November 2016

In this November edition of Northeast Connections, be sure to check out our highlights of regional programs, open funding opportunities, and of course, recent telehealth news (don't miss the article on  Telehealth in the Northeast). It's certainly been a busy fall and here's just a peek at some of what NETRC has been up to:
  • We've been thrilled to receive invitations to present at a variety of events recently, including:
    • At the American Public Health Association Annual Meeting and Expo in Denver, CO, we co-presented a Learning Institute on Telehealth. We also participated in a roundtable session to discuss the advances in connected health technologies.
    • At the Broadband for Islands Summit hosted by the Island Institute, NETRC participated in a panel discussion about topics that are of particular interest to islanders, including better access to healthcare through telehealth. We were intrigued to learn about plans for the construction of a fuel depot/convenience store/telemedicine clinic on Cliff Island (near Portland, ME).
    • At the New England Rural Health Conference, we were excited to discuss the future of telehealth with many of our rural health partners.
    • At the North Country (NY) Telemedicine Conference, NETRC's Principle Investigator, Dr. Terry Rabinowitz, MD, DDS, presented on his work providing telepsychiatry to rural nursing homes. 
    • Next week, we'll be presenting at the Value-Based Care Summit hosted by Xtelligent Media in Boston!
  • In collaboration with the Consortium of Telehealth Resource Centers, we recently completed a new series of fact sheets on telehealth for the National Organization of State Offices of Rural Health. We hope they might be of help to you!
  • As announced in previous newsletters, we are thrilled to host our next Regional Telehealth Conference on May 23+24 at UMass Amherst. Please see below for an opportunity to join the agenda.
As always, do not hesitate to reach out with any questions.


The NETRC Team

P.S. Don't forget, National Rural Health Day is on November 17!
Regional Program Highlights

Project ECHO at UMass

UMass is launching its first ever Project ECHO® (Extension for Community Healthcare Outcomes) teleECHO clinic on hepatitis C. The clinic will launch on December 9th 2016 and consist of weekly 90 minute-long sessions starting at 12:30pm on each Friday. Each session will include a short didactic lecture on a specific topic relevant to management of hepatitis C in primary care, and the rest of the time will be spent on discussing de-identified cases (submitted in advance) which serve as the impetus for in-depth discussions relevant to clinical care for patients with hepatitis C. There is no cost to participate. The sessions will be led by UMass gastroenterologist, Dr. Curtis Barry, and clinical pharmacist Dr. Annie Vong from Atrius Health.

Visit to learn more and sign up!

Addressing Primary Care Quality Gaps through Tele-Ophthalmology in the Lower Naugatuck Valley

NETRC was excited to meet Christina Gentile, MPH, Epidemiologist at Griffin Hospital (CT) at the American Public Health Association Meeting and Expo. Christina presented a poster on her work with Griffin Hospital and the Yale-Griffin Prevention Research Center to launch a teleophthalmology screening program in a primary care setting using telehealth.

Check out Christina's poster!

Are you interested in launching a diabetic retinopathy screening program? Explore our complete webliography on teleophthalmological screening.

Infusing Telehealth Technology into Health Assessment Courses in Nursing Curricula

Faculty at the UMass College of Nursing have integrated telehealth technology and skills into their undergraduate and graduate degree programs. To better prepare the nurses of tomorrow, UMass is offering telehealth curriculum because:
  • Telehealth's impact on patient health visit is expanding. Evidence shows that synchronous televised accessibility is reported by patients/clinicians to be as effective as standard office visits.
  • With infusion of telehealth teaching and learning strategies into nursing curricula, students will develop a cutting-edge virtual assessment skill set required to be on the forefront of healthcare professionals who offer distance visits to patients in their own communities.
Check out their poster to learn more!

We would love to feature your work in our next newsletter.
Please contact us to share!

Open Funding Opportunities

Background: The  purpose of the Rural Health Network Development Grant Program is to expand access to, coordinate, and improve the quality of essential healthcare services, and enhance the delivery of healthcare in rural areas.  These grants support mature, integrated rural healthcare networks that have combined the functions of the entities participating in the network in order to address the needs of the targeted rural community. Entities apply for the grant may be working together on telehealth projects.

