Over the past decade increasing healthcare and elderly care costs and demographic changes are rapidly making traditional healthcare concepts unaffordable for many developed countries. Telecare and telehealth applications have become increasingly popular because of their promise to reduce costs and staffing requirements while maintaining or even improving care. Most of the existing applications are centred around the clinical users. Patient factors are considered, but usually only incorporated into the user interface design rather than the system and its application. The patient population, and especially the large proportion of elderly patients, has unique needs, capabilities and limitations that must be considered throughout the design process of such applications. In this paper we present a taxonomy of usability requirements and design concepts for home telehealth systems which enable a more patient centric design. We systematically explore the usability problems of past and current telehealth applications. Problems faced by users of home telehealth systems are identified and solutions delineated. The paper aims to build a good understanding of the technology needs of the elderly population. It represent a solid foundation for constructing novel and more general telehealth solutions in order to make the technology more effective and more widely available.