Tripler Army Medical Center (TAMC), located in Honolulu, Hawaii, serves as the US military’s tertiary medical referral center for the Western Pacific. Over 20 years ago, the TAMC Department of Pediatrics developed an asynchronous provider-to-provider teleconsultation pilot program, eventually named the Pacific Asynchronous TeleHealth (PATH) system. A secure teleconsultation platform for pediatric sub-specialty provider-to-provider advice, the platform grew based on the needs of users, eventually expanding to serve all age-groups, with over 60 different specialties based at TAMC providing teleconsultation. Eventually, the success of PATH drove further expansion to serve military clinicians located in other overseas locations beyond the Asia-Pacific. This cost-effective model can be applied to civilian healthcare settings, particularly where geographic distance or limited connectivity are challenges to delivery of synchronous telehealth or in-person specialty care.