The Problem Space

Off-the-shelf video SDKs often fail under the massive load of peak telehealth hours. Furthermore, standard P2P mesh networking degrades severely on mobile devices, destroying battery life and dropping frames. Synchronizing electronic medical records (EMRs) during live video calls often introduces unbearable latency.

Our Engineering Approach

To build an enterprise-grade telehealth platform, we decouple the video routing from the clinical state management using an event-driven architecture.

Key Architectural Decisions:

1. WebRTC SFU (Selective Forwarding Unit): Instead of a mesh network, we implement a custom SFU (e.g., using mediasoup or LiveKit) to route video packets efficiently. The server receives one stream per participant and forwards it, drastically reducing client-side CPU load.
2. Event-Driven EMR Sync: We utilize HIPAA-compliant event buses (like AWS EventBridge) with KMS encryption at rest and in transit. Clinical state changes (notes, prescriptions) are published as events, ensuring the video microservices never process or store PII.
3. Edge Optimization: The React/Next.js frontend is deployed to Edge Networks, ensuring sub-100ms time-to-interactive for rural patients with high latency connections.

Target Outcomes

• Zero Video Drops: Designed to support massive concurrency without server overload.
• Microsecond State Sync: EMR updates reflect instantly without blocking the main video thread.
• Absolute Compliance: SOC2 and HIPAA compliance are baked into the infrastructure layer via isolated VPCs and strict IAM roles, rather than patched on as an afterthought.