Now that the concept of the Multinational Telemedicine System (MnTS) was been tested and proved to be operational, the need to go ahead and transform the research project into a functional multinational telemedicine system is the next logical step. We face several challenges and we need answers as soon as possible so momentum is not lost. Who will oversee the whole system? Who will be the main beneficiaries? How will reliable satellite communications be provided during a disaster to operate the system? How will we overpass the legal challenges regarding the practice of medicine by the physicians providing advice at a distance crossing borders virtually? All these are questions we need to answer and find solutions that allow us to transform an idea and a project to reality.