News & Events

Mountrail County Medical Center is now offering virtual visits through telemedicine. 

For non-urgent visits such as medication refills, routine follow-up appointments, etc., they are encouraging all patients to consider the telemedicine visits.

Tammie Braaflat, FNP says that from a Primary Care Provider perspective they are able to still offer the same level of care, without requiring unnecessary travel during the pandemic. Patient’s routine healthcare needs have not stopped due to COVID-19 and medical conditions like diabetes, high blood pressure, asthma and depression can all be managed through telemedicine. Feedback from the patient perspective has been overwhelmingly positive as most patients needing routine care are also being very cautious with leaving their homes during the COVID-19 pandemic.

Telemedicine is not new, especially in rural areas. Mental health, psychologists and counseling professionals have used this method for quite some time, and most specialty visits through the VA Health System are done by Telehealth.

Braaflat says it is easy for a patient to switch their currently scheduled appointment to telemedicine. They would just need to call the receptionist at the Clinic at the Mountrail County Medical Center and ask them to make the switch.

Patients can also schedule new appointments the same way. Patients that are unsure if they need an appointment can call the clinic. If the receptionist is unsure, they will transfer you to a nurse for more information.

There are many ways to use the technology at the clinic beyond the telemedicine. Patients can email their provider through the patient portal. That allows them to directly message their provider with simple questions like whether they need an appointment. The receptionist should be able to help you set up the patient portal if you have not already done so.

Telemedicine appointments are very easy to navigate with a computer, tablet or smartphone. It uses video and audio allowing patients and their provider can to see each other. Patients without access to a smartphone, computer, tablet etc. can visit with their provider over the phone.

The clinic has been working to set up schedules for all providers as they face the potential challenges with COVID-19. There is a designated provider on-call 24/7 to manage acute emergent and non-emergent patient concerns.  Patients with acute healthcare concerns are urged to contact the clinic directly during normal business hours to speak with a nurse to arrange for the most appropriate visit.

Currently most of our acute visits are being managed through the Emergency Department by the Emergency Provider on-call. Any patient with fever, cough, or any other respiratory symptoms are being treated and screened separately in specially designated area of the hospital. 

A different provider is on staff in the clinic for non-acute/non-urgent clinic services and taking care of the residents in the Bethel Home. Braaflat said she had been working in the clinic for the past two weeks, which has also lowered her exposure risk to potential COVID-19 patients.

This helps to ensure they are taking the best care possible for all patients, and especially those in the nursing home. Braaflat says that a lot of planning has been going on to ensure the care provided within the hospital, clinic, and Bethel Home is done in the safest manner taking into consideration the fragile nature of the nursing home population.

Braaflat says that for the last two weeks most of her clinic visits have been telehealth visits. Anyone that has called has been encouraged to schedule their visits through telehealth if possible. She says that they

have been handling a wide range of visits this way, including those health conditions like diabetes, etc., as well as rashes, prescription refills and more. If during the visit they determine a patient needs to have lab work, or radiology they are ordering the appropriate tests at which time the patient would have to come to the hospital.

With the MCHC campus doors locked, Braaflat says patients might drive by and see an empty parking lot. This is because of the telehealth. A lot of time and energy has gone into planning how to best take care of the community, patients and residents. They are still there wanting to provide the services patients need, especially during this stressful time when more people are facing uncertainty with employment, anxiety and depression. She says it is important that patients can still access their primary care.

Braaflat also says that Medicare and many insurance companies have removed many of the restrictions on telehealth visits, meaning they can bill insurance just like a regular clinic visit.

Connecting to your provider for a telemedicine appointment is very easy. You go to the Mountrail County Health Center webpage at stanleyhealth.org. On the home page there are links to connect to each of the providers. You check in within a few minutes of your appointment time and are connected.

Virtual physical therapy visits are also possible for patients for follow up appointments. The initial appointment would be conducted face-to-face, but follow up appointments may be done virtually.

This article has been republished with the gracious consent of the Mountrail County Promoter.

This article has been published with the gracious consent of the Mountrail County Promoter.

