This month's newsletter contains many exciting updates! Here's a few notes before you begin to browse:
  • If you are attending ATA 2016 in Minneapolis, see below for a regional networking opportunity.
     
  • Again this spring, there's a ton of policy and regulatory activity throughout the region. We've mentioned just a bit in Regional Highlights, including a new rule for MaineCare that went into effect on April 16. If you are in Connecticut, don't miss this news article on Medicaid reimbursement for eConsults. 
     
  • Are you interested in Project ECHO? Be sure to check out the note about Project ECHO for LGBT health in Regional Highlights. The National Telehealth Webinar on Thursday will also focus on Project ECHO programs!
     
  • Other free webinar opportunities highlighted below include a HRSA Office of Regional Operations sponsored Tele-Behavioral Health Webinar Series. HRSA is also hosting a webinar on Thursday at 2:00 pm EDT to discuss CMS' Transforming Clinical Practice Initiative!
     
  • Be sure not to miss the message from this month's featured program, The MAVEN Project.
As always, we've compiled a range of recent news articles and highlighted many new publications added to the NETRC  Resource Library.

Please do not hesitate to reach out if we can be of assistance!

Sincerely,

The NETRC Team

Regional Highlights

Below is just a small sampling of the exciting things happening in our region:
  • MaineCare (Maine's Medicaid program) adopted a new Telehealth Services policy effective April 16, 2016. Notable changes include the removal of the prior approval process for use of telehealth, the addition of an "originating site fee" to be paid to the site housing the patient, and a new section on telemonitoring.
     
  • The Massachusetts Health Policy Commission (HPC) released requests for proposals for three new grant programs making a total of $9.5 million available to drive innovation in health care delivery and payment in Massachusetts. This includes a Telemedicine Pilot Initiative to fund up to 3 providers and/or payers for up to 18 months to increase access to behavioral health services for vulnerable populations with unmet behavioral health needs in Massachusetts.
     
  • The Weitzman Institute, a program of Community Health Center, Inc., has launched a new Project ECHO for LGBT health in collaboration with the CDC, the National Association of Community Health Centers, and the National LGBT Health Education Center! Primary care providers are invited to enroll at NO COST. 
     
  • The New York State Office of Mental Health released a Proposed Rule Making on April 13 that would update their telepsychiatry services regulations. Please review the current regulations and the related Telepsychiatry Standards Guidance. Public comments are being received on the Proposed Rule, but we understand an updated version will be published in the State Register on April 27.
     
  • NETRC will be attending New Jersey's first Rural Health Symposium on Thursday, April 21, 2016. We are thrilled to join the Mid-Atlantic Telehealth Resource Center to present a workshop, "Rural Telehealth Models: 21st Century Opportunities to increase Access in Rural New Jersey."
     
  • William James College is preparing a Telemental Health Conference on September 23, 2016 in Newton, Massachusetts! NETRC participated in the planning process that developed an exciting agenda, including a keynote address from Dr. David Ahern, PhD and workshops that include "Telemental Health 101 for Clinicians." Please stay tuned for the complete agenda and opportunities to register.
     
  • Interest in  joining interstate licensure compacts continues to grow throughout the region. A bill to join the  FSMB Interstate Medical Licensure Compact has passed the House and Senate in New Hampshire and is awaiting Governor Hassan's signature. Rhode Island was one of the first states to introduce a bill to join the PSYPACT , but the Health, Education and Welfare committee recommended it be held for further study. We are also watching the APRN Compact and the Enhanced Nurse Licensure Compact.
Did we miss something? Please email netrc@mcdph.org to include an update in our next newsletter!

ATA 2016: Networking in Minnesota
Are you attending the ATA Annual Conference and Trade Show in Minneapolis, Minnesota? 
Kick off the conference with Northeast Networking!

