One may face obstacles in implementing technological advances in our environment or exporting technology and knowledge by disseminating telemedicine and e-health in the rural areas or to the developing countries, or just by simply trying to advance already established medical systems. Dr. Weinstein et al have eloquently put all you need to know it order “to put it all together,” however I wanted to alert you to few other issues may become important as you proceed. So let's talk first about obstacles as they vary. They may be as simple as ignorance, or as complex as political or national lack of vision, and leadership. Frankly, there are no obstacles that cannot be overcome, and there are no valid reasons that will justify failure to start and failure to succeed. We need to adopt the slogan “Failure is not an option.” Determination to succeed is often associated with serious difficulties and growing pain, but that is not a good reason why you should stop.