communications network. This communications program will provide computers and software to 70 rural ambulance services; develop an EMS web page; develop local communication tools and training and other workshops.

Maddock Drug & Gift- Develop and Implement the First Tele-Pharmacy, 2003
In an effort to develop and implement the first tele-pharmacy in North Dakota, Maddock Drug & Gift in Maddock along with partner organizations -- the City of Rolette, IsoRX (a telecommunications company), and Weibe Electronics (a contracting company and developer of the Rolette mini-mall) -- are collaborating to develop a remote-based pharmacy in Rolette.

Dakota Medical Foundation
With funding from Dakota Medical Foundation, the NDSU Office of Research, Creative Activities and Technology Transfer will establish an advisory board and retain a consulting firm to conduct a technical and business evaluation and assess the feasibility of creating an RFID Health care Consortium.

Health Resources and Services Administration (HRSA) Telehealth G
In 2005, HRSA administered 159 telehealth/telemedicine projects. Of those, 92 were awarded funds totaling more than $34.9 million. Projects receive funds in one of four ways: The Telehealth Network Grant Program, Rural Telemedicine Grant Program, Congressionally Mandated Projects, and Special Projects.

NLM Knowledge Management & Applied Information Grants
Grants to health-related and scientific organizations that wish to optimize the utility of clinical and research information.NLM anticipates making 8-10 new awards each year, spending approximately $4 million per year to support new awards in this program.

North Dakota MED Net II
This grant was provided by the National Library of Medicine to integrate Internet access to nine small health care facilities where students of the U of North Dakota School of Medicine receive training.

Small Hospitals Receive Grants Through UND Center for Rural Heal
Fifteen rural North Dakota communities will benefit from grants given to small hospitals through the North Dakota Medicare Rural Hospital Flexibility Program (Flex) administered through the Center for Rural Health at the University of North Dakota School of Medicine and Health Sciences.

Technology Opportunities Program: Minot State University, 2004
The North Dakota Center for Persons with Disabilities at Minot State University is creating a high speed data network using Internet2 technology for telehealth, training, and planning to support services for North Dakotans with developmental disabilities.

United States Department of Agriculture (USDA) Distance Learning
Follow the link above to see what USDA Distance Learning and Telemedicine Program Awards have been given out in this state.


HIT Survey Information
North Dakota Health Information Survey
This information was obtained from and prepared by North Dakota Health Care Review, Inc., The Medicare Quality Improvement Organization for North Dakota.
  • 25% use EHRs, just under 10% plan to implement in the next two years
  • 90% have health information technology (HIT) systems currently in place
  • 90% have patient account systems
  • 15% have patent scheduling systems
  • 15% have pharmaceutical supply chain management
  • 13% have medical-surgical supply chain management
  • About 5% use an EHR and an additional 22% plan to implement one within the next two years.
  • 75% have an individual designated as an IT manager
  • About 25% have an electronic CPOE system or access to one
  • 50% have an electronic lab information system (LIS) or access to one
  • About 30% have an electronic radiology information system (RIS) or access to one
  • About 25% have an electronic pharmacy system or access to one
  • About 25% have an electronic PACS system or access to one
  • About 30% have an electronic patient support system or access to one
  • About 10% currently use bar coding technology, and about 15% more plan to implement bar coding within two years. Over 75% of those utilizing it use it for supply chain management.
  • 50% currently use telehealth to provide care to their patients and another 3% plan to implement within the next two years.
  • About 70% finance their HIT systems through their operational budget and about 70% through their capital budget with 60% of these using both sources of finance. 70% have received grants to finance their HIT systems. One-fourth have used loans and none have used bonds.
  • 75% expect their organization's IT budget to increase in the next two years
  • Over 90% cite lack of financial resources as a barrier slowing or preventing implementation of an EHR in their organization. Other frequently cited barriers were availability of well-trained staff (50%), difficulty in justifying expense/determining return on investment (>35%), and HIPPA compliance issues (25%)

