Telehealth Network Grant Program: Penobscot Community Health Center 

The Georgia Health Policy Center recently spoke to Ellen Thurlow, project manager with Penobscot Community Health Center, about their efforts to sustain 24-7 acute care services for rural Jackman, Maine so that people are able to stay in the community and get the care that they need. 

 

To date, what has been the biggest accomplishment of your telehealth program?  

We are proud we have been able to develop this groundbreaking way to maintain access for the folks in the Jackman community and surrounding areas to 24-7 acute care services that historically, has not been sustainable. What we did was collaborate with several partners, including health care partners and the community, which was very heavily involved in developing this program. This new model for delivering care is groundbreaking and working out very well for everyone. 

The model involves using paramedics and giving them some advanced skills through a new education program that Dr. Jonathan Busko, the lead physician, developed. The education portion is distributed by our partner, Eastern Maine Community College, which certifies the advanced practice paramedics. The town of Jackman contracts with Northeast Mobile Health Services to provide the paramedic service. We also brought in Somerset Public Health, the community health organization leader in the area, to develop education programs to give the paramedics community health services skills in addition to their advanced acute care skills. The community plays a role in selecting who will provide care and oversight of the program, since they are paying a large part of the bill.  

Beyond the ambulance service, the advanced practice paramedics are on site 24-7 at our acute care room in the Jackman health care clinic. When the clinic is open, paramedics work with the on-site physician providing acute care service. After hours, paramedics utilize telemedicine technology with a remote physician. We partnered with St. Joseph’s Healthcare, which provides physicians to be the remote site for the telemedicine services. 

 

What is a tip you would share with an organization launching a similar telehealth program?  

It is very important to be specific and very detailed about what the scope of practice is going to be for the people providing this type of service. Additionally, it is very important when you are communicating with various groups about a project to be very consistent in your communication. It is confusing and complicated enough on its own without the added complexity of mixed communication.  

Don’t underestimate the amount of time and expense it takes to get regulatory approval and develop these partnerships with organizations. The emergency services and physician services each have varying regulations and rules. It takes time to develop the workflow and the scope of what will and won’t be done so that everyone is comfortable with the model of care. Lastly, once you get the program underway, have regular and consistent communication with all your network partners, including the community.  

 

How does participation in the Office for the Advancement of Telehealth’s grant program impact your broader health improvement efforts? 

The Jackman region, because of its remote rural location, has not had access to some community type health services that other areas have, for example, hospice care. We are planning to have these paramedics get education so that they can provide hospice care, Because of the success that we have had in implementing this model, there is hope that this type of program could be developed maybe not in exactly the same way but could be adapted for other remote areas in Maine. 

 

What will your organization be doing more of or differently to emerge stronger from the pandemic? 

The pandemic helped organizations to be more open and receptive to finding creative solutions to problems and to collaborate with other folks. Additionally, the public has become aware of what can be done with telemedicine. So now, the technology folks and the medical community can partner to develop the tools that we need going forward to provide the type of care that is needed regardless of the location. 

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