This chapter presents the experiences of four organizations in the United States that successfully implemented telehealth-based programs, and describes the numerous mechanical factors – such as patient and technology selection, reimbursement and return on investment, and regulatory and policy issues – that are central to ensuring program success. The primary theme that emerges is that the human element is essential – particularly in meeting the core challenges of engaging other providers and patients in successfully deploying telehealth programs. The authors posit that human factors represent 90 percent of the effort of successfully implementing such programs – the technology in and of itself represents only 10 percent.