 North Dakota's Responses for the 2006 TASC HIT Survey
The Technical Assistance and Services Center (TASC) surveyed 19 Critical Access hospitals in North Dakota to identify their use of HIT. All of the CAHs have at least six beds (swing and acute not including DPU) and a little less than half of them have over 25 beds. A summary of the survey is as follows:
  • 84% of hospitals have no formal IT plan
  • 68% planned to purchase information technology
  • 8 of 19 said they have their clinicians use handheld computers/ PDAs
  • 42% physicians, physicians assistants, and nurse practitioners
  • All hospitals have internet (95% high-speed, 21% wireless, 5% dial-up)
  • 84% of hospitals say they have encrypted secure e-mail access for all staff to protect patient confidentiality
  • 100% have claims submissions, patient billing, and payroll computerized
  • 26% have no type of patient management system in place
  • Only 1 hospital uses bar-coded patient identification bracelets
  • 89% do not have electronic medical records to track patient history
  • 58% of hospital pharmacies have no type of computerized function
  • 68% of laboratories surveyed have no type of computerized system
  • 11% of the hospitals have an automated medicine dispensing machines
  • 26% of hospitals use telepharmacy (using an offsite pharmacist to review orders)
  • Only 11% have computerized clinician review of radiology results
  • 8 out of 19 hospitals use teleradiology technology to transmit images electronically
  • 8 out of 19 said they use telemedicine to consult with clinicians at other sites regarding patient diagnosis and/or treatment
  • 16% of hospitals said they share clinical data with selected other departments with in the hospitals
  • 32% of hospitals surveyed that physician clinics in their community were connected electronically to the hospital's information system
  • Not one hospital said they shared their clinical data electronically with other hospitals

Other HIT Activities
North Dakota Maps

North Dakota State Office of Rural Health

North Dakota's HIT Steering Committee

Rural Hospital Quality Improvement Report

University of North Dakota
School of Medicine and Health Sciences
  • A grant was received to provide educational and medical video conferencing
  • Grant covers a four state region including; North Dakota, South Dakota, Montana and Minnesota
  • Thirty different sites have video conferencing access
  • The grant provides physicians and health practitioners with accurate results of laboratory analysis
Center for Rural Health
  • Provides continuing technology education to faculty located in rural communities
  • Satellite based distance education network called Medstar that delivers audio-educational programs to rural health care facilities in the region
  • Has a computer operated database to disseminate information
Health Information Technology Center
  • Center received more than $1 million from a General Services Administration program to support and assist rural communities' access to health care and telemedicine technology
  • Moved medical information by providing capabilities for digitizing clinical information medical records
Institutional Development Awards Program
  • Funding from the NIH produced the Chemistry and Biology Network that links researchers at NDSU and UND via a high speed internet connection
  • Program ended in 2004
North Dakota State University: College of Pharmacy's Telepharmacy Project
  • Currently has four rural community pharmacies as part of their program
  • Educates pharmacy students on telepharmacy technology
  • Plans are to have 53 telepharmacy sites in North Dakota
  • Studies quality of care in delivering drugs using telemedicine, the cost effectiveness of the program, and the impact on access to health care.
North Dakota State College of Science: Allied Health Distance Education
  • Offers educational programs for health professionals in isolated areas via interactive technology
  • Emphasis given to rural areas and isolated regions in North Dakota
North Dakota Department of Health
  • Currently uses the Materials Management Information System from Caduceus Systems to distribute and dispense drugs and medical supplies in the event of a bioterrorism attack
  • Tracks medical supplies needed for North Dakota residents
  • Ability to dispense medical supplies to over 100 sites within the state
"University and States: Activities in Telemedicine, Telehealth, Health IT, and Research", a report by Carolyn Bloch, Bloch Consulting Group, Copyright 2005 Bloch Consulting Group.

For additional information, please visit the Rural Health Resource Center web site at www.ruralcenter.org.