Delivery of care at a distance by telehealth is becoming a major mode of care provision worldwide. Although benefits are more for the elders, the digital divide prevents them from using the full potential of such applications. Absence of guidelines or laws directly related to telehealth in Sri Lanka has made many service providers to implement such initiatives haphazardly. The main objective of this study was to assess current telehealth practices in Sri Lanka with the view to streamline services. Characteristics of institutes providing telehealth were studied using a voluntary web-based self-administrated questionnaire. Nine institutes fully completed the questionnaire. All telehealth services were provided by the Sri Lanka Medical Council registered health professionals. Eight programmes were expecting improvement of patient convenience and better coordination of healthcare like in the rest of the world. Three had institutional medical health record systems which were standalone. Six were providing services on health promotion and primary healthcare while the global trends concentrated on clinical care. None were addressing rural scarcity of specialized healthcare, unlike other countries. Three used video conferencing for Telecare and only one issued internet-based prescriptions. Multi-factor authentication and end-to-end encryption of data were used by a few. Inadequate guidelines increased cost of supporting technology and inability to refer patients between institutions were identified as main barriers in telehealth implementation. In comparison with global standards, protocol measures taken to coordinate telehealth were found to be inadequate in Sri Lanka. Therefore, we recommend that existing medical guidelines and legislation be modified to keep abreast with the rapidly expanding technologies in telehealth.