Innovative ICT applications such as patient-present telemedicine consultation services can save lives, yet following pilot-testing few have achieved long-term viability. Partners Health Care’s TeleStroke service, in full operation, is financially self-sustaining. Interviews with clinical, technical and administrative personnel at Partners and two “spoke” hospitals revealed practical lessons learned. Analysis through the lens of the Resource Based View reveals that many valuable assets and capabilities that Partners and its spoke hospitals developed are necessary for a successful TeleStroke program yet could be acquired or copied (they are not rare or inimitable). We note further that Partners’ overriding goal for TeleStroke is to achieve clinical success in its catchment area, without depleting financial resources; competitive advantage is sought within the catchment area but not beyond it. Resource analysis reveals that other institutions could develop successful telemedicine services for acute stroke care, since the needed assets are readily available, most of the capabilities can be imitated, and viable substitutes are limited. We contend that the lessons learned in this case study -- about the effective deployment of assets and capabilities -- are broadly applicable to other settings, in health care and other industries.