Telehealth – the provision of health services at a distance in an electronic form via modern telecommunications networks – has been increasingly proposed as an alternative to more conventional, person-to-person modes of delivery and as having a potential transformative role within health care structures. The proponents of telehealth point out its potential to contribute to more equitable healthcare - reaching, for example geographically and socially excluded populations, to develop enhanced modes of service delivery for health, and to reduce or at least contain the escalating costs of healthcare provision. Against this background of ambition and potential, this paper utilises Swanson and Ramiller’s (1997) concepts of organising visions of information systems innovations to explore the processes by which telehealth innovations acquire an identity, and (sometimes) recognition and acceptance within relevant communities.