This paper addresses the use of telemedicine to support managing evacuation from Cape Verde to Portugal enabling better quality and global cost reductions in the health system management. Cape Verde health system lacks many specialists like pediatric cardiologists, neurosurgery, etc. In this study telecardiology shows good results as diagnostic support to the evacuation decision. Telemedicine can also be used for monitoring patients in post evacuation, helping to address the lack of responsive care in some specialties whose actual use will help save resources both in provision and in management of the evacuation procedures. Additionally, with telemedicine many evacuations can be avoided whereas many cases will be treated and followed locally with remote technical support and evacuations will be more efficient, by reducing expenses in travel and accommodation, and therefore contributed to the health system improvement. This study provides some evidence of how important telemedicine really is to cope with both the geography and the shortage of physicians.