North Dakota

Success Stories

Reaching Out While Bringing Together

Catholic Health Initiatives Reaches Farflung Patients While Consolidating Specialty Services

In a state like North Dakota, healthcare providers are few and far between. Catholic Health Initiatives (CHI), based in Fargo, operates 11 critical access hospitals, 17 clinics, and seven rural health clinics in a single division. “If I drove to all our facilities in a giant circle, it would be 1,700 miles,” explained Marvin Smoot, president of Physician Enterprise of CHI in North Dakota and Minnesota.

The rise of telehealth services as a result of the COVID-19 pandemic has helped CHI not only deal with the national health emergency but has opened doors to providing better patient care overall.

“Because of our rural location, we are perfectly situated to take advantage of telehealth options,” Smoot said. “We went from doing zero telehealth visits to around 6,000 in the past six months.” However, the sheer number of visits is not what makes CHI’s telehealth application unique, but the many ways it has applied tools to better serve its patients.

Marvin Smoot of Physician Enterprise of CHI has visited with the Great Plains Telehealth Resource & Assistance Center (gpTRAC) several times over the years.

Reaching Extremely Rural Patients

With a population of about 1,000 people, Baudette, MN, is so close to the Canadian border that your phone might drop over to Canadian cell towers. When some of CHI’s patients living just outside of Baudette needed healthcare services, providers found a unique way to bring those services directly to them.

“Some of these patients lived 20 miles in the woods and didn’t have equipment or connectivity to do a telehealth visit,” Smoot said. “So, we gave our providers jet packs, or iPads with wifi hotspot capabilities. When patients required care, we sent a nurse to their home with these jet packs. The nurse would take a medical history, take vitals, and connect through the hotspot to the provider back at the clinic for the telehealth appointment. We have peripherals like a Bluetooth-enabled stethoscope, which allows the provider to listen to the patients’ heart and lungs through earbuds. This system helped us meet our three COVID-related goals: to preserve access, clinicians, and personal protective equipment.” 

Since telehealth services can be delivered over a distance, this system allowed these patients to continue receiving care in Baudette even when the local provider came down with COVID. “At one point, our provider at this location was symptomatic and couldn’t work for a period of time,” Smoot said. “We were able to link those patients to our provider in Breckenridge for care, which was seven hours away. It was a seamless transition for our patients.”

Bringing Together Farflung Staff

Besides reaching out to treat patients who were geographically distant from providers, clinics, and hospitals, CHI also found that telehealth technology helped its own family of providers grow closer and more collaborative during this time.

“Prior to COVID, our providers were pretty isolated from one another,” Smoot said. “The distance just made it difficult to work as a community. Now, with all the increased connectivity, we’re able to share many more resources in the care of our patients.”

For example, CHI runs a pain clinic located in Carrington but its behavioral health services operate out of Williston, which is four hours away. The distance made it impossible to collaborate on patient care without telehealth.  Now, however, the two services work together regularly.

“When a patient receives a diagnosis of a lifetime of pain at the pain clinic, we now immediately set up a collaborative appointment with our mental health provider,” Smoot said. “The pain specialist, the mental health therapist, and the patient connect virtually to come up with a supportive plan of action to cope with the long-term pain. This helps prevent the patient from self-medicating and hopefully reduces the likelihood of opioid addiction and abuse.”