Increasing life expectancy and rates of chronic conditions place increasing demands on aged care health and support services. One response preferred by older adults and seen as cost effective is aging in place, whereby older people remain in their own homes and avoid aged residential care. For this to take place, it is crucial that older people maintain effective relationships with support networks and that older adults and these networks have adequate information to support patient centred health and wellness care at home. This study explored how smart home telehealth, a form of telehealth where health care is provided at a distance using smart home digital technology (sensors), could assist older people to age in place and enhance their health and wellbeing. It was a two-phase project, preceded by a workshop with experts:1) 41 interviews with older adults and their informal support networks, seven focus groups with 44 health providers working with older adults, which informed 2) a pilot implementation of a co-designed telehealth system, addressing key barriers identified in Phase 1. The system used low cost, easily accessible, and commercially available sensors, transferring information via email and/or text messaging. It was successfully piloted with five older adults and twelve of their respective support networks for six months, who reported an increased feeling of security and improved interpersonal communication. The findings indicate that smart home telehealth could assist aging in place, and the study provides insights into successful co-design of smart home telehealth services at scale that could be implemented and deployed in contexts wider than aged care.