Telehealth is considered one of the best strategies to support the increasing demand for health services. Unfortunately, most Telehealth initiatives fail before the operational phase or they do not reach the expected potential usage. Although several studies and pilot projects have demonstrated that there are several mature technologies available for supporting a wide range of clinical services over distance, the current state of large-scale Telehealth services is still inadequate for the needs of health professionals, policy makers, researchers, users and other stakeholders. Consequently, this paper evaluates the current operational barriers of large-scale Telehealth services provisioning, focusing specifically on the challenges of Information and Communications Technology. Some complementary assets, besides the core clinical and medical protocols, are required for performing technological innovations in large-scale service operations. Furthermore, the paper ends with a brief evaluation of two frameworks used by telecom providers during the technological convergence waves of the 1990s. An analysis comparing the Telecommunications Convergence phenomenon of those days and current Telehealth context can provide insights for developing a more consistent Telehealth operational framework.