After receiving dire requests for health care services from rural communities, the St. Alexius Medical Center of Bismarck, North Dakota started a pilot program in 2003 that brought online speech therapy to rural denizens of the state. An article in The ASHA Leader described the success of the pilot program. Two program participants lived in Ashley, a town about 120 miles away from Bismarck. They suffered from post-stroke speech-related difficulties and would not have attended therapy had it required travel to Bismarck. Overall, the telepractice program saved the Ashley residents 56 trips to Bismarck (totaling 13,440 miles of travel) and $4766 in expenses. The efficacy of the pilot program even prompted Blue Cross Blue Shield of North Dakota to reimburse patients for seeking telepractice SLP services. This momentous decision represents a major success for the overall sustainability and cost-effectiveness of telepractice.