Telemedicine as we know it has been around for almost 50 years. It has moved from humble beginnings as an experimental curiosity delivering rural healthcare to become something on track for mainstream acceptance across the healthcare system.

This growth curve has accelerated dramatically in the past few years with the introduction of new technologies, new applications and particularly with the birth of the wireless world and a newfound familiarity and acceptance of technology by the general populace. As the United Nations reported earlier this year, more than 6 billion people worldwide now have access to cell phones (compared to only 4.5 billion with access to toilets!)

In the year ahead, the interests of providers, health organizations, vendors, policy makers and the public all seem uniquely aligned to make this a year of exponential growth for telemedicine.

But you already know that. What is both more interesting and subtle is the how and why of this growth trajectory.

I've put together what I think are the four big themes that will dominate telemedicine in the coming year.

Telemedicine is a key enabler for health system transformation. This is the year that healthcare planners everywhere realize telemedicine must be a fundamental part of their plans. We are living longer, but with an increasing burden of chronic disease. Healthcare systems everywhere are stretched to the max trying to deliver quality care that they can pay for.

This has resulted in immense creativity from payers and providers alike, many of whom now realize that virtual healthcare – telemedicine – is  a key enabler for many of their ideas.

[Slideshow: ATA 2013 in pictures]

Think of new initiatives like ACOs, Medicare re-admission penalties and the medical home –programs that need telemedicine at their core – including telehomecare, remote monitoring, text messaging, videoconferencing and eConsultation. Many innovative organizations already get this and are implementing telemedicine services on a large scale.

This is the year that telemedicine becomes a fundamental enabler of innovation as people work to transform the healthcare system.

From telemedicine anywhere to telemedicine everywhere. Telemedicine began with hardware-based videoconferencing systems, private networks and telephone call centers, important pillars that still remain.

However, in the last decade, advances in technology have enabled new channels for telemedicine. The Internet, tablets, smart phones, remote monitoring, wireless applications and devices – even an ICU in a band-aid or wrist watch. We have software that enables patients to connect with their providers using many different channels and we are starting to see decision support and analytics to supplement human interaction. We are truly capable of delivering telemedicine services anywhere.

However, the fact of the matter is that it is not yet everywhere. To get there, we need payers to pay for it, as well as new business models and solutions that are practical and provide value. I boldly predict that this year will be the tipping point when telemedicine and virtual care technologies become available everywhere and are used at least once by more than 50 percent of the population.

Telemedicine – now it's personal. People who haven't experienced telemedicine often make the assumption that by using technology, the human touch, the compassion has been lost.

Those of us in the field know just how wrong this interpretation is. Just ask the patients who use it. In addition, a recent survey by Cisco found that 74 percent of consumers are "open to virtual doctor visits" using technology to improve access and convenience.

The bottom line – consumers know that telemedicine improves their care and they will start to demand it. This year, it will become a significant factor in choosing their providers.

You will do great things. Many of you have led the remarkable advances in telemedicine this past year, and we expect no less in the coming year.

The ATA, of course, is here to support you. Since its founding 20 years ago, the ATA has provided a place for a diverse group of health providers, academics, industry and policy makers to come together with a common cause of advancing telemedicine.

This year, the ATA launched its new web site, making it easier to find the information you need and the people you want to communicate with. A shiny new education portal contains a comprehensive collection of online webinars. ATA members, powered by some new grant funding, have accelerated the development of many new practice guidelines. The member special interest groups (SIGs) have never been larger or more engaged. And the ATA will continue to work with its membership to help drive change and lobby for improved reimbursement and laws that enable telemedicine to thrive. We expect an unprecedented amount of new telemedicine legislation this year, particularly at the state level.

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