Navigating Remote Healthcare Challenges

February 14, 2024


With the healthcare landscape constantly shifting, real-time clinical decision-making support systems (CDSSs) is crucial to care for patients, especially those struggling with specialist access. For Dr. John Kroger, a seasoned family medicine practitioner, the journey from traditional methods of seeking advice to adopting innovative tools has been significant. In this blog post, we explore Dr. Kroger’s background and dive into a recent experience where PicassoMD played a pivotal role impacting his patient care on a remote island off the coast of Maine.

A Journey in Medicine

Dr. Kroger began his medical career in Houston, Texas, at Baylor College of Medicine, graduating in 1990. Following this, he completed his family medicine residency at Lancaster General Hospital in Lancaster, PA, from 1990 to 1993. He devoted the next 30 years to Swift River Family Medicine and Rumford Hospital in Rumford, Maine, offering full-spectrum family medicine, including inpatient care, and obstetrics.

Having delivered nearly 700 babies during his career, Dr. Kroger decided to embrace a new challenge and joined the staff at Islands Community Medical Services on Vinalhaven, an island located 15 miles off the coast of Maine. Before PicassoMD, he relied on contacting former colleagues at Central Maine Medical Center for real-time clinical decision support by simply texting and waiting for a colleague to reply. This traditional approach had its limitations, especially when faced with the unique challenges of being on a remote island.

Introducing PicassoMD

With some help from PicassoMD, a mobile and web platform designed by providers for providers to connect primary care providers and specialists instantly, Dr. Kroger now has full access to specialty care in seconds. Dr. Kroger shares his recent experience using the First Available Curbside feature, which enables primary care providers to connect specialists in real-time.

Recalling a recent patient case, Dr. Kroger saw a pregnant woman - 28 weeks gestation - after a recent fall. He noted that the typical recommendation would require four hours of continuous fetal monitoring, a service not available on the island. With a specialist in the palm of his hand, Dr. Kroger initiated a First Available Curbside on PicassoMD to ask an OB/GYN advice on the mother who had fallen. Initially, the recommended course of action aligned with conventional practices, involving monitoring at a hospital. However, together they were able to review the chief complaint, patient symptoms and modify a treatment plan to serve the patient given her unique home on a remote island miles from a labor and delivery department.

Benefits of PicassoMD

The use of PicassoMD’s First Available Curbside feature facilitated prompt communication between a specialist in real-time and Dr. Kroger. Together they solidified a management plan taking into account the unique and difficult constraints of managing high risk pregnancies in the middle of the Atlantic Ocean. The specialist who helped Dr. Kroger practices over 630 miles away in Washington, DC at the maternal medicine department of Howard University Hospital, but through our solution they were connected in 32 seconds. Two dedicated providers, one in Maine and one in our Nation’s Capital connected to help a woman after a traumatic fall.


Dr. Kroger's journey in medicine reflects the dynamic nature of healthcare, where adapting to new technologies becomes crucial for providing the best possible care. PicassoMD’s instant First Available Curbside feature proved to be an invaluable tool for primary care providers practicing on a remote island, dealing with time constraints, navigating long distances, and highlights the importance of innovative tech enabled solutions in the ever-evolving field of healthcare are a needed partner to improve care and outcomes, even for our patients yet to arrive.