Altru Health System Improves Clinical Research Efficiency and Access for Underserved Patient Populations


Altru Health System Increased Enrollment from 4% to 11% of its Oncology Population, Improving Care Options for Patients

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AltruAltru Health System (Altru) ( is a non-profit community healthcare provider and member of the Mayo Clinic Care Network headquartered in Grand Forks, North Dakota, United States. The health system serves a population of 225,000 residents in a rural catchment area spanning 4,000 square miles in the states of North Dakota and Minnesota, and employs over 3,250 professionals and has been committed to caring for the region for more than 130 years. Altru offers a wide range of world-class healthcare services and is the leading provider for rural patient access to innovative clinical research with an emphasis on convenience and proximity.

Altru’s accreditations include The Joint Commission’s Gold Seal of Approval® for its hospital and home care, which recognizes the health system’s commitment to quality, safety, and compliance. The Altru Cancer Center is recognized by the American College of Surgeons with a Commission on Cancer (CoC) accreditation for maintaining high levels of excellence in the delivery of comprehensive patient-centered care. The College of Healthcare Information Management Executives (CHIME) recognizes Altru as a leading health system that is Digital Health Certified Level 9, one of the highest standards a health system can attain for innovation and application of healthcare technologies that are modernizing healthcare delivery.

Altru is the third largest employer in the state of North Dakota and is consistently recognized as one of the best places to work in the region for exemplary employee culture, career growth, and staff morale. Employees benefit from one of the lowest state tax rates in the country, a lower average cost of living, and generous compensation packages, making the region an attractive destination to live, work, and raise families.

The Altru Cancer Center Research Department opened in 1977 to conduct clinical trials with The North Central Cancer Treatment Group (NCCTG), an outreach program led by the Mayo Clinic to provide rural patients with new and unavailable treatments for their conditions. The department conducts upwards of 20 clinical trials at any given time and Altru researchers have successfully completed over 1,000 studies across biomedical research, health services, general medicine, cardiology, vascular disease, diabetes, renal disease, and neurology.

Altru is compliant with Good Clinical Practice (GCP) guidelines that assure the rights, safety and well-being of trial subjects are protected and the credibility of its clinical trial data. All Altru research staff maintain Association of Clinical Research Professionals (ACRP) memberships and good standing with professional research organizations.


Altru partnered with Paradigm Health, Inc. (Paradigm) to improve the efficiency of its clinical research program. There were three guiding principles for the joint effort:

  1. Increase the availability of clinical trials as a care option for Altru patients;

  2. Help the Altru Research Department leverage technology, data, and process automation to drive clinical research efficiency and deliver exceptional results; and

  3. Reduce unnecessary burdens placed upon staff in the Altru Research Department that could otherwise contribute to poor mental health in the workplace or turnover among a team recognized for its high strategic value.


The Altru Research Department is accustomed to high demand and a fast paced working environment. “Altru Health System’s commitment to excellence and continuous improvement led to a collaboration with Paradigm to evaluate our existing technology, data and processes with the purpose of identifying and breaking down barriers that inhibit the potential of our Research Department,” said Kari Jensen, Director of Quality and Safety, Altru Health System.

Patient recruitment infrastructure and staffing capacity were identified as barriers negatively impacting the department. These limitations inhibited a key research objective of the health system–enable every Altru patient, regardless of physical location, with opportunities to benefit from clinical research as a care option. The Research Department utilized numerous disparate systems and data at Altru Cancer Center, such as the EHR, molecular testing lab results, and pathology notes to pre-screen potentially eligible patients for clinical trials. However, the patients receiving care at Altru clinics outside of the main cancer center could not be pre-screened because the level of effort to do so entailed incorporating even more disparate systems and data, which far exceeded the staffing capacity and technology available to the Research Department.

“The healthcare industry has a moral obligation to reduce the barriers of patient access to clinical research. Patients in rural communities face geographic and socioeconomic burdens that inhibit access to novel treatments. It is imperative that we expand patient access to research through community health systems to provide all people with equal opportunities and the possibility of achieving better health outcomes.”

Ashlee Dagoberg, PT, DPT
Manager of Research Program
Altru Health System

“Altru Health System delivers five star care to patients, and that is a byproduct of our focus on our own employees’ wellness, team building efforts, and a strong culture that fulfills our people with a great sense of purpose,” said Marlene Miller, Director of People Resources, Altru Health System. “One of our goals is to decrease voluntary turnover among first year employees by 4%, and working with partners that help us increase efficiency, reduce administrative burden on our people, and improve patient access to care, all contribute toward that objective.”


Altru adopted Paradigm’s Platform and incorporated Paradigm’s clinical services. Paradigm integrated Altru’s disparate data and source systems on the company’s platform, which fulfilled the necessary infrastructure for efficient, data-driven patient screening for clinical trial opportunities across all Altru locations. Paradigm’s Platform and clinical services were deployed in Altru’s clinical workflows to pre-screen every Altru patient for potential clinical trial participation, regardless of location, prior to upcoming care visits. The Altru Research Department utilized the pre-screening results to prioritize eligible patients and prepare Altru healthcare providers to present clinical research as a care option during routine patient visits.


Altru expanded patient access and increased enrollment in clinical trials across the entire rural health system. Pre-screening increased from 10,200 annual patient visits within Altru Cancer Center to over 21,200 cancer patient visits across the health system, while reducing Altru staff burden through effective use of the Paradigm platform and virtual CRC services.

“Altru Health System historically enrolled four percent of our cancer patient population in clinical trials,” continued Dr. Dagoberg. “Our partnership with Paradigm and our Research Department’s implementation of industry leading best practices increased this enrollment to 11% of the population. This has a profound impact on patients’ lives in a rural community that otherwise would not have access to clinical research as a care option.”


About Paradigm

Paradigm is rebuilding the clinical research ecosystem by creating a platform that enables equitable access to trials for all patients, while enhancing trial efficiency and reducing the barriers to participation for healthcare providers. Incubated by ARCH Venture Partners and backed by leading healthcare and life sciences investors, Paradigm aims to break down barriers across the trial ecosystem through one seamless infrastructure implemented at healthcare provider organizations, bringing potentially life-saving therapies to patients faster.