From resuscitating extremely preterm babies across the United States, to supporting trauma combat casualty care in Ukraine, to international critical care networks and supporting philanthropic activities in sub Saharan Africa, telemedicine has come of age. In this session, Ed Percy, who has been involved in all of these initiatives, will describe the characteristics of a platform that can support delivering healthcare into situations as challenging and complex as active war zones, refugee camps, as well as rural hospitals in the US, and major academic centres in Europe. Attendees will learn about the key underlying technical requirements of such a solution, some of the obstacles to be overcome and some learning lessons for ensuring successful deployments.