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It’s plain, simple, obvious and so far pretty much ignored. From Mark Terry:

In discussions of telemedicine modalities, text messaging, also more technically referred to as SMS for Short Message Service, isn’t the elephant in the room, the one everybody’s ignoring and afraid to talk about. Text messaging is the elephant at the door, the one everybody knows is trying to get into the room, but nobody’s quite sure how it’ll fit through the door, how big it is, or what exactly they’re going to do with it once it gets through.

(Thanks to ICMCC.)