Sponsor: HRSA, FORHP         Deadline: November 28, 2016

Background:  The Smart Rural Community Collaboration Challenge will provide up to $5,000 to support the development and deployment of innovative broadband-enabled solutions to support rural commerce and economic development, education, energy, health care, public safety or other community-oriented initiatives. The successful applicant(s) will demonstrate how the broadband-enabled technology will generate improvements to community strength and growth consistent with the goals of this program.

Sponsor: NTCA - The Rural Broadband Association         Deadline:  December 1, 2016

Background:  The purpose of the Network Planning program is to assist in the development of an integrated health care network, specifically for entities that do not have a history of formal collaborative efforts.  Health care networks can be an effective strategy to help smaller rural health care providers and health care service organizations align resources and strategies, achieve economies of scale and efficiency, and address challenges more effectively as a group than as single providers.

Sponsor: HRSA, FORHP         Deadline: January 3, 2017

Use of Technology to Enhance Patient Outcomes and Prevent Illness (R01)

Background:  National Institute of Nursing Research ( NINR ) and National Institute on Deafness and Other Communication Disorders ( NIDCD ) invites applications for clinical research focused on the development and utilization of technologies that can help address patient outcomes. Relevant areas of technology include remote healthcare delivery to patients via telehealth, robotics to enhance medication adherence, on-site (e.g., clinical or home setting) care delivery, mobile heath to increase access and adherence, web-based decision support tools, and others.  Research projects may focus on assessment, diagnosis, intervention development, or intervention implementation.

Sponsor: NIH         Deadline:  February 5, 2017

Request for Breakout Sessions -  Extended!


The Northeast Telehealth Resource Center will host the next Regional Telehealth Conference in Amherst, MA (UMass Hotel and Campus Center) on  May 23+24, 2017 ! T he conference will begin with hands-on afternoon workshops and an evening networking reception on May 23, followed by a full-day conference on May 24 with nationally recognized plenary speakers and a variety of breakout sessions.

We're now accepting breakout session proposals for May 24, 2017!

The application deadline has been extended to November 18, 2016.   NETRC will follow up with all applicants on November 21.

Stay tuned for more information about our exciting agenda, sponsorship and exhibit opportunities, and the launch of our early bird registration.

Updates about the conference will be posted at

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

Center for Connected Health Policy, November 8, 2016
Recent policy updates include the release of the final CY 2017 Medicare Physician Fee Schedule. Changes include additional telehealth codes for end-stage renal disease, advance care planning codes, and new codes for patients requiring critical care services.  CMS also finalized their proposal to use a new place of service (POS) code specifically designated to report services furnished via telehealth and to use the facility PE RVUs to pay for telehealth services.

CMS finalizes rule to implement MACRA, marginally incorporates telehealth
Center for Connected Health Policy, October 25, 2016
In October, the Centers for Medicare & Medicaid Services released its final rules for implementation of the Medicare Access and CHIP Reauthorization Act (MACRA), signed into law in April 2015, including details on its two payment incentive schemes, the Merit-Based Incentive Payment System and the Alternative Payment Model programs.  The role for telehealth in cost effective care delivery is minimized in some ways but is still included as a means for achieving quality improvements in care and for uses that help meet population health management goals.

MobiHealth News, October 25, 2016
An appropriations bill that recently passed the Senate includes a section allowing for the military's TRICARE program to reimburse for telehealth, including mobile health applications. The American Medical Association and American Academy of Family Practice supported the bill's telehealth provisions with the exception that they urged a change to consideration for billing and licensing purposes of the service delivery location being identified as where the provider is rather than the patient site.

