JACKMAN, Maine July 1—An innovative project employing paramedics as urgent care providers—connected via telehealth to emergency room physicians 100 miles away—has launched successfully in one of Maine’s most remote communities.
The federal grant-funded project has been up and running for about a month in this frontier community (pop. 823) less than 20 miles from the Canadian border. It ensures round the clock access to care at Jackman Community Health Center, the lone clinic in an area best known for its outdoor culture, with hunting, fishing and ATV/snowmobile trails and beautiful mountain vistas.
Until now, medical assistants and the clinic’s only doctor were on call for emergency care after hours, and per-diem providers filled the gap on the weekends and when the doctor was away. But this model was not financially or logistically sustainable, and the nearest hospital emergency rooms – either in Skowhegan or Greenville, Maine—were an hour or more away over occasionally treacherous and moose-trafficked roads. The new model addresses local need in a sustainable but very 21st century way.
“We know that access to care is critical to ensure quality of life in this beautiful, but very remote area,” said Dawn Cook, vice president and chief operating officer of Penobscot Community Health Care, which owns and operates the clinic. “The question was: how do we sustain that access? Many partners came together to make this happen, and it’s working well.”
PCHC, along with North East Mobile Health Services, St. Joseph Hospital in Bangor, Jonnathan Busko, M.D., an emergency department physician at St. Joe’s, and the town of Jackman, were the principal partners. For months, while legal and technical details were worked out, NEMHS paramedics assigned to the health center took intensive courses in urgent care—care that they are providing with the real-time telehealth guidance and supervision of ER docs at St. Joe’s. The courses were developed by Busko and run by Eastern Maine Community College—and will continue to be available for enhancing the skills of paramedics working in Jackman and other remote areas.
“We believe this project has the potential to revolutionize healthcare in rural parts of the state, said Rick Petrie, project director and chief operating officer for NEMHS. “A project like this is only possible when a diverse group of healthcare providers is willing to come to the table, identify the gaps in the current healthcare delivery system, and develop a program to bridge those gaps. We must be willing to step out of our traditional roles to accomplish those goals.”
Busko, who is the medical director of Care Delivery Transformation at St. Joseph Hospital, suggested that the project could be a model for rural communities nationwide who are faced with hospital and clinic closures and loss of health care access. “This is the essence of community-guided and community-supported health care,” he said. “St. Joseph, a member of Covenant Health, is proud to be part of this. We believe innovation and improving health care access are part of our mission.”
Thus far, the after-hours paramedics, who are housed in the same building as the clinic, have seen about 100 patients for complaints ranging from earaches to cuts to heart attacks. Some patients with issues requiring a full ER visit went by ambulance to a hospital or, if appropriate based on the tele-health visit, treated and released. The paramedics are also available to provide acute care during regular clinic hours, as needed.
Paramedics are also serving the region by providing community health services in an effort organized by Somerset (County) Public Health. This will enhance the services available in the region in many ways.
The project, including the paramedic training and necessary technical upgrades at the clinic, has been partially funded by a federal grant.
This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $1.2 million dollars with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.
For more information:
Kate Carlisle | 703-589-8605 (m) | firstname.lastname@example.org