Meet and greet with colleagues from New England, New Jersey, and New York

Date: Sunday, May 15, 2016
Time: 4:30 - 5:30 PM
Location: The ATA Experience Zone in the Expo Hall 

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Can't make it to the networking event? 
Visit NETRC and the Consortium of Telehealth Resource Centers at Booth #2309
 

Featured Program

A message from our colleagues at The MAVEN Project:


Can your organization utilize a national corps of volunteer physicians focused on increasing access to medical care via their pro bono services? 
The MAVEN Project  is looking to gauge your interest in FREE specialty and primary care utilizing telemedicine technologies in your state. The MAVEN Project, short for Medical Alumni Volunteer Expert Network, is an independent 501(c)(3) nonprofit founded by Dr. Laurie Green, a managing partner and practicing ob/gyn in San Francisco, California while she was president of Harvard Medical School alumni association.
 
Our mission is to improve access to quality healthcare for underserved populations by linking our corps of expert volunteer physicians to clinics and organizations in need. We recruit alumni of U.S. accredited medical schools and training programs through medical school alumni and other physician organizations to serve the specific needs of vulnerable populations seeking care at Federally Qualified Health Centers (FQHC), free clinics, community health clinics and other organizations (collectively, "Health Centers").
 
Specialist and primary care MAVEN volunteers are matched with physicians, nurse practitioners, and physician assistants at Health Centers. Services include:

Direct patient evaluation in concert with Health Center providers

Volunteer-to-Health Center provider consultations

"Curbside" advice to Health Center provider for targeted medical needs

Education and mentoring for Health Center providers and staff

 

If your organization is interested in learning more or speaking with The Maven Project, please either
 
Fill out the 2 minute survey at http://goo.gl/forms/af3ksNDQBE
 
or contact:  Rebecca Roland, Telehealth Program Manager
916.370.8605

Featured Webinar Series


Presented by HRSA's Office of Regional Operations

This free Webcast Series is designed for provider organizations who would like to develop or expand tele-behavioral health services for underserved populations.

Part 1: An Introduction to Tele-behavioral Health: What's New and Why it Makes Sense

Part 2: The Finger Lakes Community Health Center Model of Tele-Behavioral Health
Thursday, April 28, 2016, 1:00 - 2:00 PM EDT

Part 3: Implementing Technology Assisted Care into Behavioral Health Settings
Thursday, May 19, 2016. 1:00 - 2:00 PM EDT

National Telehealth Webinar


Presented by the Heartland Telehealth Resource Center

Presenters:  E. Rachel Mutrux, Senior Program Director, Missouri Telehealth Network, Director, Show-Me ECHO and Eve-Lynn Nelson, PhD, Director, Center for Telemedicine & Telehealth, University of Kansas Medical Center Licensed Psychologist and Professor, Pediatrics

Thursday, April 21, 2016, 2:00 - 3:00 PM EDT

ECHO, Extension for Community Healthcare Outcomes, is a healthcare capacity building project developed at the University of New Mexico by Dr. Sanjeev Arora. Dr. Arora developed the project in 2003 to increase the number of providers treating Hepatitis C in rural areas. ECHO brings knowledge from specialists to primary care providers, who then can care for patients in their own communities. An interdisciplinary team of experts will hold weekly or bi-weekly videoconferences with primary care providers interested in learning more about a specific disease state or condition. Each ECHO session consists of clinical case presentations and discussion and a brief didactic.

Show-Me ECHO in Missouri, funded by state appropriation in 2015, has started 6 different state-wide ECHO projects and plans to have outcomes showing increased provider capacity, decreased cost, and improved professional satisfaction. The Missouri ECHOs are in the areas of: Endocrinology, Hepatitis C, Autism, Childhood Asthma, Chronic Pain Management, and Dermatology. Kansas ECHO has been in existence for nearly a year and includes Pediatric Epilepsy and Chronic Pain Management. 

Register today!
 

