In the US, electronic health records (EHRs) are being fast tracked with generous subsidies to adoption via the HITECH Act and ARRA funding to regional extension centers (REC). We have the FCC insisting on a National Broadband Plan. Who’s looking after telehealth and telemedicine in rural areas to see how this all comes together accessibly? This white paper by the Northwest Regional Telehealth Resource Center (NRTRC), part of five heretofore unknown Telehealth Resource Centers (TRC) funded by the Department of Health and Human Services that bring together smaller telehealth networks, is a good primer on how the letters in the alphabet soup are converging for better care. The highlight of this paper is REACH Montana and its evolution from linking three rural clinics to a consortium of providers at 18 locations. NRTRC press release. White paper (12 pages).