Becky Lenfestey has lived in Frenchboro for the past eight years. A mother of three young boys, she will be the first one to tell you how hard it is to get to the mainland for a routine doctor’s appointment.
The car ferry service to Bass Harbor, she explains, is restricted to one round-trip each Wednesday, Thursday, and twice on Sunday, a 50-minute trip each way. Even with a perfectly timed appointment on the mainland, Lenfestey says, “anything would be an overnight trip.” With her oldest son in school, seeing a physician on the mainland also means pulling him out of school. “Two days of missing school for a regular doctor’s appointment is too much.”
Luckily for her and the other 3,000 people scattered across the outer islands in the Downeast area, they don’t have to see a “regular” doctor to stay healthy. Twice a month, their medical care comes to them—aboard a high-tech boat called the Sunbeam.
For the past six years, the Maine Sea Coast Mission and Mount Desert Island Hospital have offered telemedicine services aboard the Sunbeam to island residents of Frenchboro, Matinicus, Swan’s Island, and Isle au Haut. Mission nurse Sharon Daley, who lives in Islesboro, travels to each island aboard the Sunbeam. The vessel has an examination room equipped with a television and a camera, connecting Daley and her patients to an MDI Hospital physician on the mainland in real time through a high-speed ISDN line.
“I end up being the provider’s hands,” she says. After the initial checkup, Daley faxes her exam notes to an MDI Hospital-affiliated physician prior to their videoconference. Daley often works with Julian Kuffler, MD, and Linda Maxwell, a physician’s assistant, both from the Community Health Center in Southwest Harbor.
The boat is equipped to travel in inclement weather and even serves as the icebreaker for the ports on the islands. It takes three people to run the Sunbeam. Mike Johnson is the captain, Storey King is the engineer/deckhand, and Felicia Brand is the steward and backup deckhand. All three have a 100-ton master license.
Beyond their able seamen, Dailey and Dr. Kuffler consider the camera scope one of their best assets. Daley uses it to take close-up photos of a patient’s sore throat, rash, or other ailment. The photos are then magnified on the screen for Kuffler. “It’s actually bigger than what I get to see in person,” he says. The photo is so detailed that a couple of years ago the duo successfully diagnosed skin cancer from the photograph of a suspicious mole.
“It took getting used to,” Kuffler admits. But now he finds working remotely with Daley and his patients on the Sunbeam “a great, private way to deliver care.”
Becky Lenfestey’s three boys love the Sunbeam. “They know it’s pretty neat and Sharon always shows them the technology. It’s a great learning experience for them,” she says. “I don’t know what we would do without it.”
Besides providing regular doctor visits for patients of all ages, the Sunbeam also offers counseling and educational services to island residents. People can meet with a psychiatrist in the privacy of the exam room or can go to an Alcoholics Anonymous meeting without setting foot on the mainland.
Gary Delong, director of the Sea Coast Mission, remembers a new mother going through postpartum depression on one of the islands. Daley set her up with a doctor on the mainland who provided counseling sessions twice a month for six months. She told Delong that the telemedicine program saved her life. “Because of her economic and logistical issues she couldn’t take her kids to the mainland overnight for these appointments,” he says. “She couldn’t have gotten that quality access without the boat. That’s what it’s all about.”
The Mission is now working with two area dental hygienists, Alicia Woodward and Monica Jones, who are earning their bachelor’s degrees at the University of Maine, Orono. The women offer free screenings, cleanings, and sealants to the children on Swan’s Island, Frenchboro, and Isle au Haut. The Mission is hopeful that these services will be available to adults in the future.
Funded primarily by individuals and foundations, the telemedicine program is one of the reasons MDI Hospital was named the Outstanding Rural Health Organization of the Year by the National Rural Health Association (NRHA) in May. The Sea Coast Mission and MDI Hospital have also collaborated on a grant-funded program called Community Cares, which provides primary care and chronic-disease management to uninsured and underinsured residents of the outer islands.
“We’re just scratching the surface of what you can do with telemedicine,” Kuffler says. In the future, the Sea Coast Mission and MDI Hospital plan to expand the educational component of their telemedicine program to help support the existing EMTs who live on the islands.
“Telemedicine is not the way to practice all of your medicine,” Kuffler says, “but for these people it makes all sorts of sense.”
Editor’s update: Gary DeLong retired from Maine Sea Coast Mission in 2010; Rev. Scott Planting is now its executive director. Patricia Dutille is now the Sunbeam’s steward.
