Evaluation of the Telecommunications and Information Infrastructure Assistance Program:Dakota Telemedicine System

Kyle Snow
Medcenter One Health Systems developed the Dakota Telemedicine System (DTS) to connect a central hospital (Medcenter One) to the Veterans Administration Hospital in Fargo and 10 remote sites. The project is partially funded by grants from the Rural Utility Service, as well as the TIIAP grant. North Dakota is characterized by a predominantly rural population that is underserved by medical services, typically located in major towns or cities that may be quite distant. Through telemedicine, primary care providers in remote clinics can obtain immediate consultations with specialists at larger care facilities before making diagnoses or transferring patients to major facilities for treatment. Additionally, patients may consult with specialists for follow-up care from a remote site. The system utilizes dedicated T1 lines to connect remote sites to Medcenter One, an integrated medical care facility, and each other via a bridge located at the hub site (Medcenter One). The system uses teleconferencing equipment to provide its services. Dedicated analog telephone lines are also used to arrange consultations and fax patient records from site to site. Currently Medcenter One serves about 5 percent of its patient population through telemedicine consultations. During the time of DTS, the referral rate from local clinics has declined, as more patients are treated in their own community. Patients and doctors are generally positive about telemedicine, both noting its convenience for the patient (and in some cases the doctor) as important outcomes. The only problems experienced by the project have been in getting sites connected as the infrastructure within the state develops.
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