Operational TC begins with the PREP mnemonic: Prepare through Planning and Training; recognize when to “make the call,” execute the consultation, and problem solve challenges. Ultimately, the safety and quality of care is the responsibility of the local caregiver and therefore telemedical support in the area of engagement (AOE) requires preparation and a PACE (Primary, Alternate, Contingency, and Emergency) plan to be successful. If a local caregiver intends to have consultation available but is unable to reach a remote consultant through one communications method, alternate methods should already have been established and tested. Thus, PACE planning takes two forms, one about when to utilize telemedicine and one for how to use telemedicine. See example in Table 1. A detailed example is in Appendix A.