Payers Push Congress to Expand Medicare Telemedicine
HealthLeaders Media, October 21, 2016
Commercial health insurance companies are offering to share their data on the value of telemedicine to federal actuaries who are estimating the cost of expanding remote coverage under Medicare.  Telemedicine in Medicare is reimbursable only on under a narrow set of circumstances, but Congress is examining ways to expand it. Any legislation to expand Medicare telemedicine that comes with a price tag attached will require scoring by the CBO, which has limited experience in estimating the value and cost of telemedicine because of the federal government's limited exposure.
Federal Telemedicine News, October 16, 2016
At a recent conference FCC Chairman Tom Wheeler announced the production of a white paper and guide to best practices which detail how technology strategies for telecommunications can address the barriers to equitable communications by the cognitively disabled.  The 40-member Disability Advisory Committee has stressed the need for more efforts by tech vendors to assure equitable usability for their communications products and encourages development of novel approaches such virtual reality to serve the disabled.
mHealth Intelligence, September 27, 2016
This update covers laws and policies for Medicaid and private insurance and standards of state professional licensing boards.  A total of 35 states mandate private payer coverage, and 48 provide for some level of Medicaid reimbursement for live interactive telemedicine; however, only 12 specify payment for store-and-forward services, and 19 cover remote patient monitoring. 

News on the Practice of Telemedicine

New York Presbyterian taps American Well to subtly power their app-based virtual visits
mobihealthnews, November 7, 2016
New York Presbyterian has added a new capability to its suite of digital health tools with the integration of American Well into its NYP OnDemand app, offering patients video consultations via two clinic services called Digital Urgent Care and Virtual VisitNow. This is the latest feature in the NYP OnDemand service, which launched in July and has been gradually adding new features.

Telemedicine helps cardiologists extend their reach
The Pulse, October 17, 2016
The article profiles programs at Oregon Health & Science University and Scott & White Memorial Hospital in Texas, and notes that despite demonstrations of telecardiology improving patient access and reducing  rehospitalization, less  than 7% of non-specialty hospitals participate in such programs.  Interviews with NETRC's Danielle Louder and the president of the American Telemedicine Association cover recent advances in innovations and persisting barriers in reimbursement policy.
Improving access to stroke care in Pennsylvania
Federal Telemedicine News, October 7, 2016
Hackensack Meridian Health System in New Jersey recently implemented a telestroke program among its five member hospitals using the platform of C3O Telemedicine, Inc.  C3Os Acute Neurology Telemedicine program was designed to improve timely access to specialists for stroke patients and other neuro-critically ill patients.
In the Northeast, telehealth gets creative--with good results
mHealth Intelligence, October 5, 2016
An interview with NETRC's Danielle Louder highlights several programs in the northeast that are finding cost effective value in telehealth strategies that enable remote patient monitoring, chronic disease management, and distant virtual access to clinicians.  She will be presenting at the Value-Based Care Summit in Boston on November 15, 2016.
Rural clinics turn to telehealth to combat addiction
Kaiser Health News, October 3, 2016
In the face of the growing epidemic of opiate addiction, certain health professionals and federal government agencies have advocated application of telehealth strategies to address the shortage of substance abuse treatment providers.  A program in Virginia supported by a recent federal grant delivers telepsychiatry to substance abuse clients at remote rural clinics, but it is struggling to address barriers to delivery of Medication Assisted Treatment using buprenorphine, including a requirement that medication monitoring be done face to face by a physician licensed by the Drug Enforcement Administration.
Healthcare leaders tout telehealth as "The Future of Medicine" at New York HIT Summit
Healthcare Informatics, September 29, 2016
At the recent Health IT Summit in New York a panel presentation titled "Telehealth: New Platform for Population Health" leaders of programs at New York Presbyterian-Weill Cornell Medical Center, Montefiore Health Systems, and consulting firm KPMG discussed how telehealth strategies are rapidly evolving in relation to changes in clinical practice, performance-based payment, and technology developments.  They agree that telehealth will change how physicians practice medicine, and that early adopters will have a competitive advantage in the future.
Cigna builds out telehealth services for health plan members
Healthcare IT News, September 28, 2016
Cigna recently reported that telehealth will become a standard benefit for most of its employer-sponsored group health plans as well as many of its individual health plans, including those in ACA subsidized marketplace exchanges.  Using platforms from either American Well or MDLive, patients can access acute care for minor medical conditions from doctors using personal computer or mobile devices and starting in January obtain video consultation from behavioral health professionals.
UPMC launches telehealth startup to keep nursing home patients out of the hospital
Healthcare IT News, September 21, 2016
The University of Pittsburgh Medical Center recently announced an initiative to use a telehealth platform from Curavi Health to reduce the rate of hospitalization of nursing home patients.  The system makes use of an equipment cart and software to enable physicians to remotely interact with patients and nursing home staff through a pan/tilt/zoom camera, Bluetooth stethoscope, digital otoscope, document scanner and a 12-lead EKG system.

