Telemedicine Platform Development
Telemedicine platform enables medical consultations via video, chat, and document exchange. In Russia regulated by 323-ФЗ (article 36.2): remote monitoring allowed, primary diagnosis prohibited. However, follow-up consultation and treatment correction allowed with prior in-person consultation in history.
Video Conferencing Technologies
Video consultation is WebRTC. For medical context critical:
- Confidentiality: E2E encryption (DTLS-SRTP), connection doesn't pass through third-party servers
- Recording: only with patient consent, stored encrypted
- Low latency: critical for accurate symptom assessment
Livekit — open-source SFU, deployed on-premise. Medical data stays within organization. Supports recording via room services.
Whereby Embedded or Daily.co — managed services with HIPAA BAA (for Western markets). For Russia self-hosted preferred.
Consultation Scenarios
Asynchronous (chat-based): patient describes symptoms, attaches photos. Doctor responds at convenience. Suitable for non-urgent questions, dermatology (skin photos), repeat prescriptions.
Synchronous (video): live video call. Waiting queue with real-time wait time. Doctor clicks "accept" → patient connects.
On-call doctor: pool of doctors on duty, first available accepts request. Implemented via PubSub: patient publishes request, first doctor accepts via Redis SETNX.
Digital Examination
Before video call patient fills complaint form: pain location (interactive body image), severity (1–10), duration, associated symptoms. Data displayed to doctor before call starts.
Consultation Documentation
Doctor during consultation fills structured protocol:
- Complaints (per patient)
- Objective findings
- Diagnosis / assumption
- Recommendations
- Referrals / prescriptions
Protocol after consultation becomes part of medical records in MIS. Doctor's electronic signature via qualified certificate (КЭП) or enhanced unqualified.
Prescriptions and Referrals
Electronic prescriptions (form 107-1/у) in RF require doctor's qualified e-signature and РЭМД integration (Electronic Medical Records Registry). Pilot regions: Moscow, Tatarstan.
For commercial clinics without РЭМД: PDF document with clinic seal, scanned at pharmacy.
Lab Integration
Assign tests → patient picks lab from partner list (Helix, Invitro, LaboratorI) → results auto-appear in account. Implementation via lab API or HL7 FHIR.
Administration Analytics
- Average consultation wait time
- Consultations by specialty count
- Conversion from booking to completed consultation
- Doctor ratings by NPS results
Timeline
MVP (video calls, chat consultations, patient and doctor account, consultation recording): 4–5 months. Full platform with asynchronous consultations, digital exam, e-signature, MIS and lab integration: 7–12 months.







