Back in March, I asked if state Medicaid programs could drive the reimbursement of remote monitoring applications, after Indiana approved reimbursement. In a follow up story, the Ft. Wayne Journal Gazette runs a column by Gerard Voland is the dean of the School of
Engineering, Technology and Computer Science at Indiana
University-Purdue University Fort Wayne. While Voland seems a bit out of touch on specific remote monitoring technologies (he's a big on videoconferencing), he does note most of the key barriers to adoption:

Although reimbursement by Medicaid to those eligible for such
assistance is a major step forward for Hoosiers, there are other
obstacles that must be overcome if telemedicine is to fulfill its
promise. One technical obstacle is bandwidth capacity, for without
sufficient bandwidth it becomes impossible to transmit large amounts of
data efficiently. Fortunately, bandwidth capabilities are expanding
rapidly across the state while the costs for such services are being
steadily reduced.

Other unresolved issues include malpractice liability coverage for
health care providers in telemedicine, licensing these professionals
and ensuring confidentiality of electronic records.

Finally, the most difficult obstacle may be the reluctance of many
physicians, nurses and especially patients to embrace this new
technology because it differs from traditional health care.

Indiana overcame the biggest barrier to adoption, reimbursement, when the state decision to reimburse for telemedicine went into effect last May.