RECENT TELEHEALTH NEWS
Content compiled by Michael Edwards, NETRC Consultant
Telehealth Policy News

My Times, March 30, 2016
Blue Cross-Blue Shield of Massachusetts now offers non-emergency medical treatment provided via Internet video on the American Well platform.  Access to such care on a 24/7 basis is especially important for residents of offshore islands and communities distant from a hospital.
 
Healthcare Dive, March 24, 2016
With 30% of Medicare payments now tied to alternative payment models and HHS planning to raise that percentage to 50% by the end of 2018, health care organizations are motivated to consider telemedicine delivery of services to increase quality of care and patient access while holding down costs.  Last year's Medicare Access and CHIP Reauthorization Act (MACRA) specifically singles out telemedicine and remote patient monitoring as permitted under alternative payment models.
 
STAT News, March 22, 2016
Currently. Boston's Brigham and Women's Hospital lets about 10 patients make "virtual visits" to their providers from their homes, a pilot program that soon will expand to 100 per week.  Other examples of innovative telehealth programs in Massachusetts are presented, and a recent legislative bill (HB 267) is discussed that mandates parity in private and Medicaid coverage of telehealth services.
 
Fierce Health Payer, March 16, 2016
Blue Cross Blue Shield plans across the country are starting to reimburse more telemedicine services.  Recent examples include BCBS programs in Alabama, South Carolina, and Pennsylvania.
 
American Academy of Family Practitioners, March 11, 2016
The Medicare Payment Advisory Commission, an independent body of experts, recent held a forum to explore the potential of expanded Medicare coverage of telemedicine services to address the goal of improved access and reduced costs for medical care.  Despite the data on low utilization under the current policies restricted to rural medical facilities for patient location, key members remain concerned that broader coverage will result in a spike in costs for unnecessary consults.
 
Hartford Business Journal, March 3, 2016
Federally qualified health centers in Connecticut will receive Medicaid reimbursement for electronic consults between specialists and primary care providers serving underserved populations.  The approval for this "eConsults" program for Medicaid coverage is rare on a national level, and it came in response to pilot program research by the Weitzman Institute of Community Health Center, Inc, of Middletown, VT.

News on the Practice of Telemedicine

mHealth Intelligence, April 01, 2016
A telemedicine abortion pilot has begun in four states, giving women an opportunity to receive their medications by mail and receive guidance on its usage through a telehealth visit with a doctor from their own home.  The project, developed by New York-based Gynuity Health Services, recently launched in Hawaii, Oregon, New York and Washington.
 
NEJM  Catalyst, March 29, 2016
The CEO of Permanente Medical Group charts out how certain crucial steps must be taken to get physicians to embrace the new telehealth technologies.  Five recommended elements are described and justified: 1) c ommunicate the "why", 2) compensate accordingly; 3) keep it simple; 4) mind the workload, and 5) invest in the culture.
 
Survey: Telemedicine helps the patient more than the provider
mHealth Intelligence, March 29, 2016
A survey conducted of health system executives by a Georgia telemedicine organization, REACH Health, revealed that telemedicine tends to be a top priority for the coming year and that those already engaged with it find the biggest challenges lie in the areas of reimbursement and in integration with their EHR system.
 
Headlines, heuristics and subtlety in interpreting connected health studies
cHealth Blog, March 28, 2016
Telehealth expert Joe Kvedar discusses ways to interpret conflicting research reports about the outcomes of remote telehealth monitoring of heart patients.  He suggests that better outcomes, such as reduced rehospitalization rates, are achieved when the telehealth intervention is integrated into the patient's ongoing care process and when special efforts are made to promote good adherence to the intervention program 
 
mHealth Inteligence, March 25, 2016
The global research  organization Vitality Institute has recently produced a checklist for mHealth developers and healthcare providers who gather, store and use data from patients using consumer technology.  Their work has now evolved into a set of five guidelines which they hope will be a useful framework for integrating mHealth technology into mainstream health care.
 
