Telehealth units are one of many university administrative units created to foster innovation in universities over the last 40 years. Despite the proliferation of such units, few organizational studies have examined the work undertaken inside of these units. This qualitative study used a sequential two-part research design to understand the perceptions of experienced leaders from mature university-based telehealth units regarding the nature and requirements of their units' work. In Part I of the study, telephone interviews were held with 21 leaders from 17 university-based telehealth units. In Part II, videoconference focus groups were held with a subgroup of 15 of the same leaders from 14 of the units. Seven key findings emerged during data analysis. First, the nature of the push and pull that the units experienced from the university and community depended upon whether the units existed primarily to research and develop telehealth, increase access to services through telehealth, or resolve healthcare disparities using telehealth. Second, in addition to developing telehealth practices and services, many units were actively involved in building the capacity for telehealth regionally, at the state level, and nationally. Third, units' level of ownership and involvement in developing telehealth ranged from consulting with--and facilitating the efforts of--others who provided telehealth services, to providing or paying for the telehealth services directly. Fourth, telehealth units' success was more dependent upon effective processes than outcomes. Fifth, telehealth units' ability to harness and focus the energy, talents, and resources of others in finding creative ways to make telehealth an integral part of the university and community healthcare systems was essential to success. Sixth, units were more and less intentional in integrating five practice areas to effect change. Last, two units undertook initiatives that adopted a systemic approach to resolving healthcare disparities, of which telehealth was only a part. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]