October 5, 2021

Understanding the System Design & Architecture of a Telemedicine Platform

Cosette Cressler

Understanding the System Design & Architecture of a Telemedicine Platform

Covid-19 has changed the way we interact with our healthcare providers—maybe forever.

While telemedicine has been around for quite a while, its usage exploded as customers began to explore new, safer ways to engage with their healthcare practitioners. If you're curious to see exactly how the telehealth trends are changing, here are 55 statistics that show the increasing telehealth adoption.

Telemedicine platforms provide safer, quicker, and more convenient solutions for patients while also enabling providers to save time and money. It’s no wonder that so many healthcare organizations and private practices are actively investing in building their telemedicine apps.

In this article, we will explore the essential features of a telemedicine app, the technical pillars of a telemedicine platform, and the entire telemedicine system architecture.

Let’s dive in.

Essential Components of a Telemedicine Platform

At its core, a telemedicine platform’s purpose is to facilitate the communication between a patient and doctor or medical professional. It does so through a range of technologies that encompass the storing, sharing, and analyzing of data.

An effective telemedicine app needs to have three versions of itself—one each for the patients, practitioners, and healthcare admins. Each of these user types requires a different features of the healthcare platform to be useful to them.

Patient App Features

The patient’s version of the telemedicine platform is usually either a mobile app or a web app. The key features of this platform are:

  • Authorization method: The patient needs to be able to register and sign in to the platform in a secure way.

  • Patient profiles: Profiles enable the patient to add crucial data like age and self-declared health issues.

  • Medical record storage: The uploading and downloading of medical records adds another layer of communication between patients and practitioners.
  • Scheduling: The patient needs the ability to make, change, or cancel an appointment.

  • Real-time communication channels: The core feature, live chat, video, and/or audio streaming allows the patient to get effective medical care from their provider.

  • Payment gateways: Patients need a safe and secure way to make financial transactions.

Healthcare Provider App Features

The provider’s version of the telemedicine app is most often a web app. A mobile app wouldn’t be as easy to use in an office setting. The important features of the provider’s version are:

  • Doctors profile: A profile allows each doctor to easily share information such as job title, education, and more with their patients.

  • Appointment manager: Doctors need to be able to see their appointment list and make changes when necessary.

  • Scheduling: Doctors also need to be able to alter their schedule and availability.

  • Access to the EHRs: EHRs (Electronic Health Records) are digitized versions of the patient’s medical health record and provide crucial background information for the healthcare provider.

  • Real-time communication channels: Communication needs to be two-way. Additionally, the provider needs access to the same real-time channels as the patient.

  • Prescriptions: Integration with local pharmacies and prescription software allows the provider to write and fulfill prescriptions when necessary.

Admin App Features

Lastly, the admin version of the platform allows the most access and functionality and it’s almost always a web app. This version allows you to control many or most administrative functions in a healthcare organization. The key features are:

  • User profile: The admins themselves need profiles to track who makes changes in the system and to set different access levels.

  • Patient profile management: The admins will need access to a patient’s profile in order to edit information, upload new medical records, see their financial status, etc.

  • Doctor profile management: Again, admins need access to a doctor’s profile in order to see their availability, schedule their appointments, and even disable their account if necessary.

  • Analytics: Data allows the admins to glean insights from both patients and doctors. The app can track revenue, the number of virtual visits, and much more.

  • EHR system integration: The admins need to be able to manage the integration of the telemedicine app with the existing EHR (Electronic Health Records) system.

  • Payment management: Again, just like the healthcare providers themselves, admins require access to see and manage the financial history of a patient.

  • Notification management: Admins also require the ability to manage the app’s notification systems—to set up, schedule, and trigger when a patient or doctor should be notified.

Now that we are familiar with the essential features of a minimal viable telemedicine platform, let’s discuss the telemedicine system architecture.

Telemedicine Platform Architecture and Data Flow

Healthcare organizations often consist of a complex mix of technologies. Your telemedicine platform has to interface with all of these technologies—which is made more complicated by the fact that the mix of tech is different for every organization. Therefore, for the sake of brevity and relevance, we won’t get into the minutiae of the hundreds of possible combinations of software. Instead, we'll broadly cover the scope of technical components needed for an effective telehealth platform.

A telemedicine system architecture can be broken into four main categories: clients, communication components, APIs and business logic, and storage and infrastructure services.

Clients

A client is the interface or app that a user sees and engages with. A telemedicine platform has 3 clients—one for each of the 3 versions (patients, practitioners, and admins) we discussed above.

As we mentioned earlier, these clients can be mobile apps or web portals. The technology you'll use to build the clients will depend largely on which you choose to go with—mobile, web, or both. 

