December 2015 
Happy Holidays!

We are beginning to see a trend - interest in telehealth is exploding! It is no surprise that 2015 was an incredibly active year, from announcements of new programs and new technology, to many new policies and regulations. New York and Connecticut stood out this year after passing laws requiring private payer reimbursement - we've heard from many new colleagues in these states looking to get involved. Maine also showed a lot of interest and looks to roll out new and improved Medicaid rules soon. The Massachusetts Telemedicine Coalition and other stakeholders in MA continue to pursue policy changes, but many providers are developing successful programs throughout the state while they wait. New Hampshire no longer requires an initial in-person visit to establish a physician-patient relationship and we eagerly await updates after Vermont passed a progressive law requiring Medicaid reimbursement for primary care services provided via telehealth outside of a health care facility. Some of our most urban partners in Rhode Island and New Jersey continue to explore the new potential that telehealth offers and we hope conversations will lead to even more activity for these states in 2016. 

In addition to our collection of monthly news updates, webinars, and newly discovered resources, we've included a review of 2015 headlines, an anticipated funding announcement, and a special holiday offer from Telemedicine Magazine.

We look forward to working with you in 2016!


The NETRC Team

2015 Headlines in Review

Did you catch everything that happened this year in telehealth?
Below are a few of this year's headlines we've been watching from the northeast and beyond:

Green = Legislation Updates         Red = Policy & Regulation   
Grey = News from Associations          Blue = Best Practices + More 


Anticipated Funding Opportunity

Rural Utilities Service - Distance Learning and Telemedicine Grant

Have you heard? The FY2016 RUS-DLT grant from the USDA is expected to be released early this year! This is a popular grant that awards providers in rural areas $50,000 - $500,000 for the acquisition of telemedicine equipment and other capital assets. NETRC will be watching for the announcement in the Federal Register, but below are a few resources that may be of help as you begin to prepare:

Happy Holidays!

Exclusive offer from Telemedicine Magazine

Get 20% off your 2016 subscription to Telemedicine Magazine
when you use code "TRC" at check-out. 

Subscribe Today


Maine Quality Counts
Presenters: Northeast Telehealth Resource Center, MaineHealth, and Acadia Hospital
Special thank you to our colleagues, Scott Oxley, Rick Redmond, Corey Fravert, and Tho Ngo, for joining the NETRC team on this webinar!
Recording now available

National Telehealth Webinar Series
Presented by: Northeast Telehealth Resource Center
Presenters:  Don Hilty, MD, USC Keck School of Medicine and Kaweah Delta Medical Center, and Terry Rabinowitz, MD, DDS, University of Vermont Medical Center
Thursday, January 21, 2016, 2:00 - 3:00 PM EST

Content compiled by Michael Edwards, PhD, NETRC Consultant
Telehealth Policy News

Fierce Health IT, December 4, 2015
The latest telehealth bill to be introduced in the Senate, the Telehealth Innovation and Improvement Act, would expand Medicare coverage to telemedicine services in rural areas. The bill calls for charging the Center for Medicare and Medicaid Innovation to evaluate telehealth care models for cost, effectiveness and improvement in quality of care without increasing the cost of delivery.
National Law Review, November 23, 2015
This overview discusses changes in telemedicine reimbursement is becoming a major driver for growth in telemedicine adoption. Private insurers in particular are recognizing that telemedicine can generate cost savings and improved patient satisfaction.
ATA News, November 23, 2015
Governor Cuomo signed a law in November that adds licensed physical and occupational therapists to the list of telehealth providers eligible for reimbursement under the state's parity law.
iHealthBeat, November 17, 2015
The American Medical Association recently reviewed telehealth ethical guideline recommendations made by the AMA Council on Ethical and Judicial Affairs and sent them back to committee for further work. The goal is to address how physicians who use telehealth can ensure privacy and educate their patients on the limitations of telehealth and rights and benefits of follow-up in-person care.
iHealthBeat, November 17, 2015
The Centers for Medicare and Medicaid Services recently finalized a new Medicare payment model for hip and knee replacements that grants more flexibility in the use of telehealth services than in current reimbursement policies. Specifically, this final rule sets a precedent by waiving the geographic and originating site requirements that normally apply to Medicare reimbursement for telehealth services.
NJ Spotlight, November 13, 2015
The New Jersey legislature recently heard from a wide range of testimony on telemedicine benefits and concerns by experts and stakeholders. Despite widespread support, some speakers urged caution, including an argument by the COO of the Medical Society of New Jersey that state law shouldn't allow doctors with no connections or presence in the state to treat New Jersey patients.
News on the Practice of Telemedicine

CTeL News, December 17, 2015
CTeL examines the responsibility of the provider in meeting the standard of care during a telemedincine encounter, highlighting that it will be the provider's license on the line and not the direct-to-consumer company, health system, or insurance company.

