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Area veterans receive care through Community Based Outreach Clinic

GRAFTON, N.D. -- It's been a couple of years since John Donnelly or Ernest "Hod" Hutson have made the 120-mile trip from their Grafton homes to the Fargo Veterans Affairs Medical Center.

Dan Stenvold
Dan Stenvold, a Vietnam veteran, is a strong supporter of the VA Grafton Based Community Outpatient Clinic. In the background is Walsh County Veterans officer Chris Kratochvil. Photo by Eric Hylden/Grand Forks Herald

GRAFTON, N.D. -- It's been a couple of years since John Donnelly or Ernest "Hod" Hutson have made the 120-mile trip from their Grafton homes to the Fargo Veterans Affairs Medical Center.

It's not that the World War II veterans, both of whom are in their 90s and served in the Army Air Corps in Europe, are in perfect health. It's simply that they get most of their medical care through the VA's Grafton Community Based Outreach Clinic.

"It's much better to be this close," Donnelly said.

The Grafton clinic, which opened in 1997 at the Life Skills and Transition Center (formerly the North Dakota State Developmental Center), was the VA's first outpatient clinic in North Dakota. Before that, all veterans had to travel to the Fargo VA medical center for virtually any health-related treatment.

"We're very, very fortunate to have a clinic of this quality right here in Grafton," said Dan Stenvold, mayor of nearby Park River, N.D., and president of the North Dakota Vietnam Veterans of America.

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While the Grafton clinic, which has a regular client base of about 900 veterans, is convenient for people living in Walsh County, it still can be quite a commute for veterans living in more rural areas in North Dakota and Minnesota.

Once a week, a bus brings veterans in several northeastern North Dakota communities, such as Cavalier and Drayton, to the VA Medical Center in Fargo to see specialists.

"Transportation is an issue," said Dr. Robert McCartney, an Army veteran who served in Korea in the 1970s. He has been the primary care provider at the Grafton Veterans Clinic for about four years.

Telehealth trend

Today, the Fargo VA Health Care System, which serves about 33,000 veterans in North Dakota and northwest Minnesota, operates nine community-based outpatient clinics in Bismarck, Dickinson, Grafton, Grand Forks, Jamestown, Minot and Williston, as well as in Bemidji and Fergus Falls, Minn.

A tenth clinic is scheduled to open in spring 2014 at Mercy Hospital in Devils Lake.

It will be the state's first VA Primary Care Telehealth Outpatient Clinic, staffed by a part-time physician and full-time nurses. Veterans will be able to consult physicians and specialists five days a week via video for services that range from cardiology to mental health.

All outpatient clinics, including Grafton, have been implementing the telehealth program over the past three or four years.

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"It's a good way to provide special care, especially for people that are living in real remote places," McCartney said, "for low-income veterans, those with transportation problems or those who need specialty care, such as mental health treatment."

Cramped

Grafton landed the state's first VA outpatient clinic in 1997 largely through the efforts of former state Sen. Harvey Tallackson, D-Grafton, who lobbied the state Legislature to make room for such a facility at the underused state-owned Developmental Center.

The facility, tucked away in the first floor of a century-old building, has far outgrown its size.

Specialists share rooms with the telehealth equipment.

Patients in wheelchairs cannot get into exam rooms until someone removes another chair.

"It's like musical chairs," said Karen Shereck, medical support assistant.

Patients consult with McCartney in tiny patient rooms that are stuffy and noisy.

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"I know what the weather is outside without going out," he said. "I can hear people talking about it through the walls."

Sen. Heidi Heitkamp, D-N.D., who discussed veterans issues during a July 4 holiday tour of North Dakota, said Grafton's clinic needs to be a larger facility.

"The clinic's just too small," she said. "They have a great doctor there, and the veterans have some amazing stories about the staff there. But they need space."

Remote

The VA considers North Dakota -- along with Alaska and Wyoming -- as the most rural states in the nation, where veterans must travel the farthest to receive health care.

Telehealth program use has doubled or tripled since it began in Grafton, according to McCartney.

Services have grown, too. For the past year, it has been implementing a home telehealth, one of the VA's latest programs to reach veterans.

It includes sophisticated equipment, such as wristbands that patients wear to transmit vital information, such as blood pressure, from their homes to health care providers.

"It used to be that they came here for all of that," said Jane Shephard, an LPN at the Grafton Clinic.

And patients can see the results through MyHealth"e"Vet, which provides online access to make appointments, view medical records and retrieve test results on their home computers, laptops or smartphones.

The VA's goal is for veterans to have one annual face-to-face, in-clinic visit with a health care provider, while other consultations or routine tests are performed remotely, either via computer or telephone, according to McCartney.

"Having put 40 years in private practice, where everything was face-to-face, it's quite a change. It's something you have to get used to," he said.

Even as a physician, he said, there's a difference between listening to a heartbeat in an office setting and through a machine 50 or 100 miles away.

While the older veterans in Grafton have accepted the telehealth system -- driving to the clinic and sometimes having to talk with a doctor in Fargo through a computer and video screen -- they wonder how some of their friends in other communities will be able to adapt to the changes.

"It rubs me the wrong way," said 90-year-old Connelly, who lives in Grafton. "They give you an Internet address and tell you to go to your computer. I don't have a computer. The trouble is, if you get a computer, it's obsolete as soon as you get it. At least I can come here."

Call Bonham at (701) 780-1110, (800) 477-6572 ext. 1110 or send email to kbonham@gfherald.com .

Related Topics: GRAFTON
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