Mobile telehealth apps, for example, are quickly growing in popularity. Check out our guide on building a telehealth app for iOS for a complete technical walk-through. Another great option is to create a cross-platform telemedicine app that works on all mobile devices as well as the web. Using a front-end tech stack that includes React Native or Ionic makes this process easy.

Communication Components

Communication Components

As we mentioned earlier, the core feature of a telehealth platform is real-time communication. Patients and practitioners need to be able to communicate and engage with each other. This can be done via video streaming, live chat, audio, or all three.

Which of these real-time communication channels you implement is up to you. However, most of the existing platforms have both video streaming and live chat.

A key difference between a telehealth app and any other kind of live chat app is HIPAA compliance. HIPAA (Health Insurance Portability and Accountability Act) is a federal law that protects sensitive patient health information from being disclosed without the patient’s consent or knowledge. Penalties for violating HIPAA laws can be severe with a minimum fine of $50,000 for a willful violation

Because any kind of communication between patient and practitioner is considered PHI (protected health information), it falls under HIPAA. Therefore, a telemedicine platform needs to have all the necessary security measures in place to meet HIPAA requirements.

This can be a huge headache if you code these security measures from scratch.

Fortunately, you don’t have to. Whether you're looking to add real-time text chat, voice, video, or all of the above—CometChat provides a cloud-based HIPAA compliant  SDKs & APIs. Our SDKs are easy to set up and quickly integrate with any system. Learn more about building a HIPAA-compliant chat for telemedicine systems in this article.

The most important factor is making sure whatever software you choose can easily integrate into your tech stack.

APIs and Business Logic

APIs and Business Logic

The 3 different clients have to communicate with each other, the back-end databases, and third-party software. This is done via the APIs and business logic layer and usually consists of many different microservices. These microservices live on a back-end server such as AWS or Azure.

The internal microservices are each responsible for different types of workflows such as video calls through one of the many instant messaging protocols or even identity authorization through a SSO (Single Sign On) service. The microservices can also be used to implement relevant and useful external APIs. For example, Human API is a self-reporting health diagnostic platform that can read data from smart devices such as Apple Watches. This data can then be sent straight to your practitioner or added to your medical records. Utilizing third party APIs to develop a telehealth app can make the process quicker and more effective.

This business logic layer is responsible for communicating between client and server and for executing crucial “business logic”—i.e. the logic that determines how data is transformed, calculated, and stored and how it is routed to other people or software. This includes tasks such as routing, authentication, sessions, and caching.

The API and business logic layer also encompasses the integration of the platform with any existing third-party software such as the EHR system.

Storage and Infrastructure Services

The last technical pillar of a telemedicine system architecture is the storage and infrastructure services. This usually consists of cloud-based services such as AWS, Azure, or IBM Cloud. 

The cloud-based service hosts the API and business logic layer, stores user and business data, and manages the IT infrastructure. The IT infrastructure then manages functionalities such as load balancing, CDNs (Content Delivery Network), and version deployments.

When building a telemedicine platform, it’s important to choose a cloud service that is HIPAA-compliant because you’ll be storing protected health information in your databases. Both AWS and Azure have robust security settings to ensure that your platform meets HIPAA requirements.

Putting It All Together

Now that we’ve gone through the four main components of a telemedicine platform architecture, let’s see what it looks like all put together.

Telemedicine App Architecture Diagram
Telemedicine App Architecture Diagram

As you can see in the above diagram, the three clients are all on the left-hand side. Data flows to and from these clients and passes through the APIs and business logic layer which is hosted on the cloud-based service infrastructure (everything inside the blue background). The business logic layer handles routing data to and from the databases and interfaces with the communication channels such as WebRTC and CometChat’s live chat SDK.

Conclusion: Designing a Telemedicine Platform System

As always, the exact architecture and system design of your telemedicine platform will largely depend on your specific requirements, the frameworks your development team is familiar with, and your budget.

The best way to increase speed-to-market and reduce costs is to use existing HIPAA-compliant frameworks for each component of the telemedicine system architecture. For example, you can use AWS, or an equivalent cloud service, for your infrastructure, storage, and server management and CometChat’s HIPAA-compliant chat service for real-time communication channels.

It's easy to get started with CometChat’s HIPAA-compliant chat API. Just sign up to our developer dashboard and start building your chat app for free. 

If you still have questions, feel free to talk to our experts and get answers before you get started. 

Interested in learning more about HIPAA compliant chat systems or telehealth apps? Check out these tutorials and guides:

About the Author

Cosette Cressler is a passionate content marketer specializing in SaaS, technology, careers, productivity, entrepreneurship and self-development. She helps grow businesses of all sizes by creating consistent, digestible content that captures attention and drives action.

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