The Continua Health Alliance is nearing the first release of its Design Guidelines, an important milestone towards the establishment of a personal telehealth ecosystem. These guidelines address the technical barrier for a personal telehealth ecosystem: interoperability amongst multivendor systems. This paper describes why it is essential to address interoperability, regulatory aspects of multi-vendor systems and reimbursement for establishment of a personal telehealth ecosystem. In addition we elaborate on the impact that Continua has on the development of the personal telehealth domain. First we motivate why the establishment of such an ecosystem is an essential part in addressing the healthcare challenges in society.