The Telemedicine Revolution
COVID-19 accelerated telemedicine adoption by a decade. We designed a platform that handles over 10,000 daily consultations with sub-second video connection times and 99.99% uptime.
Core Architecture
Service Breakdown
The platform is composed of five core microservices: Auth Service for patient and provider authentication with MFA, Appointment Service for scheduling and availability management, Video Service for WebRTC-based consultations, Chat Service for real-time messaging, and Documentation Service for clinical notes.
Technology Choices
| Component | Technology | Rationale |
|---|---|---|
| Frontend | Next.js + React | SSR for SEO, excellent UX |
| Video Engine | WebRTC (mediasoup SFU) | Low latency, scalable |
| Database | MongoDB Atlas | Flexible schema, global scaling |
| Message Queue | RabbitMQ | Reliable async processing |
| Cache | Redis | Session management, rate limiting |
Video Consultation Implementation
We chose WebRTC with a Selective Forwarding Unit (SFU) architecture using mediasoup. This allows multi-party calls while keeping server CPU usage low. The SFU simply forwards media streams without decoding them.
Real-Time Clinical Documentation
Doctors can take notes during consultations using a collaborative rich text editor. Notes are saved in real-time and automatically associated with the patient record via FHIR resources.
Results
- 10,000+ daily consultations with 4.8/5 patient satisfaction
- 99.99% uptime over the past 12 months
- Sub-200ms average video connection time
- 90% of patients prefer telemedicine over in-person visits for follow-ups
