GRAND FORKS-As the need for psychiatrists in western North Dakota continues to rise, a residency program at the University of North Dakota School of Medicine and Health Sciences is looking to fill the gap in an untraditional way.

The psychiatry program, which is ran primarily out of Fargo, is using telemedicine to serve rural areas of the state, where the services are most needed.

Residents conduct most of their work from Fargo via a video calling service that allows residents to talk with patients across the state at human service centers. Once a month the residents also travel to the towns to meet with patients in person.

Andrew McLean, clinical professor and chair of psychiatry and behavioral science at the UND med school, said North Dakota Legislature recently increased the number of residency slots at the school, which allowed the program to increase its numbers from four to six.

"We wanted to spread the wealth and train all of our residents in rural psychiatry and telemedicine," he said.

Residents worked with patients in Dickinson, Williston, Minot, Devils Lake, Jamestown and Bismarck.

Robert Olson, director and clinical professor psychiatry residency training program, said the telehealth portion of the program has been an elective, but will become a mandatory part of the program in July. The move will allow more residents to become a part of the program, which will allow more sites to be added, including Valley City and New Town.

He said they decided to focus on the western side of the state initially because of the high need.

"The west is in the most need," he said. "The further west you go there's fewer and fewer psychiatrists. Then when you think of the oil boom and all of the action that's happening out there, it's been an area of tremendous need."

Long-distance help

Tom Eide, director of field services for the North Dakota Department of Human Services, said the department has a psychiatrist who lives in Florida who also works through telemedicine to provide services to people in North Dakota. Telemedicine and telepsychiatry allows doctors to fill needs of clients hundreds of miles away, he said.

"If I have a specific, unique need in Williston I can use somebody in Fargo who might have that specific training to provide what is a relatively rare service for that individual in Williston," Eide said.

Rosalie Etherington, superintendent at the state hospital in Jamestown, said so far the program has been going well, adding that the program serves as "great training grounds" for residents to be exposed to psychiatry in North Dakota.

There has been an uptick in telehealth services across the state in the last three years. Improving technologies and the increasing affordability of those technologies has been a big factor in the rise of telehealth, among other factors, Etherington said.

"I think some of it is just recognition of need and recognition that despite good efforts in recruitment and trying to get providers that it was still lacking," she said.

Etherington said she believes there was some initial hesitancy about the use of telehealth devices, in part, because there was worry that clients would not like it. However, Etherington said they have found that clients have been very open to telehealth and telepsychiatry.

As insurance companies become more open to the idea of compensating doctors for telemedicine and as the cost of the equipment to provide the service continues to go down, the numbers will continue to rise, Eide said.

"We can't use FaceTime on your iPhone to get this done yet but we might be getting closer to that at some point," he said.

Joel Erickson, who attended medical school at UND, is also in his final year of residency and is assigned to the Dickinson area. He believes the telepsychiatry program has been a "good experience" and has also been helpful during his training.

"One thing that's very helpful is the good staff that's out in Dickinson," Erickson said.

He said the staff can pick up things that he or other doctors might not have noticed via the video call. The doctors can work collaboratively with staff in each location to make sure that all of the client's needs are being met.

"It becomes a little bit more of a team effort than psychiatry already is," he said.