Will reimbursement by insurance payers and private employers (presumably self-insured) and a greater comfort level with the video consult mean that telemedicine will finally step out of the waiting room? This Economist article (free registration may be required) with high points from a recent Rome conference seems to not be able to make up its mind, though it tries to be positive. Taking a comparative view, Israel leads with ‘relatively lax guidelines’, with doctors able to e-prescribe and perform referrals to specialists online. China’s health-care reform focuses on telemedicine“, but Peteris Zilgalvis, a health official at the European Commission pointedly states “If you have a chaotic system and add technology, you get a chaotic system with technology” (Editor’s emphasis). The US is somewhere in between with state licensure, limited cross-state privileges, uneven and contradictory regulation and low reimbursement rates, which also applies to many EU countries. Shortages and scarcity of specialist doctors seem to be the spur in many countries, though the betting in the US is on services providing greater convenience (American Well, Doctor on Demand, Teladoc, MD Live, Virtuwell) and payer plans’ reimbursement . The telemedicine robot depicted in the article seems to be quite out of place for the vast majority of telemedicine out of the hospital setting.