Medical Economics, December 10, 2015
This review covers how many of the ethical challenges with telemedicine surround the lack of face-to-face contact that traditionally takes place in healthcare. State legislators and medical boards are torn between the position of the Texas Medical Board in an ongoing legal case that prescribing medication with no prior doctor-patient relationship compromises patient safety and that of the American Telemedicine Association that it is feasible to establish the relationship through an interactive video session.
Telehealth in New York State
Federal Telemedicine Review, December 6, 2015
A stakeholder coalition group in New York, the Workforce Advisory Group, contracted the Center for Health Workforce Studies under state funds to survey health care organizations on services being delivered by telemedicine and perceived barriers to implementing telehealth services. The report recently released found that about half of both FQHC and hospital respondents make use of telehealth services and provided details on application categories and plans and barriers for future use.
Study: Hospitals can profit from the use of tele-emergency services
Fierce Health IT, December 3, 2015
A study recently published by South Dakota-based Avera Health concludes that hospitals can benefit financially from receiving tele-emergency services, primarily when such services are used as a substitute for backup calls for physician assistants or nurse practitioners to the emergency department. A total of 49 rural hospitals in the network of 89 contributed data for the study.
Federal Telemedicine News, November 29, 2015
Grant awards recently announced for the USDA Rural Development's Distance Learning and Telemedicine program totaled $23.4 million for 75 projects.  Recipients for telemedicine projects in the northeast included: Finger Lakes Migrant Health Care Project (New York), Home Health Visiting Nurses of Southern Maine, Kno-Wal Lin Home Health Care Management (Maine), and Maine Rural Health Collaborative (a group of five hospitals in northern and eastern Maine).
Healthcare Informatics, November 24, 2015
Terry Yonker of Finger Lakes Community Health recently presented on successes of a teledentistry program in New York at a telehealth conference in Delaware. Their program uses telehealth to help deliver oral health screening and care coordination for rural children who are patients at eight federally qualified health centers in the Finger Lakes region.
Recent telehealth survey: providers are catching on
National Lew Review, November 24, 2015
A recent survey conducted by the Robert Graham Center for the American Academy of Family Physicians and Anthem highlights the progress in telehealth adoption among primary care providers and barriers experience from state legal and regulatory issues, reimbursement, and provider training on effective use.
Dartmouth Hitchcock Center for Telehealth, November 13, 2015
Kevin Armstrong, who assumed the post of clinical nursing director for the Connected Care Center earlier this year, describes his current involvement in helping to launch several new telehealth services in the areas of emergency medicine, intensive care and pharmacy.
The Hippo, November 12, 2015
Changes in New Hampshire laws this year are leading to expansion of services delivered by telemedicine for Medicaid patients. Now the private insurance provider, Anthem, has opened the door to coverage of primary medical care provided by video sessions using Android and Apple mobile devices.
Mass General connects parents with sick children through telemedicine
The Examiner, November 4, 2015
This story profiles a system in use at Massachusetts General Hospital's Pediatric Intensive Care Unit for telehealth linkages between clinical providers and parents. The parents are provided an iPad which can connect to a computer station at each bed allowing remote parent participation in clinical rounds and video sessions with clinicians to discuss issues in their child's care.

Telemedicine Technology News

AMD Global Telemedicine Press Release, December 21, 2015
Massachusetts-based AMD Global Telemedicine discusses their new partnership with MercyCare Community Physicians for a "first-of-its kind Telehealth Clinic in Iowa.
Fierce Health IT, December 8, 2015
The Cleveland Clinic recently published a study on their mobile CT stroke treatment program which documents faster treatment by consulting specialists for ED patients with strokes. The mobile CT scans transmitted to a neuroradiologist and vascular neurologist allowed achievement of average time to intravenous thrombolysis treatment of 32 minutes vs. 58 minutes by usual ED services.

Medical Marketing and Media, December 2, 2015
A nonprofit institute, the Hacking Medical Institute, which arose from a healthcare entrepreneurship program at Massachusetts Institute of Technology, will soon start producing consumer reviews of mobile apps and other digital health tools that have been vetted by Harvard University clinicians. 

American Academy of Sleep Medicine press release, December 1, 2015
The American Academy of Sleep Medicine announced that sleep medicine practices nationwide now can sign up for Tell A Sleep Doc, a new telemedicine platform to provide patient access to sessions with board-certified sleep medicine physicians and accredited sleep centers. The system, scheduled to launch on Jan. 4, 2016, uses a secure,web-based video platform, an interactive sleep diary, and ability to record data collected from a Fitbit device.

