As technological advancements heighten the accuracy and immediacy of medical consultations conducted remotely, the practice of telemedicine has blossomed alongside.

A Research and Markets study released this week announced the worldwide virtual health care market should jump from last year's estimated $17.9 billion to more than $40 billion by 2021.

Driven by the steadily-increasing capabilities of digital communication, medical professionals are now only a click away from even the furthest reaches of the globe, and the widening access has opened up avenues for diagnoses and treatment once unimaginable.

However, while the availability of far-flung examinations has aided the work of rural practitioners and Doctors Without Borders volunteers, the growth of telemedicine as a practical variant to traditional hospital visits has brought to light thorny regulatory issues and widespread concerns over such programs' inherent limitations.

Although the most technologically adept remote-care facilities may obtain real-time vital signs data and control precision optics able to convey the smallest visual detail, critics fear the physical absence of diagnosticians will necessarily raise the risk that less-obvious symptoms only recognizable through physical presence (clammy skin, eye tremors, sweetened scents) would be ignored.

At this point, telemedicine remains a relatively niche alternative largely undertaken by only those prospective patients within the United States otherwise unable to easily obtain traditional care. A recent HealthMine poll found nearly a third of web-friendly consumers had yet to take advantage of the services primarily because of questions about when they would be most appropriate.

These numbers are widely expected to leap in the coming years, however. As long as telemedicine consults cut the costs of face-to-face visits so dramatically — estimates range from 50 percent to 5000 percent depending upon the nature of the meeting — health insurance companies and the large firms that subsidize the majority of their policies will aggressively urge consumers to choose the cheaper option.

Further complicating matters, state licensing boards have so zealously guarded their dominion that many doctors are forbidden from even offering an opinion when expressly requested by a regular patient vacationing elsewhere.

Literally hundreds of legislative remedies have been introduced on the local level this year as state governments attempt to streamline the process of virtual care. Still, with no clear federal rulings to outline the boundaries of telemedicine, there's an ocean of gray area separating the proposed measures.

The sheer novelty of the practice has also stymied efforts to ensure remote treatment will be reimbursed under Medicaid. While most officials agree some aspects of telemedicine should deserve full compensation, the varying degrees of aid currently in use range from the occasional scan of vital signs to exhaustive video interviews and analyses.

Defending the necessity of immediate legislation last week, Pennsylvania state Rep. Marguerite Quinn stated her case bluntly: "We're trying to put down some basic guidelines here to match policy with technology and make sure we're not thwarting the growth of this in the meantime.”

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