Block 3. Real-Time Video Architecture for Clinical Use

1

WebRTC for Telemedicine: Why It Is the Default, and Its Clinical Gotchas

Why WebRTC is the default for telemedicine platform development — and its four clinical gotchas: TURN cost, hospital firewalls, recording, P2P limits.

2

P2P, SFU, MCU: The Right Topology for a Consult, a Group Session, and a Webinar

P2P, SFU, or MCU for telehealth video? Match the topology to the consult, group therapy, or low-power endpoint — with cost math and the BAA boundary.

3

Choosing the Video Layer: Build on mediasoup/Janus/LiveKit vs Buy Twilio/Vonage/Agora/Daily

Build on mediasoup/Janus/LiveKit or buy Twilio/Vonage/Agora/Daily? The BAA-first comparison of HIPAA-compliant telehealth platforms, with cost math.

4

The Waiting Room: Queueing, Triage, and Provider Readiness

How a telehealth waiting room really works: private queueing, tele-triage routing, provider readiness, and the 30-second pre-call test that saves visits.

5

Connection Reliability: Reconnection, Network Changes, and Graceful Degradation

How telemedicine video survives bad networks: WebRTC reconnection, ICE restart, Wi-Fi-to-cellular handover, graceful degradation, and a phone fallback.

6

Latency, Quality, and the Clinical "Good Enough" Bar

What video quality a telemedicine consult actually needs: the latency budget for natural conversation, resolution by specialty, and graceful degradation.

7

In-Call Clinical Tools: Chat, File Share, Screen Share, Annotation, Vitals

How telehealth in-call tools — chat, file share, screen share, annotation, and connected vitals — stay inside the HIPAA boundary, and what breaks it.

8

Recording Clinical Sessions: When, How, and the Compliance Tension

When and how to record telehealth visits: HIPAA, two-layer consent, the end-to-end-encryption conflict, and clinical video retention and deletion.

9

Multi-Party and Multi-Role Consults: Interpreters, Specialists, Caregivers

How to run a multi-party telehealth consult: add an interpreter, specialist, or caregiver with role-based access, per-party consent, and the right BAA.

10

Scaling Clinical Video: Regions, Capacity, and Surge

Scaling WebRTC telehealth video from 10 to 10,000 consults: horizontal SFU scaling, regional media routing, surge capacity, and HIPAA availability rules.

11

Telemedicine Video Reference Architecture: The Full Picture

A telemedicine reference architecture: the ten video components, the PHI compliance boundary, and the encryption and BAA rules an auditor reads first.