North Dakota | 50 states of population health

Kelly Gooch -

NATE WHITE. COO of Sanford Health (Fargo, N.D.)

On the top challenge

"Access to and coordination of primary and specialty care are the most pressing healthcare issues facing North Dakotans. The challenge is amplified when you consider how large and rural the state is, with healthcare facilities few and far between."

On the hospital's response  

"Trying to bridge those gaps is at the crux of what Sanford Health strives for in North Dakota. We know that we need to better manage at-risk populations, reduce costs and increase quality across the state.

We've found some success — including telehealth, video visits, offering same-day and walk-in appointments and creating a team-care approach that includes physicians, advanced practice providers, registered nurse health coaches and others to provide care.

We are also embracing the National Council of Behavioral Health program — Mental Health First Aid. We've trained nearly 500 front-line staff to recognize and respond to patients struggling with mental health issues. We hope to double the number of staff we train this year.

But one of our largest successes has been incorporating a behavioral health therapist into our primary care clinics. We have 44 therapists at 51 sites and continue to grow.

We know that when patients just receive a referral for mental health from primary care, half of them don't make the follow-up appointment. This integrated model removes a barrier for people and offers them immediate access — and helps us ensure we are caring for the whole person. Beyond that, our providers are satisfied knowing their patients are able to get the care they need when they need it."

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