Telemedicine has been available and in use for over fifty years yet by most accounts it has fallen short of its promised impact on healthcare. While legal and reimbursement issues continue to plague the spread of telemedicine use, the technology has continued to improve. We feel there are additional dimensions that play a key role in the use of telemedicine; in particular, we believe that doctors’ and nurses’’ emotional state during use of a telemedicine system has a significant impact on how telemedicine is used. What are the main drivers that give rise to these emotions? How do they impact the use of telemedicine? What changes in the business process can mitigate the negative impact of these emotions? We investigate these research questions by conducting an embedded case study utilizing interview data and archival documents to gain insight into the emotional components at play during TeleStroke consultations.