Buffalo News, March 19, 2016
Dr. Radford and a team of primary care providers at the Five Star Urgent Care clinic near Buffalo, NY,  recently launched a telemedicine company, 247 Online Care.  Like national companies such as Doctor on Demand or American Well, the new regional service company allows patients using a mobile app to connect remotely with a clinical provider by smartphone or laptop webcam for a virtual medical visits.
 
Healthcare IT News, March 17, 2016
According to a recent study by a Veteran Affairs hospital in Vermont, each medical visit provided by telemedicine saved patients an average of 145 miles of travel and 142 minutes of time and reduced patient travel reimbursements.  Although telehealth volume grew over the years of the study, notably for tele-mental health, the fraction of visits achieved through telehealth remained quite small.
 
Providers find telehealth-based mentorship program valuable
Fierce Health IT, March 10, 2016
In the VA's Northwest region, SCAN-ECHO cases conferences take place weekly in four subspecialties: hepatology, nephrology, pulmonary and infectious diseases.  Evaluation of primary care provider participants revealed perceived support and value for improved rural treatment capacity improved with duration up to a year or more.
 
HIT Consultant, March 7, 2016
Map Health Management, a company focused on behavioral health and addiction treatment, is working with insurers on telehealth strategies for delivery of effective treatment and for mHealth apps to prevent relapse after discharge from treatment programs.  One promising approach allows opiate addicted patients to confer by telemedicine with both a doctor managing their buprenorphine treatment and with a behavioral health specialist.

Telemedicine Technology News

Fierce Health IT, March 21, 2016
President's Council of Advisors on Science and Technology recently released a new report with recommendations for the federal government for advancing policies on telehealth and electronic health records for older Americans.  Only a minority of the elderly are comfortable in learning to using mobile devices like smartphones and tablets, but are eager to learn given adequate support.
 
MobiHealth News, March 9, 2016
Some 81% of diabetes apps in the Google Play store did not offer privacy policies, according to a study of 211 mobile device apps published in the Journal of the American Medical Association.  The researchers from Illinois Institute of Technology found that among the apps that did have privacy policies, 17% specified that data may be disclosed to advertisers and 43% said the data would be stored in the developer's system.
 
EurekAlert, March 8, 2016
In a recently completed national clinical trial led by Joslin Diabetes Center's Beetham Eye Institute, ultrawide field (UWF) scanning technology significantly improved the ability of experts at a remote central location to identify diabetic retinopathy in a patient, and to judge whether the eye disease warranted referring the patient to an ophthalmologist for further care.
 
Person-Centered Tech News, February 16, 2016
This article reviews for interested behavioral health clinicians two software platform products for online counseling that are free and easy to use.  In compliance with HIPAA provisions for privacy of health data, these vendors offer a Business Associate Agreement.

Health Information Technology News

Fierce EMR, March 30, 2016
A new proposed rule would give the Office of the National Coordinator for Health Information Technology the power to conduct direct reviews of certified EHR products.  This editorial criticizes ONC performance in the past and encourages a review of what its mission and scope should be in the future.
 
Fierce EMR, March 24, 2016
A recent report from the Office of the National Coordinator for Health IT highlights a big discrepancy between physicians participating in the Medicare Meaningful Use Program and those on the Medicaid side.  This editorial argues that we should prevent this disparity from increasing with the implementation merit-based incentive programs under the Medicare Access and CHIP Reauthorization Act (MACRA).
 
Fierce Health IT, March 4, 2016
The National Quality Forum recently issued a new report on health IT safety and how to measure it.  The 99-page guidance offers a framework for determining the effect of health IT on patient safety and prioritizes key measurement areas. 
 
Fierce Health IT, March 1, 2016
In its annual report on the state of HIT to Congress, the Office of the National Coordinator touts success of its Meaningful Use program but notes a continuing struggle with interoperability.  Accomplishments also included a five-year strategic plan, an interoperability roadmap, and requirements for Stage 3 Meaningful Use.

