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New guidelines from the Federation of State Medical Boards say telemedicine can be OK without a prior in-person visit, a change expected to influence licensing regulations in a number of states, says federation president Humayun Chaudhry. The guidelines hold virtual visits to the same standards as an office visit, including a full medical history and informed consent, and say patients should be able to choose among participating doctors. The group also is finalizing a plan to make it easier for doctors to practice across state lines.

But does a virtual exam translate into better outcomes for the chronically ill?

"There's an evidence gap that needs to be filled," says Romana Hasnain-Wynia of the Patient-Centered Outcomes Research Institute, an agency created under the new healthcare law to study which medical treatments and procedures work best.

With a $1.7 million grant from PCORI, Dorsey's study is randomly assigning about 200 Parkinson's patients from around the country to receive either their usual care or added virtual checkups from a specialist. His pilot studies have suggested telemedicine allows needed care such as medication adjustments while saving patients' time.

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