Telehealth is a domain that enables the remote delivery of healthcare through advancing technologies amid rapid digitalization and internet diffusion, contributing to the digital transformation and sustainability of healthcare. Tools such as video conferencing, remote monitoring, and electronic messaging reduce the need for in-person visits, and the heightened demand during COVID-19 further reinforced this trend. Maintaining service quality and user satisfaction nevertheless requires accurately identifying and prioritizing system-level barriers. This study presents a decision-making model that systematically evaluates four principal barriers in the telehealth process—insufficient technological infrastructure, cost and financing, cultural and social factors, and security and confidentiality—under five criteria. The Fuzzy VIKOR approach is implemented step by step, integrating quantitative and qualitative information to yield consistent results under uncertainty. Marking a novel contribution, this study is the first to apply the Intuitionistic Fuzzy VIKOR method to systematically prioritize barriers within telehealth systems. The analysis moves the prioritization debate beyond technical considerations and indicates that economic sustainability and user trust are decisive levers for telehealth adoption. This finding suggests that strengthening reimbursement frameworks, developing cost-effective business models, and disseminating data-protection-oriented governance practices can enable telehealth solutions to scale more coherently with goals of access, quality, and efficiency. The study’s primary contribution to the literature is its systematic evaluation of telehealth barriers, which shifts the implementation discourse from a techno-centric view to a socio-technical one, thereby guiding stakeholders on the most critical steps for future development. The study offers stakeholders a practical and sustainable roadmap for optimizing telehealth systems.