T elemedicine Technology News

Medtronic launches Android app for MiniMed Connect
MobiHealth News, October 25, 2016
Medtronic recently launched an Android version of its MiniMed Connect system for diabetic monitoring, a system that combines an insulin pump and continuous glucose monitoring with a smartphone app that was initially developed for Apple products.  The keychain-sized, FDA-approved device takes data from the pump and glucose monitor and sends it to either a mobile app or a web platform where users and their care providers can access it.
Mount Sinai taps Kaigo Health for app-based health coaching
MobiHealth News, October 10, 2016
Mount Sinai Hospital in New York City recently announced plans to work with startup Kaigo Health to provide its patients with an app that combines personal health coaching, chronic disease management, and telehealth. Mount Sinai will roll out the technology for patients in its OB-GYN, maternal health, cancer and urology departments to begin with, with other parts of the hospital to follow.
Wearables, sensors focus of UMass $1.2M nursing research grant
Fierce Healthcare, October 10, 2016
The recent $1.23 million grant award from the National Institute of Nursing Research to the University of Massachusetts Amherst College of Nursing will establish a new research hub, the UManage Center, support a study on wearable and handheld sensor devices for fatigue and sleep pattern monitoring, and fund a total of 10 related pilot studies of sensor device applications for health conditions over the next five years.
Fitbit creates research library with Fitabase, publishes results of corporate wellness study
MobiHealth News, October 5, 2016
Fitabase, a partner of the consumer health monitoring device vendor Fitbit, recently launched a website that organizes and summarizes all research literature that employs Fitbit in their studies.  This story also highlights a new study that reported a 25% reduction of health care costs by a company's employee who participated in a Fitbit wellness program.
Potential for healthcare kiosks in improving care delivery
mHealth Intelligence, October 2016
This article provides a history of healthcare kiosk offerings and the recent trend away from expensive and comprehensive room-based solutions toward smaller and cheaper approaches.  Some versions are targeted for worksites to allow access to a primary care provider or health education while other  adaptations use them in clinics and hospitals to facilitate collection of patient history and completion of health screenings.
To manage chronic conditions, make connections -- either with humans or AIs
MobiHealth News, September 28, 2016
A panel discussion at the recent Health 2.0 conference provided an overview of successful mHealth apps that implement health care coaching for wellness or chronic disease management, some of which integrate monitoring of conditions for access by health care provider teams.  This story profiled offerings from Livongo, MyHealthTeams, Health Decision Technology, Wellness Layers and Sensely
1st responders & mobile wireless
Federal Telemedicine News, September 25, 2016
The National Institute of Standards and Technology has been working with industry partners to integrate commercial technologies into a mobile wireless communications system, and a prototype system was recently characterized.  Their innovative "Rapidly Deployable Public Safety Research Platform" (also called the "Nerdcart") enables more than 200 local users of broadband smartphones, wi-fi, data terminals, and older walkie-talkie radios to communicate with each other using voice, text, instant messages, video and data.

Health Information Technology News

ONC playbook aims to help practices navigate changing HIT landscape
Fierce Healthcare, September 26, 2016
The Office of the National Coordinator for Health Information Technology has launched an online tool designed to help small and medium-sized practices implement their health information technology more effectively and use HIT to achieve requirements of the Medicare Access and CHIP Reauthorization Act.  For example, one section focuses on designing or upgrading their EHR patient portals for better patient engagement  and another covers best practices for assuring privacy and security of healthcare information.

