Design a Telemedicine Video Chat

Problem framing: a compliant video consult, not just a video call

A telemedicine video chat connects a patient and a clinician for a remote consultation, and the fact that defines the architecture is not the video — it is healthcare compliance. Everything the system touches is electronic protected health information (ePHI): the video, the chat, any lab image or document exchanged, the prescription, even the fact that a particular patient saw a particular doctor. Under HIPAA, ePHI must be encrypted in transit and at rest, access must be limited to the minimum necessary by people with a legitimate care relationship, and every access must be logged in a tamper-evident audit trail. So this is a secure-by-construction system that happens to carry video, not a video app with security bolted on.

The spine is therefore the appointment as the access-control boundary: a scheduled appointment authorizes exactly its patient and clinician to a media session within a time window, and authorizes them to the ePHI for that encounter — nothing more. Around that sit scheduling and reminders, a waiting room, encrypted WebRTC media, secure document and image exchange, e-prescription, and a complete audit log. State the framing up front: the architecture is shaped by encryption everywhere, appointment-scoped minimum-necessary access, and exhaustive auditing, with real-time video as the payload.