Driving down a dirt logging road in rural Maine, paramedic Nathan Yerxa can’t help but take in the view most days. Looking out over the landscape here, it’s as if the sky and the land seem to merge.
Yerxa is a paramedic for North East Mobile Health Services and stationed in Jackman, Maine, a small town in the northern part of this state home to about 700 people. From the edge of town, you can see the Canadian border in the distance, and on any given day, paramedics here are responsible for covering an area that’s approximately the size of the state of Rhode Island.
“The remote landscape and difficult terrain make it difficult to bring resources to the area,” Yerxa said, as he drove through town in a Ford pickup truck that’s been converted to an all-terrain ambulance.
Like rural communities across the country, getting patients to an emergency room in this area is a difficult, often time-consuming task. The closest ER is about 70 miles away, a trip that can sometimes take close to two hours. While Jackman does have a community health center, the facility can’t perform many emergency procedures most larger hospitals can.
So, in an effort to save time and lives, the emergency room is being brought to Jackman in an innovative new way, harnessing technology and the expertise of paramedics likes Yerxa.
“I think it’s one of those situations where what’s old is new again,” he said.
The idea is a Critical Access Integrated Paramedic program. Paramedics here are receiving more training in critical care. While at the same time, that pickup truck Yerxa relies on is being outfitted with tools like satellite internet and a satellite phone. First responders even have heart rate monitors that can send data wirelessly to a doctor anywhere.
The concept is simple. Using technology, paramedics can instantly connect to a doctor no matter where they take a call. From stitches to ultrasounds, paramedics in this region are bridging the rural healthcare gap by instantly connecting via video chat to a doctor who may be hours away.
“It is in many ways like a high-tech home visit that you might have seen 60 years ago, but we’re also bringing urgent care services with us,” Yerxa explained.
Finding new ways for rural communities to connect is a key component to the program's success.
Nationwide 25 million people don't have access to broadband.
The COVID-19 pandemic has only magnified the issue. In Maine alone, 36,000 telehealth calls were made last month up from 650 the same time last year. Many times, though, patients and doctors have trouble connecting because of poor internet connections.
Town manager Victoria Forkus pushed hard for the program.
“We were in a way forced to implement this new program early because of COVID,” she said while sitting inside Jackman’s town offices.
The whole program is costing Jackman and surrounding communities about $450,000 a year to implement. Some of the money will come from a tax increase, which is no small feat in a town where the median income is just $29,000.
But out here, the program has overwhelming support.
“What’s the dollar amount on one of my neighbors’ lives? What’s the cost of saving a community member? It’s priceless,” Forkus added.
The concept of the program is gaining attention across the state.
Jim Rogers, with Health Connect Networks based in Maine, is lobbying Congress hard to expand rural broadband connectivity. It’s something he says is now more imperative than ever given the pandemic.
“People in these rural communities just don’t have adequate internet to support a telehealth consult,” he said.
As for Yerxa, he sees the program as something other rural communities across the country can emulate.
“Hopefully, we can now provide 24-hour coverage to patients in any of these rural locations.”
