Telemedicine consults between doctors and with their patients are, at long last, progressing on the Long And Winding Road, according to this sizable recap in the Life and Health section of this weekend’s Wall Street Journal. The focus is on virtual visit growth in the US, but it opens with Doctors Without Borders (MSF) connecting their doctors in Africa with their specialist network worldwide. Mercy Health provides 24/7 ICU/ER support for 38 local hospitals out of a Virtual Care Center outside St. Louis manned by ICU specialists. Their results? A 35 percent decrease in patients’ average length of stay and 30 percent fewer deaths than anticipated. The important statistics here are on acceptance: 72 percent of hospitals and 52 percent of practices are finally integrating some form of telemedicine into care; 74 percent of large employers are covering telemedicine cost–yet awareness is still lagging among prospective patients, with only 39 percent familiar with it according to a recent survey. Challenges remain in reimbursement (especially doctor-to-doctor), licensure, care effectiveness (citing JAMA Dermatology study, but also the JAMA Internal Medicine study TTA 13 May) and parity regulations affecting Medicaid and private insurance (32 states so far, with Medicare lagging with limitations on rural health and provisioning at doctor’s office or clinic). There are also restrictions by state medical boards on out-of-state practitioners (Texas being the poster child, slugging it out with Teladoc [TTA 11 May]–but some progress in Arkansas to permit mobile-based consults in the state, affecting many of their largest employers. Arkansas Online ). But respect doesn’t mean that there isn’t a very long slog with potholes ahead. And an even longer one for its sibling telehealth/remote patient monitoring.