Over the past several decades the concept of telemedicine has evolved to be more commonplace with many unique applications. These applications have been made possible by overcoming challenges and barriers that have been present for most of telemedicine's development. The application of telemedicine continues to undergo growth and scrutiny. However, the rapid infusion of technology continues to serve as a catalyst for adoption and validation. Looking into the future requires a review of the past. Overcoming barriers and challenges has not been easy. Many have been minimized, in part because of technologies rapid flow and diffusion. Yet there are still significant challenges that must be overcome. In many parts of the world, healthcare and education are limited because of access. This has been driven by many influences, which continue to have an impact, albeit in many cases, minimal. Future generations of telemedicine users will look back at this period as one of transition. The first 30 years or so of telemedicine implementation were fraught with barriers and challenges. The next 30 years will see and entirely different paradigm of practicing medicine, including consumerism and smart systems.