Telehealth and telemedicine can encompass many applications including direct patient care, training, supervision, consultation, continuing education, and consumer health. The field uses an array of technology from the simplest telephony to advanced robotics. Therefore, it is important to work from a model in design or implementation. This rapidly changing and sometimes chaotic environment presents engineers with a unique opportunity to address the digital divide that is reflective of the geosociopolitical makeup of the world economy. The paper begins a developmental perspective of service delivery models currently used, likening the early years to a feudal system and the current time to a mosaic. After a brief look at the digital divide and the role of culture in technology, the paper concludes with application examples from projects around the world and suggests ways that model systems can be designed with various levels of technology.