The BuddyWorks Telehealth Project (http://telehealth.upm.edu.ph/bw/) is an e-government funded project that aims to reduce the inequities in the Philippine health care system and help curb the impact of the exodus of health care providers through telehealth. The project uses electronic information and communications technologies to provide and support health care for underserved communities and geographically remote areas where health care expertise is largely unavailable. This presentation focuses on the benefits of developing using free/open source software but also the challenges of implementing telehealth initiatives in a devolved health care system. In summary, the use of free/open source platforms allowed for substantial savings and greater flexibility for program managers as they maneuvered through the difficult organizational aspects of the project. - Alvin Marcelo - Philippines