BANGOR – Telemedicine is growing in importance in rural health care as evidenced by recent grants to St. Joseph Hospital and Community Health and Counseling Services, which are collaborating on the project.

The two providers have won four grants for telemedicine totaling more than $1 million. The latest grant, for $120,073, came this month from the Maine Health Access Foundation Inc., which itself was created with money from the sale of the nonprofit Maine Blue Cross Blue Shield insurance company to Anthem Insurance Cos. of Indiana. The other three grants are from the USDA-Rural Utilities Service.

The grant money is being used to further develop a project designed to connect distant patients or people using home health services with specialists in Bangor. With inadequate reimbursements in services such as home health care, finding ways to provide care more cheaply is important, explained Ken Huhn, St. Joseph’s director of specialty and outreach services.

Huhn noted that most of northern Maine’s specialists are based in Bangor, so telemedicine is a good option. It gives patients the ability to hook into a mobile terminal to connect with health workers at St. Joseph or CHCS, which saves travel time. And when a new terminal sits on a specialist’s desk, the specialist can schedule telemedicine visits between regular office visits without having to go to a terminal in a room outside the office, Huhn said. That can mean more patients seen, as there is less need to drive to distant clinics.

Both of Bangor’s general hospitals offer telemedicine. St. Joseph’s system connects it with the other 10 hospitals in the Maine Health Alliance. Specialties that can use the system are cardiology, pulmonology, endocrinology, wound care and dermatology.

With recent drastic cuts to home health care reimbursements, St. Joseph and CHCS can use grant money to set up connections in patients’ homes to allow regular connections between health workers and the patients. A simple terminal that allows for televisits where the health worker can talk to the patient and observe visual clues about a patient’s mental health costs about $3,000. Terminals with additional diagnostic capabilities run about $5,000, Huhn said.In a demonstration Friday afternoon, a connection was established between St. Joseph and a technician located in Lowell, Mass.

The technician named Josh attached diagnostic tools, which carry their own light sources, to a terminal. As he put a probe into his ear, the inner structures all the way to the eardrum were displayed on a big-screen television in Bangor. Some ear, nose and throat specialists have said the pictures are superior to the smaller view offered by a hand-held otoscope, Huhn said.

Josh aimed a camera at his eye. The tiny blood vessels on the eyeball were clearly visible. He turned on his skin a camera with a polarized lens that reduces glare. Then he magnified the image to 50 times life-size. He froze the photo – a feature specialists find useful in the study of a particular image.

A variety of attachments can transmit temperatures, heartbeats and other important data.

Huhn said the grant would allow St. Joseph to purchase 18 stations for use by patients while CHCS will be able to get 25. With the possibility of getting matching funds for some programs, the telemedicine money can be leveraged to do even more, Huhn said.

Members of the Maine Health Alliance also include Calais Regional Hospital, Cary Medical Center, Downeast Community Hospital in Machias, Houlton Regional Hospital, Maine Coast Memorial Hospital in Ellsworth, Mayo Regional Hospital in Dover-Foxcroft, Millinocket Regional Hospital, Mount Desert Island Hospital in Bar Harbor, Northern Maine Medical Center in Fort Kent and Penobscot Valley Hospital in Lincoln.