Early in 2012, 78-year-old Gerald Matthews nearly lost his life. He was transported from Swan’s Island to Mount Desert Island Hospital in Bar Harbor, where he was quickly assessed, found to be in serious condition, and transferred to Eastern Maine Medical Center (EMMC) in Bangor. Matthews’ heart stopped several times, but physicians at EMMC were able to revive him. Upon his admission to the hospital, Matthews was diagnosed with a brain hemorrhage, which was complicated by his use of coumadin, a blood thinner medication commonly prescribed for patients with atrial fibrillation.
Matthews had been living with atrial fibrillation, the most common cardiac arrhythmia, which is an irregular heartbeat. Matthews’ condition was very serious and at first it seemed unlikely that he would be able to walk again, regain his independence, or return home to Swan’s Island. Matthews made slow and steady progress and was eventually transferred to rehab to continue working on his recovery. It was a tough, long road, but he was determined to return home. It was that fierce determination that provided Matthews with the strength to work hard during his rehabilitation and after several months he was able to return home to Swan’s Island.
Advances in today’s medical technology, and the ability to deliver that technology in rural locations, has made Matthews’ life easier following his long hospital stay. At the Mill Pond Health Center on Swan’s Island, modern technology is being used to help patients like Matthews live better lives. During his two-month stay at EMMC, Matthews had a pacemaker implanted to regulate his heartbeat. He now visits the island’s health center where they are able to retrieve data from Matthews’ implanted pacemaker and transmit the data to his cardiologist, Dr. Guillermo Crespo, at Northeast Cardiology in Bangor.
The cardiology practice provided Matthews with a Medtronic Carelink Monitor, a small data collection and transmitting device, which he brought to the health center. Periodically, the data from his pacemaker is collected and transmitted over the clinic’s phone line. Dr. Crespo and his staff analyze the data and Matthews is called with the results. In less than 15 minutes, the pacemaker data is collected, transmitted, and Matthews is on his way home—all done without the need for a costly and time-consuming trip on the ferry, a 100-mile round trip drive to Bangor, and possibly an overnight stay depending on the time of his appointment and the weather.
The use of technology is not new to the Swan’s Island clinic. Several years ago, the Mill Pond Health Center was selected by the Maine Sea Coast Mission to be the site for their first land-based telemedicine unit, an expansion of their Islands Health Services program. Over the past 10 years, the Mission has offered telemedicine services aboard their vessel, Sunbeam V, to four different islands. Currently, there are two islands, Swan’s Island and Islesford, utilizing land-based telemedicine equipment.
A Polycom videoconferencing system is used for the delivery of the telemedicine services. The system not only allows patients to see providers on the HDTV screen, but also has a digital stethoscope for transmission of heart and lung sounds, and two handheld cameras for close up images of skin rashes, tick bites, eyes, ears, throat and other body parts. In addition to providing primary healthcare encounters, the telemedicine equipment is used to deliver counseling services with Mount Desert Island Hospital’s Behavioral Health providers, and drug and alcohol counseling through Acadia Family Center in Southwest Harbor.
Advanced technology is also being utilized to provide care management of diabetic patients on Swan’s Island. A new service, relying on technology, provides diabetic patients with the opportunity to bring their glucometers to the health center and have their blood sugar readings downloaded to the clinic’s laptop. The blood sugar readings are then electronically transmitted to Catherine Richardson, R.N., a diabetic care manager with Mount Desert Island Hospital, for review prior to the patient’s scheduled telemedicine diabetes counseling appointment. Having these additional blood sugar readings allows Richardson to work closely with patients, delivering diabetes education and mapping out a plan for the patient to follow to manage their disease.
The newest addition to the technology-driven list of healthcare services offered at the Mill Pond Health Center is internet-based telehealth sessions with United Cerebral Palsy (UCP) providers in Bangor. Keith Tibbetts, a licensed professional clinical counselor at UCP, connects with patients on Swan’s Island using iHASMD, which is specialized computer software accessed over a secure internet connection. After several months of providing internet-based counseling, Tibbetts says, “Although face-to-face is always the best form for counseling, telehealth is a great resource that UCP finds more than adequate for providing services. Technology can be an obstacle with difficulties at times, but when thinking of the savings in travel and time, it is well worth the minimal frustration of learning something new. To have a facility on Swan’s Island that helps individuals with accessing counseling services and other medical services is exceptional.” The iHASMD program allows the counselor and patient to see and hear one another during virtual counseling sessions using a laptop computer. The Mill Pond Health Center on Swan’s Island is the first site to link remotely with counseling services at UCP.
Through today’s communication and networking technology, the delivery of healthcare in rural settings is constantly changing. Leslie Watson, a nurse with Hancock County Homecare and Hospice, worked with an elderly patient who lived alone on Swan’s Island this past summer to remotely and wirelessly monitor weight, blood pressure and oxygen level on a daily basis. Watson set up the necessary equipment; a scale, blood pressure unit, and pulse oxymeter in the patient’s home—all wirelessly connected to a sending unit that collected and transmitted the data. The sending unit was connected to a phone jack in the patient’s home and once the vital signs were collected, the unit would dial a toll-free number and transmit the data to a nurse on the mainland who would monitor the results. If the patient failed to transmit the vital signs by a designated time, the nurse would phone to see if the patient needed any help. Networked diagnostic devices are making at-home patient monitoring commonplace in urban areas, and now it is available in rural settings, like islands off the coast of Maine.
The residents of Swan’s Island do not have to rely solely on technology for their healthcare. Various medical providers visit the island in-person throughout the year, but the addition of the technology-assisted healthcare has provided more frequent, more convenient, and less costly options enhancing the lives of many residents. Gerald Matthews is only one of the residents being monitored more closely through the use of technology. He sums it up by saying, “It’s great. I can come over here to the health center and have things done. I can get my heart checked, my bloodwork done, whatever I need and I don’t have to go on the ferry and up to Bangor… Just to think of the technology we have today compared to what we had a few years back—it’s terrific!”