A medical image acquisition system compatible with all medical imaging modalities for connectivity with all Patient Archive Communication Systems (PACS) and Vender Neutral Archive (NNA) systems, namely, technology which provides economical storage and convenient access to images from multiple medical image modalities, records from any modality, edit, review, and then archive to streamline workflow and improve productivity across the hospital enterprise, namely, a telemedicine management computer server, imaging system streamer server, a computer input device, a computer output device and recording device that displays medical images including real time images' displaying said imaged on multiple displays in multiple location all connected to a network, an operator, namely, person, user, clients' having association with said medical images allowing the user the ability to concurrently collaborate on said images and telestrate directly of the image, annotate, with board and chap on and about those images interactively, in live or prerecorded forms