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Telehealth

Purpose and Target Population 

  • Mission: To enhance the sustainability of island communities by providing island residents technology enabled access to health care providers, services, and systems. The Collaborative’s aim is to break down barriers to access by enabling patients to connect with different health systems and providers using simple telehealth tools.   

  • Value: The Collaborative reduces substantial costs and time island residents face accessing off-island providers. The project builds on the Maine Seacoast Mission’s knowledge of each island’s infrastructure, culture, and relationships with island leaders. The telehealth solution is customized to each island.

  • Focus: reducing the access barriers for island residents and enhancing the health systems/providers connections with their patients.

Planning and Implementation

  • With retirements of key health providers, the Maine Seacoast Mission sought to design a telehealth solution to ensure continued access to health services on the islands. Its telehealth activities have been operating since 2002.

  • MCD Global Health obtained a federal Network Development Planning Grant from the Federal Office of Rural Health Policy to develop a collaborative of partners and design a telehealth strategy.  The Collaborative is facilitated by MCD Global Health (MCD) and Maine Seacoast Mission. Members include MDI Hospital, a critical access hospital plus three health center locations on Mount Desert Island; Northern Light Health, an integrated health system with Maine Coast Memorial Hospital, Blue Hill Hospital, and Eastern Maine Medical Center; MaineGeneral Health, a comprehensive health system with MaineGeneral Medical Center and Center for Cancer Care; St. Joseph Hospital; and Islands Community Medical Services, a rural Federally Qualified Health Center on Vinalhaven Island.

  • During a one-year planning process funded by the Network Planning grant, the project brought together hospitals, health centers, health care providers with experience in telehealth and rural medicine, and island residents. Monthly meetings resulted in an external environmental scan and network organizational assessment. These tools were used to establish network goals and objectives and, ultimately, a strategic plan that:

    • Identified opportunities to improve access to health care for islanders through telehealth while considering community needs, existing resources, and operational challenges.

    • Developed a comprehensive assessment to outline a collaborative approach to increasing access to health care for Maine’s unbridged island communities.

    • Developed a framework for network implementation and operation, including scope of work and budget.

  • In September 2024, The Collaborative received an additional, 3-year grant from the Northern Border Commission to establish, implement, and optimize a telehealth network (funding period September 30, 2024–September 29, 2027). The Collaborative has three main goals:

    • Facilitate access to and provide health care services through a strong collaborative network, in which every network member organization is actively involved and engaged in the planning and implementation of activities.

    • Expand the delivery of new or enhanced health care services, including through telehealth, to serve Maine’s unbridged island communities and improve access to care across the region.

    • Utilize community engagement and evidence-based or innovative, evidence-informed telehealth models in the delivery of health care services.

  • How it works: The Collaborative is in the process of implementing a strategy to create access points where telehealth backpacks will be deployed to enable residents to connect to mainland health providers. To make the system work, The Collaborative is working with the provider sites on staffing, training, workflow, reimbursement, and technology issues.

Best Practices  

  • Engaging partners and communities in the planning process and maintaining engagement throughout implementation.

  • Use of a Seacoast Care Collaborative Operations Plan to guide a shared understanding of program approaches and needs across network members and use plan to manage ongoing program implementation. 

  • Provide support to network members to implement and optimize telehealth programs. 

  • Maintain a communication strategy to disseminate information, resources, and surveys to islanders.

Challenges and Solutions 

  • The islands each have small populations making it harder to garner the attention of the health systems. Working together through the Maine Seacoast Mission, the islands have engaged mainland providers in the collaborative. Getting the mainland providers to the islands to meet residents and see first-hand the access challenges has been instrumental in engaging providers.

  • The cultures of each of the islands differs, requiring careful navigation of relationship among island leaders and residents.

  • Each of the providers has their own telehealth systems and technologies; working through compatibility issues has been time-consuming.

Contact 

Maine Seacoast Mission’s Island Health Program Activity: Seacoast Care Collaborative (The Collaborative)

The Maine Seacoast Mission serves all 15 unbridged islands from the down east Cranberry Isles to Casco Bay (and every unbridged island in between) with year-round populations.  The Seacoast Care Collaborative is one activity of the Mission’s larger Island Health program. The Collaborative targets the islands east of Casco Bay:

  • Great Cranberry 

  • Islesford (Little Cranberry) 

  • Frenchboro (Outer Long Island)

  • Matinicus

  • Monhegan

  • Swan’s Island

  • Isle au Haut 

  • Islesboro

  • North Haven

  • Vinalhaven

Above: Geographic distribution of island communities served by the Seacoast Care Collaborative