Once largely restricted to the largest urban hospitals, telehealth is gradually expanding beyond its city confines. According to estimates from the American Telemedicine Association, about 10 million people a year now receive some form of telemedicine service. Fueled by multiple converging dynamics — including rising consumer demand as people live longer, breakthroughs in medical science, the requirements of the Affordable Care Act, and recent technological advances that make remote and online healthcare more feasible and affordable – rural and remote hospitals are likely to be the chief adopters.