Mark Matulaitis wears a neck brace after a recent operation and has virtual house calls with his neurologist via his laptop and special Skype-like software. [Photo by Patrick Semansky / Associated Press]

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Mark Matulaitis holds out his arms so the Parkinson's specialist can check his tremors. But this is no doctor's office: Matulaitis sits in his rural home as a neurologist a few hundred kilometers away examines him via the camera in his laptop.

Welcome to the virtual house call, the latest twist on telemedicine. It's increasingly getting attention as a way to conveniently diagnose simple maladies, such as whether that runny nose and cough is a cold or the flu. One company even offers a smartphone app that lets tech-savvy consumers connect to a doctor for $49 a visit.

Now patient groups and technology advocates are pushing to expand the digital care to people with complex chronic diseases that make a doctor's trip more than just an inconvenience.

"Why can't we provide care to people wherever they are?" asks Ray Dorsey, a neurologist at the University of Rochester Medical Center who is leading a national study of video visits for Parkinson's patients and sees broader appeal.

"Think of taking your mom with Alzheimer's to a big urban medical center. Just getting through the parking lot they're disoriented," he adds. "That's the standard of care but is it what we should be doing?"

Among the hurdles: While Medicare covers some forms of telehealth, it doesn't typically pay for in-home video exams. Plus, doctors who practice by video-chat must be licensed in whatever states their long-distance patients live. Some states restrict the kind of care and prescribing available via telemedicine.

About 40 percent of Parkinson's patients don't see a specialist, in part because they live too far away, even though research suggests those who do fare better, according to the Parkinson's Action Network.