You assume that you know the face of opiate addiction. You believe you can tell just by looking at a person, but that is not true. A person is  often struggling in plain sight. It affects all ages and demographics and could be anyone that you know.
Addiction to opioids can happen quickly and easily. Many times, it persists with that person not looking for the “high” but rather just struggling to feel normal. Withdrawal is so profound and so deep that the only way they can get by is to have that opiate on board. They seek it out just to try to have a normal life. It snowballs and takes over their life.
That is where a new program at the Mountrail County Medical Center’s Rural Health Clinic is looking to help. Abbey Ruland, PA and Tammie Braaflat, FNP are offering a MAT Program to help patients looking to move forward and through addiction to a successful and healthy life.
MAT stands for Medication-Assisted Treatment, a strategy for combating opioid use disorders that combines behavioral counseling with prescription medications containing buprenorphine, such a Suboxone.
By the time patients come to them, they say, they are often desperate. They may have lost their job or relationships to the drug addiction. They may have used up their financial resources to get more drugs. They say it is not in an attempt to get high, but rather to take away the horrible pain that comes with the addiction.
Both have taken the required coursework on how to prescribe the medications that will help and credit current CEO Ben Bucher for also having providers on staff in Cando that are part of the MAT programs. They are also working with them with the ECHO Project. Through the University of North Dakota School of Medicine and Health Sciences, the North Dakota Opioid Use Disorder TeleECHO gives providers a virtual learning network with other treatment providers. This program gives collaboration, support and ongoing learning with subject-matter experts and healthcare staff as they look for new ways to support patients in their home communities.
Ruland started her training while still working with Trinity in New Town. She finished that just before returning to practice in Stanley. Braaflat took her training in Bismarck in November and finished the online portion in December. They say that much of the training was in pharmacology and the science of chemical addiction. They learned about the different medications that could be used to treat the addiction and how each works, as well as the side effects and things to watch for during treatment.
It covered how to start the process, known as induction, and the protocols to follow so they do not cause sudden severe withdrawal. It included skills for interviewing and counseling patients. It is about spending the time getting to the bottom of the issue, including the “whys” and “hows” and how to change going forward.
They say it opened their eyes to the differences in the traditional ways to look at addiction and slip ups. Instead it needs to be treated like any other disease. Rather than condemning for a slip up or relapse, instead it is creating open dialog about the ups and downs in the process. It is about not condemning the patient, but rather helping them to avoid those issues in the future. They want to build honest and open relationships to be a pillar of hope for the patient.
Opioid addiction needs to be treated like any other disease. You don’t look at a diabetic and ask why they don’t stop eating or why they don’t just do what is necessary. You work with them. Addiction needs to be treated the same way.
The goal  is to help patients get their lives back on these medications. They want them to be able to regain a sense of normalcy that will allow them to function within their relationships and jobs.
Treatment with MAT will help patients in their own community. In the past patients have had to travel as far away as Bismarck. That is  not realistic if their whole life  then revolves on going that far to get the help they want.
Opioid addiction often starts with a prescription. The addiction happens so fast. For many it is a prescription after a surgery and then the patient finds they can’t go without it. It happens quickly and unexpectedly. It then turns into the need to get more pills, often on the street. It can also turn to a heroin addiction rather than pills because that is cheaper and easier to find.
The buprenorphine works to bind tightly to the receptors while providing no altered sense or euphoria. It allows the patient to get through the painful, profound withdrawal from the opioids.
The MAT program is open to patients ages sixteen and up. The buprenorphine can be used by pregnant patients. It is recognized by all major medical organization. Research shows that this treatment method shows better outcomes. It is not substituting one drug for another, but rather finding a way to help patients reach their goals.
Depending on where the patient is in their addiction and what opiates they are using, they will work with them as they stop and then start the buprenorphine. It is all timed out and dosages will be adjusted as needed. They say that everyone’s story is different, so they are focusing on helping each patient meet their goals. It is not an overnight fix, but they can get there.
It is hope in a hopeless situation. They want their patients to be able to see the light and help them get there. Like any other medical problem, the patient has to have the desire to get better. With open and honest conversation, they can help them get there. They will guide you through this to feel good again. They stress that  they want their patients to know that they are there with compassionate open minds to help. They want them to know they do not need to be scared or ashamed to ask for the help.
Although the program in Stanley has only started in the past few weeks, they already have patients that are benefitting from the program. Opioid addiction is a large issue in Mountrail County, but both are quick to point out that if  you are dealing with it or have a family member dealing with it just losing a single person is a big deal.
They have made sure that the pharmacy is carrying the medication that is dispensed by prescription. At the beginning of treatment, patients will likely be seen twice a week until they are stabilized with their withdrawal and treatment. It will then be based on patient needs, but likely at least monthly.
The length of treatment with buprenorphine will also depend on the patient. For some it could be a lifelong prescription. For others it could be working on a plan to get off it as well once the addiction is treated and their situation changes. That is no different than any other medical diagnosis like diabetes, heart conditions, blood pressure and more that require long-term or lifelong treatments.
You can schedule appointments with either Ruland or Braaflat by calling the clinic at 628-2505. If you are concerned about discussing addiction as the reason for making the appointment, they say that you can tell the scheduler you are looking for medication review or a checkup. They say that discretion is one of their highest priorities as they work towards their goal of wanting people to feel better and find hope for a better future.