Sunday, August 14, 2011

Northa Dakota HIT Update

North Dakota is involved in several initiatives and rapidly providing essential broadband services and health technology needs in the state. Today, the Dakota Carrier Network (DCN) CCI Broadband project provides high-speed fiber connectivity to more than 175 largely rural and underserved areas where many community anchor organizations lack access to necessary last mile broadband speeds. DCN received $10.7 million in grant dollars but will provide a cash match of $4.6 million. DCN will complete 100 percent of the project by August 2013.

DCN intends to deploy 169 miles of new fiber with backhaul speeds as fast as 1 gigabit per second (Gbps) to enable last-mile service across the state. The project also proposes to enhance e-health in the state by deploying a dedicated 10 Gbps healthcare network to over 200 hospitals, clinics, and other healthcare providers. They are committed to providing telemedicine, teleradiology, telepharmacy, and enabling the exchange of health information electronically. For more information on DCN, email Seth Arndorfer at

The procurement of an HIE system began in late 2010 with the release of a RFP. At that time, the proposals and demonstrations by the top three vendors were reviewed. In June 2011, the team recommended to the Health Information Technology Advisory Committee (HITAC) that the contract be awarded to Optuminsight.

The first phase of the HIE project will deploy “Direct” functionality by November 2011. “Direct” is a bridge to meaningful use while the state HIE is being implemented. Direct is a simple and secure method for participants to send encrypted health information directly to known trusted recipients.

Once the HIE is fully implemented in 2011-2012, participants will be able to use a robust bi-directional HIE to fully support meaningful use and health IT requirements. The state Department of Health, Division of Disease Control, will be able to receive electronic messages to include laboratory results, surveillance data, and be able to update immunization registries.

HITAC has formed HIE Domain Workgroups currently being rolled out. These workgroup teams are playing a key role in planning, advising, and providing guidelines that will cover topics related to governance, business opportunities, legalities and policies, technical infrastructure, and also tackle issues related to the clinical workforce, communications and education, and finance.

The Clinical Workforce Team was specifically formed to:

• Support HIT and HIE adoption and meaningful use among state providers

• Develop and evaluate the project in terms of data collection and performance measurements

• Define and address high-value/high priority uses and/or use cases for HIE consistent with proposed meaningful use of certified EHR technology and additional clinical priorities

To help providers obtain the skills and tools needed to make technology changes in their practices, the Regional Extension Assistance Center for HIT (REACH), a nonprofit federal HIT Center is helping Minnesota and North Dakota primary care providers advance HIT. REACH provides readiness assessments, practice and workflow redesigns, help selecting a certified EHR product, help connecting with vendors, and provides information on privacy and security best practices. For more information, go to

To provide financing assistance, Senate Bill 2332 established a HIT planning revolving loan fund with the Bank of North Dakota to provide low-interest loans to healthcare entities to help build their HIT infrastructure. The loan fund can assist with the purchase, installation, and be used to support functional standards based interoperable HIT systems.

It is anticipated that available funds for loans could be $5.4 million which includes the additional $5 million appropriated by the 2011 Legislature. The maximum loan amount per applicant is $100,000 for standalone individual practitioners not affiliated with a multi-professional entity, provider system, or network, $400,000 for hospitals and multi-professional entities, and $800,000 for entities with three or more provider-owned facilities as in the case of a hospital with two or more clinics or three hospitals all under common ownership/governance.

North Dakota residents are eligible for the loans to purchase install and/or support software and hardware required to implement a fully functional, standards-based, interoperable EHR system certified by ONC. The loans can be used towards systems containing patient medical histories, electronic personal health records for people with chronic diseases, along with using the system for electronic prescribing.

Initial applications are due by August 22, 2011 with applicants to be notified by September 9, 2011 if their loan has been approved. For more information, go to

There is also a Federal financing option available to help meet the expense for EMR software to help rural areas and towns with up to 20,000 in population. The USDA Community Facilities Program provides flexible financial tools including the Community Facilities Guaranteed Loan Program, the Community Facilities Direct Loan Program, and the Community Facilities Grant Program. For more information, email or call (701) 530-2037.

For more information on North Dakota’s progress, go to