Rural Assistance Center Director Kristine Sande

Editor’s Note: The University of North Dakota-based Rural Assistance Center (RAC) is a one-of-a-kind national health information clearinghouse that has established a stellar reputation among rural health care practitioners, service providers, and consumers in all 50 states and in 20 foreign countries. RAC was launched 2002 after winning a nationwide federal Department of Health and Human Services grant competition. The Center is part of the Center for Rural Health and the UND School of Medicine and Health Sciences.

Center director Kristine Sande, who holds a master's in business administration from UND, was a raised on a farm in rural Garrison, N.D., and has worked most of her career in rural-oriented business, including Nodak Electric Co-op, before joining the Center for Rural Health to work with rural Medicare services. In 2002, Sande became the first (and it the current) RAC director.

In the following Q&A with UND Office of University Relations writer Juan Miguel Pedraza, Sande talks about RAC's mission, the clientele it serves, and its widely praised success at creating a model for rural health information collection, organization, and distribution. For more information about RAC, see www.raconline.org.

OUR: Briefly tell us how the Rural Assistance Center got started and what its main purpose is.

KS: We applied for a Department of Health and Human Services grant to start the Center. The idea for the Center came from the Department's Rural Initiative. We got the grant because of the expertise and technology resources that we have at the Center for Rural Health. We also partnered with the Rural Policy Research Institute, a multi-state research consortium sponsored by the University of Missouri-Columbia, Iowa State University, and the University of Nebraska.

Among those organizations, we mustered the best rural health expertise in the nation, which made the University of North Dakota a real attractive spot to house the Rural Assistance Center.

Our primary goal-our purpose-is to be a national clearinghouse for health care- and human services-related information to rural communities. We actively market our mission to spread the word about the services that we provide.

OUR: What is your primary product?

KS: Our primary product is information services and most people access that information through our Web site (www.raconline.org). We try to pull together relevant rural health and human services information and then make it available and easily accessible-we want to make it easier for people to find that information.

We also have a listserv for both health and human services. We take many of the resources that we find out there and push them into peoples' electronic inboxes to help keep them abreast of what's going on in the field, opportunities they wouldn't want to miss such as funding and events in their area.

Our third main service is customized assistance. People can call or e-mail us with specific information requests. We have four information specialists who are master's prepared librarians to help people. The kinds of questions we see run a broad range, such as who is the contact at a particular federal agency to help us deal with our particular health issue.

We primarily aim to serve rural people and organizations, but we also help anyone interested working on rural health and human services issues, such as congressional offices doing casework. Basically, we're here to help anybody who is trying to improve or maintain rural health and human services at any level, we're here to provide that support.

OUR: At a press conference at the UND med school that was part of your fifth-year anniversary, Dr. Elizabeth Duke, administrator of the federal Health and Human Service Department's Health Resources and Services Administration, said that the federal rural health care leadership was extremely impressed by the track record you've established in just five years. What's behind this success?

KS: I think one of the biggest surprises for all of us was how our Web site took off. We've topped 1.5 million hits or contacts, including 500,000 so far this year.

The listservs are actually excellent tools for outreach, not only to they get information out to people that's important for them to do their jobs, it's also a way for them to forward such information to friends and colleagues. It's been a very important piece of our success in expanding our reach. We also are linked on a least 4000 other Web sites, such as Newsweek, the national Centers for Disease Control, the American Association of Retired People (AARP), and the National Library of Medicine.

People such as Dr. Duke at the highest federal level recognize its value. They point out that this center that is exactly what's needed in terms of advancing rural health care. Clearly, RAC has become a vital tool for health care professionals in rural settings.

I'd say that in terms of our success, the most important thing that we do is to put people in contact with people who know the answers to questions. We have helped people in every state in the nation and in 20 foreign countries. We've fielded more than 4700 e-mail or phone requests for special information.

OUR: What's the biggest challenge you're dealing with in terms of rural health care?

KS: In an urban setting, a big hospital might have one or more grant writers, medical librarians, and lots of other specialists. But in the rural setting, a physical therapist might be called upon to write grants.

People in rural health care wear lots of hats. So we get lots of calls from people in such a setting who wants to find out how to go about writing a grant. Part of why this is so important is that in rural settings, there are higher rates of poverty, more uninsured and elderly, long distances and limited transportation options, and lower volumes of facility usage. So we're talking very special needs in the rural health care and human services environment. Their information needs are particularly great. That's where we fit in.

RAC is the nationally recognized as the premier source for rural health care and human services information.

One of really neat things about this job has been when we do go to conferences, people coming up to us and say "You're from RAC we love you." They get so excited to be meeting the people helping bring them sorely needed infomation. When you see that other people are really excited it's completely gratifying. It helps to keep us enthusiastic about what we're doing.