Telehealth is a means for providing care to our rural patients. This mode of healthcare delivery is not without challenges with technology, research, quality improvement, practice and education. Here we present the TRIP-E Meta Model. This model was derived from a two phased process. First, we performed a review of literature and from this developed the first attempt at model development. Second, we took student evaluations from a telehealth education program for Doctor of Nursing Practice students. Based on their feedback, we then further advanced the first model to the TRIP-E Meta Model. This model is a comprehensive guide to research, quality improvement, practice and education. As a meta model, the TRIP-E can have other theories applied for projects. This feature of meta models provide flexibility for the model. We invite others to test this model for its flexibility and usability.