Sunbeam V
The coast of Maine is home to a myriad of small islands, many of them sparsely populated and difficult to reach. These islands rely on a ferry system to bring residents back to the mainland to receive health care. For some islands, ferry service is limited to once a month; hazardous weather conditions can reduce this schedule even further. Receiving health care often necessitates long waits for appointments, and inconvenient and time consuming trips to the mainland.
It would seem that telemedicine could provide a more efficient way to deliver health care services to these islands. But the population on many of the islands was so small (as few as 30 residents on one island) that the cost of purchasing and installing video conferencing equipment on each island was difficult to justify.
Residents in a state whose motto is "It's the way life should be" were not willing to give up on telehealth, however. They would work together to create an innovative and seaworthy telemedicine solution.
The Maine Sea Coast Mission is a non-denominational, nonprofit organization that brings humanitarian aid and spiritual comfort to thousands each year, from mid-coast to Downeast coastal Maine. To provide services to island residents, Sea Coast Mission owns and operates a 72-foot vessel, the Sunbeam V. The boat delivers food, clothing, and medical supplies to islanders, while also providing opportunities for social gatherings and pastoral care.
The outfitting of the Sunbeam with telemedicine equipment was the brainchild of Rev. Gary DeLong, executive director for Maine Sea Coast Mission. "We were looking for new ways to serve our constituents, and telemedicine seemed like a natural," he says. The Mission formed a partnership with the Regional Medical Center in Lubec, which was already providing telemedicine services to other parts of Maine.
By using the Sunbeam as a portable telemedicine spoke, the Mission is able to share the costs of one telemedicine station with several different islands. The Sunbeam makes its rounds much as it always has, but now it docks with a registered nurse and the ability to video conference in to a health care provider on the mainland.
"In the cabin of the boat, I have a complete exam room set up," says Sharon Daley, the telemedicine services coordinator for the Sunbeam. Daley is the RN who travels on board the vessel, facilitating telemedicine visits between the island patient and mainland provider. "I have everything from an otoscope and a derm cam to bandages and aspirin," Daley adds. She is able to facilitate treatment for a wide variety of specialties including dermatology, psychiatry, endocrinology and geriatrics. She is also able to do some laboratory work, including collecting samples for testing on the mainland.
Sharon reports that the level of acceptance among patients is high. "Islanders are very comfortable with technology--many of them use the Internet to deal with their isolation," she says.
More problematic is appointment scheduling. Unpredictable weather can mean that a whole day's appointments need to be canceled and rescheduled. And patients sometimes prefer simply walking in to setting up an appointment in advance--a situation that can prove frustrating to mainland providers.
During the past two years, DeLong reports that the Sunbeam has treated hundreds of cases; the Sea Coast Mission is currently looking for ways to expand the use of its telemedicine equipment. Expanding services to more islands is hampered both by limited ISDN lines in such places, and also by the capabilities of the Sunbeam herself--there are only so many ports in so many days that are logistically possible to visit. Instead, DeLong says that the Mission is looking to expand the use of the equipment by adding health education and prevention to its current uses.
A lot of that of course, will depend on funding. The program relies almost entirely upon donations, with some support from the Office for the Advancement of Telehealth (OAT). Financial support and operational support are critical to the Maine Sea Coast Mission's continuation and expansion of its telemedicine program.
As DeLong puts it, "We need to educate people about what telemedicine can do and what a successful program looks like."
For more information about the Maine Sea Coast Mission, please visit www.seacoastmission.org.
