The goal of this article is to provide technical and operational blueprints for two successful global telehealth programs. We designed a physician-to-physician consultation program to provide subspecialty expertise to physicians in warn-torn Ukraine. Leveraging secure web applications, telehealth platforms, and image sharing platforms, we repeatedly iterated upon infrastructure and workflows, which in turn facilitated development of a parallel international program for Department of State (DOS) employees and families. We provide descriptive statistics and metrics of both programs' successes and failures and detail iterative improvements with workflow visuals. To measure subspecialty imaging consultation value-add, two radiologists performed a retrospective comparative review of DOS program initial versus consulted imaging reports in consensus, measuring diagnostic report agreement and rating clinical impact of identified discrepancies on a 3-point scale (mild, moderate, major). Bivariate analyses using Chi-square tests assessed for associations between diagnostic discrepancies and patient or imaging factors. P<0.05 was considered statistically significant. The Ukraine program (05/2022-08/2023) provided 114 patient consultations with 77 subspecialty radiology consults, >50 WhatsApp chats, and >1,000 messages exchanged, and 92% overall consult request response rate. The DOS program (11/2022-07/2023) provided 275 consultations with 70 subspecialty radiology consults and 36-38% rate of alternative diagnoses, with 20% rated as incurring moderate or major clinical impact. Bivariate analyses demonstrated no significant patient or imaging association with diagnostic disagreements (all p>0.05). Global telehealth infrastructure and multiple applications and platforms can be optimized in a workflow to provide efficient, high level clinical and imaging consultation services across the globe.