Sanford Health wants to help workers by bringing preventive care options to the oilfields.

The medical-care landscape of North Dakota is changing drastically with the oil boom, making it difficult for oilfield workers to seek out basic care.

“North Dakota is fairly rural in nature, but many communities have health care facilities. I don’t think anybody was exactly predicting the population growth, and hence the health care demand would have grown so fast,” says Stephanie Murdock, enterprise vice president of corporate occupational medicine for Sanford Health in Bismarck, N.D. “The boom has made health care access difficult for those [oilfield] workers.”

Sanford Health is an integrated health system headquartered in the Dakotas and is now the largest rural, not-for-profit health care system in the nation with locations in 126 communities in nine states.

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Sanford Health has three free-standing occupational medicine clinics in western North Dakota – in Bismarck, Minot and Dickinson – that triangulate the Bakken Shale play. Medical staff performs employment-related health care in those clinics such as drug testing and physicals, according to Murdock.

“As the oil boom kept getting bigger we started hearing from our clients that, ‘It’s great that we can get these services here, but we’re deep in the Bakken and to have our workers drive hours for health care is a struggle for our company,’” Murdock says.

Sanford Health believes it has a solution for those in the oilfields with the new O.P.C. mobileMED units the case system rolled out this summer.

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The units will provide health care services directly in the oilfields for oil-producing companies (O.P.C.) and their subsidiaries, according to a press release from Sanford Health.

The key to Sanford Health’s plan centers on partnerships with companies serving the Bakken oilfields and includes deploying two mobile clinics on wheels that can move around the Bakken to meet the needs of employers, and one modular clinic – soon to be located in Watford City.

The mobile clinics will provide work-related and non-work-related health care services, such as employment physicals and screenings, and acute care for sore throats, coughs and other illnesses. Sanford Health will also be able to conduct lab work and do X-rays from the mobile units.

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“O.P.C. mobileMED is a win-win situation for the industries and local communities,” says Joel Blanchard, M.D., medical director of Sanford Health Occupational Medicine and O.P.C. mobileMED. “Providing direct, on-site services to oilfield employees will decrease the burden on local health care facilities, reducing over-crowding in clinics and emergency departments.”

The clinics

The timeline of the trucks was a fast process, Murdock says, with the Sanford Health Board of Directors approving the O.P.C. mobileMED business plan in August 2013 and the process of looking for a vendor beginning immediately afterward.

LifeLine Mobile, of Columbus, Ohio, was chosen as the vendor in January. The two O.P.C. mobileMED units arrived in Sanford Health’s hands in mid-May and went online in early July.

Each unit is 45 feet long and 8 1/2 feet wide and stands 13 feet 2 inches tall. The units weigh about 17 tons each but are rated for up to 27 tons.

“We buy the cab-chassis and ours are truck-based as opposed to ones made out of RVs,” says Lee Guse, president and owner of LifeLine Mobile. “Truck-based tend to be a little longer-lasting. They cost a little more, but total cost of ownership is lower over time because a truck is made to last a long time and do heavy-duty work.”

The base model cab-chassis is an International model 4400 SBA 6X4 with an air conditioned crew cab, oversized alternator, tandem rear axle, heavy-duty block heater, engine exhaust braking on top of air brakes and diesel engine.

Guse notes that each unit is outfitted with an automatic five-speed Allison 3000 HS transmission, power windows and locks, cruise control, air-suspended passenger seating, exterior awning and even a cattle guard to protect the front bumper.

“The distances traveled in North Dakota are greater than most of our customers need to travel, so these units have a crew cab on the front where most of our customers don’t get a crew cab,” Guse says. “Sanford intends to go out with a little bit of a larger crew and wants its people to ride in comfort.”

On the inside of the clinic, there are professional medical office furnishings such as casework, solid-surface countertops, computer networking wiring, recessed entry mats, hospital-grade flooring, diesel power generator, air curtains over each doorway, special insulation, high-intensity exterior lighting, restroom and hydraulically operated side-out walls to expand the space inside.

On the medical side, there are exam furnishings, tools, image processors and audio testing equipment.

“We did have quite a bit of input on the units and LifeLine Mobile was great to work with,” Murdock says. “We knew that for us to be successful and meet the needs of the oilfield, we needed to do just about everything in this truck. We worked with LifeLine and said we’re looking for a truck that can have at least two exam rooms, it needed to have a drug-testing bathroom, it needed to have a hearing booth, it needed to accommodate X-ray and then we also have telemedicine on board.”

Telemedicine allows the patients and staff that are in the mobile units to connect, through video, to a specialist anywhere within Sanford Health.

The project had an initial investment of $2.7 million for the two units, along with $4.8 million in annual operating expenses, according to Murdock.

In the community

Staffing the mobileMED units was the biggest obstacle, Murdock says, because of the unemployment rate in the state.

“It’s difficult to find staff for new initiatives,” Murdock says. “However, from the start when writing our business plan, we were dedicated to staffing the units with highly qualified health care workers. We’ve successfully recruited two teams with the understanding that if we need to fly staff into the Bakken to make sure we can fully commit to this initiative, we would.”

Staff for the two units were hired in November and December of 2013 with each unit having a three-person crew, which includes an advanced practice practitioner, a nurse and a driver-tech.

“What’s really unique about it is that the nurses or the radiology technicians have been cross-trained,” Murdock says. “They have received their CDL certification, so they can drive the truck. They have been cross-trained to shoot X-rays and everywhere we could maximize staff, we did. It’s a real unique and efficient cross-training program.”

With training completed and the units in hand, the next step for Sanford Health was figuring out where to have the truck located.

“Now we are talking to companies and asking them where they would like us to be located, where their concentration of workers are and what is the most beneficial,” Murdock says. “Whether that’s at a crew camp one day and a company site the next, we’ll work with them to come up with the appropriate dispatch plan.”

Shortly after receiving its first unit in May, Sanford Health put it on display at the Williston Basin Petroleum Conference and it drew a strong response from the community, Murdock says. Over a three-day period, more than 1,200 individuals toured the truck.

“The communities are very excited. Their hope is that if we can take some of those routine health care type things like drug testing, it’ll help ease things at the local clinics,” Murdock says. “This will also help with some of the preventive health care that gets missed, like flu shots, for those in the Bakken. If we’re out there making it convenient for them, hopefully we can reduce some of those illnesses with some prevention.”

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