Healthcare can now be provided from a distance allowing doctors to make a diagnosis or give an opinion on possible treatment without meeting the patient directly. This requires digital imagery via telehealth which is theoretically well suited to New Caledonia's geographic and demographic characteristics. After using video-conferencing with mainland France over a period of several months as part of a continuing medical training programme, it became clear that a telehealth network would improve local health care efficiency and this concept is being incorporated into the Territory's overall health policy. A needs assessment was conducted to assess the expectations of doctors and this highlights the need to develop such a network, as soon as possible. The exact mode of communication has not yet been determined and in this article the expressed needs of doctors and the proposals with advantages and constraints are discussed in legal, ethical, financial, organisational and medical terms.