Recent Telehealth Resources

Bashshur RL, Howell JD, Krupinski EA, Harms KM, Bashshur N, Doarn CR.  The empirical foundations of telemedicine interventions in primary care.  Telemed. eHealth 22(5):342-375, 2016 Link
Center for Connected Health Policy. State telehealth laws and Medicaid program policies: a comprehensive scan of the 50 states and District of Columbia.  CCHP, August 2016 Link
Chapman Smith SN, Govindarajan P, Padrick MM, et al.  A low-cost, tablet-based option for prehospital neurologic assessment: The iTREAT Study.  Neurology 87(1):19-26, 2016 Link
Christopher V.  Virtual rounds offer a glimpse into the future of healthcare.  Healthcare Transformation 1(3): 194-205,  2016  Link
FCC Disability Advisory Committee.  Individuals with cognitive disabilities:  Barriers to and solutions for  accessible information and communication technologies.  Consumer and Governmental Affairs Bureau, Federal Communications Commission, Oct. 2016 pdf
FCC Disability Advisory Committee.  Best practices to promote effective access to and usability of ICT products and services for americans with cognitive disabilities.  Consumer and Governmental Affairs Bureau, Federal Communications Commission, September,  2016 pdf
FCC Disability Advisory Committee.  Individuals with cognitive disabilities:  Best Practices to Promote Effective Access to and Usability of ICT Products and Services for Americans with Cognitive Disabilities.  Consumer and Governmental Affairs Bureau, Federal Communications Commission, September,  2016 pdf
Dayal P, Hojman NM, Kissee JL, Marcin JP.  Impact of telemedicine on severity of illness and outcomes among children transferred from referring emergency departments to a children's hospital PICU.  Ped. Crit. Care  Med. 17(6): 516-521, 2016 Link
Estai M, Kanagasingam Y, Huang B, et al.  The efficacy of remote screening for dental caries by mid-level dental providers using a mobile teledentistry model.  Commun. Dent. Oral Epidemiol. 44(5):435-441, 2016 Link
Mackintosh N, Terblanche M, Maharaj R, et  al.  Telemedicine with clinical decision support for critical care: a systematic review.  Syst. Rev. 5(1):176,  2016 Link
McConnochie KM, Wood NE, Alarie C, Ronis S.  Care offered by an information-rich pediatric acute illness connected care model.  Telemed. eHealth 22(6):465-472, 2016 Link
Pathipati AS, Ko JM.  Implementation and evaluation of Stanford Health Care direct-care teledermatology program.  SAGE Open Med. 4:2050312116659089, 2016 Link
Prabhakaran K, Lombardo G, Latifi R.  Telemedicine for trauma and emergency management: an overview.  Curr. Trauma Rep. 2(3):115-123, 2016 Link
Scurlock C,  Becker C.  Telemedicine for trauma and emergency: the eICU.  Curr. Trauma Rep. 2(3): 132-137, 2016 Link
Sutherland R, Trembath D, Hodge A, Drevensek S, Lee S, Silove N, Roberts J.  Telehealth language assessments using consumer grade equipment in rural and urban settings: Feasible, reliable and well tolerated.  J. Telemed. Telecare [epub ahead of print] January 2016 Link
Wallis LA, Fleming J, Hasselberg M, Laflamme L, Lundin J.  A smartphone app and cloud-based consultation system for burn injury emergency care.  PLoS One 11(2):e0147253, 2016 Link
Wood BR, Unruh KT, Martinez-Paz N, Annese M, Ramers CB, Harrington RD, Dhanireddy S, Kimmerly L,  Scott JD, Spach DH.  Impact of a telehealth program that delivers remote consultation and longitudinal mentorship to community HIV providers.  Open Forum Infect. Dis.3(3):ofw123, 2016 Link