Recent Telehealth Resources

Battaglia C, Lambert-Kerzner A, Aron DC.  Evaluation of e-consults in the VHA: Provider perspectives.  J. Fam. Pract. 32(7):42-48, 2015 Link

Canadian Agency for Drugs and Technologies in Health.  Telehealth services for the treatment of psychiatric issues: Clinical effectiveness, safety, and guidelines.  CADTH Rapid Response Report, Jan. 2015 Link

Carey EP, Frank JW, Kerns RD, Ho PM, Kirsh SR. Implementation of telementoring for pain management in Veterans Health Administration: Spatial analysis. J. Rehabil. Res. Dev. 53(1):147-156, 2016 Link

Christie GP, Patrick K, Yach D. Guidelines for personalized health technology: final report.  Vitality Institute, March 2016 Link

Davis A, Gilchrist V, Grumbach K, James P, Kallenberg R, Shipman SA.  Advancing the primary/specialty care interface through econsults and enhanced referrals.  Annals Fam. Med. 13(4):387-388, 2015 Link

Dinesen B, Nonnecke B, Lindeman D, et al.  Personalized telehealth in the future: a global research agenda.  J. Med. Internet Res. 18(3):e53, 2016  Link

Driessen J, Bonhomme A, Chang W, Nace DA, Kavalieratos D, Perera S, Handler SM.  Nursing home provider perceptions of telemedicine for reducing potentially avoidable hospitalizations.  J. Amer. Med. Dir. Assoc. [epub before print], March 2016 Link

Godinho C, Domingos J, Cunha G, et al.  A systematic review of the characteristics and validity of monitoring technologies to assess Parkinson's disease.  J. Neuroeng. Rehabil. 13(1):24, 2016  Link

Gupte G, Vimalananda V, Simon SR, DeVito K, Clark J, Orlander JD.  Disruptive innovation: Implementation of electronic consultations in a Veterans Affairs health care system.  JMIR Med. Inform. 4(1):e6, 2016 Link

Kvedar JC, Fogel AL, Elenko E, Zohar D.  Digital medicine's march on chronic disease.  Nat. Biotechnol. 34(3):239-246, 2016  htm

Linde K, Sigterman K, Kriston L, Rücker G, Jamil S, Meissner K, Schneider A.  Effectiveness of psychological treatments for depressive disorders in primary care: systematic review and meta-analysis.  Annals Fam. Med. 13(1):56-68, 2015 Link

Mutgi SA, Zha AM, Behrouz R.  Emerging subspecialties in neurology: Telestroke and teleneurology.  Neurology 84(22):e191-193, 2015 Link

National Public Safety Telecommunications Council.  EMS telemedicine report: Prehospital use of video technologies--final report.  NPSTC, February 24, 2016 pdf

Olayiwola JN, Anderson D, Jepeal N, Aseltine R, Pickett C, Yan J, Zlateva I.  Electronic consultations to improve the primary care-specialty care interface for cardiology in the medically underserved: a cluster-randomized controlled trial.  Annals Fam. Med.. 14(2):133-140, 2016 Link

President's Council of Advisors on Science and Technology.  Independence, technology, and connection in older age: Report to the President.  PCAST, Executive Office of the President, March 2016 Link

Russo JE, McCool RR, Davies L.  VA telemedicine: An analysis of cost and time savings.  Telemed. eHealth 22(3):209-215, 2016 Link

Sreelatha OK, Ramesh SV.  Teleophthalmology: improving patient outcomes?  Clin. Ophthalmol. 10:285-295, 2016 Link

Valenzuela Espinoza A, Van Hooff RJ, et al.  Development and pilot testing of 24/7 in-ambulance telemedicine for acute stroke: prehospital stroke study at the Universitair Ziekenhuis Brussel-Project. Cerebrovasc. Dis. 42(1-2):15-22, 2016 Link

Yang NH, Dharmar M, Yoo BK, Leigh JP.  Economic evaluation of pediatric telemedicine consultations to rural emergency departments. Med. Decision Making 35: 773-783, 2015 Link