With direct live transmission of voice and video we can inform and advice the paramedic at the scene, make remote and preliminary diagnosis and triage decisions and inform the emergency room to which the patient is transported. We are virtual on board and supervise the critical ill patient from the hospital. Because we can observe the patient in the ambulance we can inform the emergency room about the clinical status of the patient and advice if a surgeon, anesthesiologist, or cardiologist should be present or prepare the OR, intensive care unit etc. In the future patients will have to be transported over greater distances because of concentration of care in the Netherlands. This includes primary (emergency) and secondary (planned) transports. With this telemedicine system the patient will be safer and it will save lives. There are worldwide developments is Healthcare: for example aging population, increase of chronic diseases. So we need new care delivery models. The use of Big Data and mining of data will become more important for example that doctors can see which treatments are most effective for particular conditions. Cloud solutions, mobility will become key-items. The pilot is conducted in the hospital in Weert. We are now in the pilot- phase and exploring items such as funding. The goal is to improve patient safety and is aimed at sparing every minute than can possibly save lives. We decrease medical risks for example in early assessment of strokes during critical moments and can save lives and minimize after effects. We optimize patient records transfer. Challenges are numbers of stakeholders (hospitals, emergency services etc.), current standards of protocols, security of data transmission and post pilot funding, Opportunities are scalability national platform, extension of scope.