HIT Consultant, November 18, 2015
The U.S. Food and Drug Administration has recently cleared for commercial use Medtronic's MyCareLink Smart Monitor, an app-based remote monitoring system for patients with implantable pacemakers. The system is a handheld portable device reader which works with a wireless mobile device app to securely transmit pacemaker status and performance data  to their physicians between clinic visits.
Wainhouse Research Blog, November 2, 2015
The Lifesize division of Logitech has recently gotten out of the business of videoconferencing hardward solutions in favor of a focus on cloud services.
Health Information Technology News

Fierce Health IT, December 9, 2015
At a recent session of the Bipartisan Policy Committee, Karen DeSalvo of the Office of the National Coordinator for Health IT government officials spoke of interoperability goals for the coming year. The ONC expects health information exchanges can connect across the country within a year and plans to facilitate development and dissemination of mHealth apps to allow better access by patients to their electronic health information.
Report: HIE-sponsored PHRs offer 'one-stop shopping'
Fierce EMR, November 22, 2015
A recent report from the Office of the National Coordinator for Health IT encourages Health Information Exchanges to adopt solutions for integrating personal health records (PHR) capabilities into their systems. This would address the problems of disparate PHRs linked with patient portals of EHR systems of diverse provider organizations used for an individual's health care.
Researchers: App shows healthcare interoperability is possible
Fierce Mobile Healthcare, November 21, 2015
In a recent publication researchers at the University of Technology Sydney demonstrated the ability of a mobile device app that they developed to collate health and fitness data from various common consumer devices and software systems and integrate it into proprietary EHR systems.
Recent Telehealth Resources
Explore our complete library with over 1,200 published resources:

Albright KC, Boehme AK, Mullen MT, ert al.  The effect of telemedicine on access to acute stroke care in Texas: The story of age inequalities.  Stroke Res. Treat. 2015:813493, 2015  Link

Boudreaux ED, Waring ME, Hayes RB, Sadasivam RS, Mullen S, Pagoto S.  Evaluating and selecting mobile health apps: strategies for healthcare providers and healthcare organizations. Transl. Behav. Med. 4(4):363-371, 2014 Link

Cajita MI, Gleason KT, Han HR.  A systematic review of mhealth-based heart failure interventions.  J.  Cardiovasc. Nurs. Nov 5. [epub ahead of print], 2015  Link

Centers for Medicare and Medicaid Services.  Chronic Care Management (CCM) Services for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs).  MLN Matters #MM9234, No. 18, 2015 Link

Gay V, Leijdekkers P.  Bringing health and fitness data together for connected health care: mobile apps as enablers of interoperability.  J. Med. Internet Res. 17(11):e260, 2015  Link

Given JE, Bunting BP, O'Kane MJ, Dunne F, Coates VE.  Tele-Mum: a feasibility study for a randomized controlled trial exploring the potential for telemedicine in the diabetes care of those with gestational diabetes.  Diabetes Technol. Ther. 17(12):880-888, 2015 Link

Hahn CK.  Telemedicine and beyond:  The current status of the law and its future.  Garden State Focus 61(5), 8-10, 2015 Link

Handschu R, Wacker A, Scibor M, Sancu C, Schwab S, Erbguth F, Oschmann P, Stark D, Marquardt L. Use of a telestroke service for evaluation of non-stroke neurological cases. J. Neurol. 262(5):1266-1270, 2015 Link

Itrat A, Taqui A, Cerejo R, et al.  Telemedicine in prehospital stroke evaluation and thrombolysis: taking stroke treatment to the doorstep.  JAMA Neurol. 7:1-7, 2015 Link

Klink K, Coffman M, Moore M, Jetty, A, Petterson S, Bazemore A.  Family physicians and telehealth: Findings from a national survey.  Robert Graham Center and Anthem, Inc., Oct. 2015 Link

Kmucha ST.  Physician liability issues and telemedicine: Part 1 of 3.  Ear Nose Throat J. 94(10-11):428-429, 2015  Link

Martiniano R, Moore J.  An exploratory study of the use of telehealth services by FQHCs and hospitals in New York State.  Center for Health Workforce Studies, School of Public Health, SUNY, NY, November 2015 Link

Martin-Khan M, Fatehi F, Kezilas M, Lucas K, Gray LC, Smith AC.  Establishing a centralised telehealth service increases telehealth activity at a tertiary hospital.  BMC Health Serv. Res. 15(1):534, 2015 Link

Merrell RC.  Geriatric telemedicine: Background and evidence for telemedicine as a way to address the challenges of geriatrics.  Healthcare Inform. Res. 21(4):223-229, 2015  Link

Meyer J, ParĂ© G.  Telepathology impacts and implementation challenges: A scoping review.  Arch. Pathol. Lab Med. 139(12):1550-1557, 2015 Link

Wilson LS, Maeder AJ.  Recent directions in telemedicine: review of trends in research and practice.  Healthcare Inform. Res. 21(4):213-222, 2015 Link