an expensive and time-consuming proposition. Even if the practitioner never practices medicine face-to-face with a patient in another state, he/she still must meet a variety of other individual state requirements, including paying substantial licensure fees, passing additional oral and written examinations, and traveling for interviews. In 2008, the U.S. passed the Ryan Haight Act which required face-to-face or valid telemedicine consultations prior to receiving a prescription. State medical licensing boards have sometimes opposed telemedicine; for example, in 2012 electronic consultations were illegal in Idaho, and an Idaho-licensed general practitioner was punished by the board for prescribing an antibiotic, triggering reviews of her licensure and board certifications across the country. Subsequently, in 2015 the state legislature legalized electronic consultations. In 2015, Teladoc filed suit against the Texas Medical Board over a rule that required in-person consultations initially; the judge refused to dismiss the case, noting that antitrust laws apply to state medical boards. Major implications and impacts Telehealth allows multiple, varying disciplines to merge and deliver a potentially more uniform level of care, using technology. As telehealth proliferates mainstream healthcare, it challenges notions of traditional healthcare delivery. Some populations experience better quality, access and more personalized health care. Health promotion Telehealth can also increase health promotion efforts. These efforts can now be more personalised to the target population and professionals can extend their help into homes or private and safe environments in which patients of individuals can practice, ask and gain health information. Health promotion using telehealth has become increasingly popular in underdeveloped countries where there are very poor physical resources available. There has been a particular push toward mHealth applications as many areas, even underdeveloped ones have mobile phone and smartphone coverage. In a 2015 article reviewing research on the use of a mobile health application in the United Kingdom, authors describe how a home-based application helped patients manage and monitor their health and symptoms independently. The mobile health application allows people to rapidly self-report their symptoms - 95% of patients were able to report their daily symptoms in less than 100 seconds, which is less than the 5 minutes (plus commuting) taken to measure vital signs by nurses in hospitals. Online applications allow patients to remain at home to keep track of the progression of their chronic illnesses. The downside of using mHealth applications is that not everyone, especially in developing countries, has daily access to internet or electronic