As technological advancements heighten the accuracy andimmediacy of medical consultations conducted remotely, the practiceof telemedicine has blossomedalongside.

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

Driven by the steadily-increasing capabilities of digital communication, medicalprofessionals are now only a click away from even the furthestreaches of the globe, and the widening access has opened up avenuesfor diagnoses and treatment once unimaginable.

However, while the availability of far-flung examinations hasaided the work of rural practitioners and Doctors Without Bordersvolunteers, the growth of telemedicine as a practicalvariant to traditional hospital visits has brought to light thornyregulatory issues and widespread concerns over such programs'inherent limitations.

Although the most technologically adept remote-care facilitiesmay obtain real-time vital signs data and control precision opticsable to convey the smallest visual detail, critics fear thephysical absence of diagnosticians will necessarily raise the riskthat less-obvious symptoms only recognizable through physicalpresence (clammy skin, eye tremors, sweetened scents) would beignored.

At this point, telemedicine remains a relatively nichealternative largely undertaken by only those prospective patientswithin the United States otherwise unable to easily obtaintraditional care. A recent HealthMine poll found nearly a third ofweb-friendly consumers had yet to take advantage of the servicesprimarily because of questions about when they would be mostappropriate.

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

Further complicating matters, state licensing boards have sozealously guarded their dominion that many doctors are forbiddenfrom even offering an opinion when expressly requested by a regularpatient vacationing elsewhere.

Literally hundreds of legislative remedies have been introducedon the local level this year as state governments attempt tostreamline the process of virtual care. Still, with no clearfederal rulings to outline the boundaries of telemedicine, there'san ocean of gray area separating the proposed measures.

The sheer novelty of the practice has also stymied efforts toensure remote treatment will be reimbursed under Medicaid. Whilemost officials agree some aspects of telemedicine should deservefull compensation, the varying degrees of aid currently in userange from the occasional scan of vital signs to exhaustive videointerviews 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 matchpolicy with technology and make sure we're not thwarting the growthof this in the meantime.”