The Maine Seacoast Mission has been serving Maine's remote island communities with spiritual, health, and youth programs for over 100 years. An emphasis on health has always been central to the Mission's work, and in 2001 it harnessed telemedicine technology to expand health care access to isolated coastal settings with the boat Sunbeam. Sharon Daley has been working as a nurse on board Sunbeam since the Island Health Services first set sail.

Since Rural Health Day, November 17th, 2011, is all about celebrating the power of rural, it is a perfect opportunity to recognize Sunbeam as a shining example of creativity and ingenuity in rural health care.

"When you live on island, there are not any medical providers on that island and it's very expensive to go off," explains Daley. "If you had a medical appointment and you had two kids, you had to go off overnight and either stay with somebody or get a hotel", which was prohibitively expensive for most island residents. "They didn't do it unless they really needed to."

Although she is not a native Mainer, Daley's childhood on a farm gave her valuable insight into island life. "Farming communities are kind of like islands." They are isolated and share a similar sense of self-sufficiency, cut off from the networks of more populated areas. Daley was interested in island living and drawn to the opportunity to have continued meaningful contact with her patients. With such a small population being served, she can focus on providing total care. "Nurses in the hospital see someone for a little while and then discharge them," says Daley, but she is able to follow their experiences in a uniquely personal way and provide encouragement as they pursue education and make life choices.

Daley measures her success by building strong relationships with the individuals she works with and observing each community. "The numbers on the islands are very small, so it is impossible to look at the number of telemedicine visits in one year and say 'I need to increase that' because you're working with a limited population," says Daley. "If I feel like there's increased access to health and people are making healthier choices, if I can convince someone to stop smoking or stop drinking, we've been able to be a part of that by offering support."

Sunbeam's rich offerings expand far beyond the reaches of basic telemedicine. Preventative and educational aspects of health care have also been integrated into the program. Flu shots, screening clinics, and WIC programs are delivered through Sunbeam, and live video technology has allowed speakers on issues of women's health, nutrition, and domestic violence to broadcast their presentations to island residents.

Daley works to identify and address the unique needs of each island community. For instance, physician did a talk on Lyme disease for Isle au Haut because there was so much Lyme disease there. A man on one island was the only person in AA. Daley connected him with a group on the mainland so he could get the support he needed through video without having to leave his community.

"The thing that surprised me," says Daley, "was that the people on the islands are not at all uncomfortable with the technology." She was also not aware of how much behavioral health programs would be a part of Sunbeam's services. Appointments with psychologists and marriage counselors have taken place through the telemedicine unit on board, and "people are very comfortable doing it this way, some people more comfortable that way."

Governor LePage has declared November 17th Rural Health Day in Maine in recognition of rural Maine's health challenges and in celebration of the innovative work being done to overcome them.