The Department of Plastic and Reconstructive Surgery at the Royal Darwin Hospital is the tertiary referral centre for Northern Australia. Its service radius is 1800km - larger than the United Kingdom. The population is remote, largely Indigenous, or mining and agricultural workers, where hand injuries and infections are commonplace. Transportation from remote communities to Darwin is difficult, costly and many patients prefer local treatment. Delayed presentation for definitive treatment increases morbidity and increases the workload at Royal Darwin Hospital. A further challenge is that the skill set of rural and remote practitioners varies, and practitioners in these locations frequently change. To address these issues, our department has instituted a pilot program that augments existing telehealth services with instructional videos that educates and guides the remote clinician in managing such conditions. Videos include the identification of hand pathology, both infective and traumatic and management of injuries in remote locations. Examples include digital tourniquets, ring and regional blocks, draining felons/abscesses, nail bed and simple extensor tendon repairs. The project aims to upskill the remote practitioner, and local treatment affords the patient earlier, definitive care close to home. Added benefits of resource de-centralisation and cost savings are significant. The project aims to expand to widely cover hand surgery and other plastic and reconstructive topics in the future.