Northern and Indigenous communities face well documented challenges to accessing services and are impeded by significant infrastructure and technological limitations prompting the urgency to adopt innovative approaches to overcome these barriers. Telehealth – the means of accessing healthcare services and information across distance – promises to augment services to address access issues, yet notable utilization and structural constraints remain. Drawing on a recent community-based study capturing the perspectives from four Northern Saskatchewan communities on telehealth utilization, this paper draws attention to the importance of community collaborations as crucial to better decision-making and pathways forward. Specifically, this work identifies the need for decolonized participatory design (PD) and participatory technology assessment models that consider broader socio-cultural and technical factors to inform Indigenous technology design, adoption, and assessment for long-term community benefit. Further, to this is the need for community driven approaches and engagement through knowledge mobilization strategies that could better inform future community development.