1. A network system apparatus allowing participant clients, to capture, retrieve and concurrently view both real time and archived medical images for synchronous or asynchronous communication, collaboration and consultation by one or more participant clients using participant client input illustrations over the medical images, comprising: a central processing unit; a telemedicine image management system server including at least one associated database having capability to communicate with a local area network; at least one telemedicine image management system streamer in network communication with a telemedicine image management system server via a local area network wherein the telemedicine image management system streamers capture one or more medical images and provide the medical images via the network communication to the telemedicine image management system server the local area network as it receives medical images from at least one source; and, a client software application enabling a multiplicity of participant roles, including consultant, collaborator and combinations thereof, in communication with a local area network, allowing the participant clients to input illustrations over medical images, the network system apparatus having the capability of appending the medical images periodically to the telemedicine image management system server, and saving participant client input illustrations over the medical images and sending those medical images to the telemedicine image management server for use with digital imaging and communications in medicine file structures; wherein one or more participant clients retrieve and view the medical images, creating illustrations over the medical images including, but not limited to drawing, annotating, telestrating and storing the medical images with the illustrations, and concurrently viewing all of the participant client's input illustrations as they happen and can save all the input illustrations from all participant clients on their local respective computer storage devices, on the telemedicine image management system server, on the picture archiving and communications system server, in a known digital imaging and communications in medicine format.