The Challenge
NovaMed is a telemedicine platform connecting patients with licensed physicians. The platform serves two user groups: patients who need a simple interface that works on any device, and physicians who need a clinical-grade workspace with patient history, prescription tools, and consultation scheduling. Built from scratch with a firm launch deadline tied to a regulatory approval milestone.
Our Approach
We began with a structured discovery phase to map existing workflows, identify technical constraints, and define the highest-value features for the initial release. Rather than trying to build everything at once, we established a phased delivery plan with working software at each milestone.
What We Built
The platform architecture separates patient and physician workflows into distinct Next.js applications sharing a common NestJS API backend and PostgreSQL database. Video consultations use Twilio Programmable Video with an adaptive bitrate configuration that maintains session quality at bandwidths as low as 400kbps — tested against real 3G connections.
Prescription management implements a multi-step approval workflow with a digital signature requirement and complete audit trail stored in an append-only audit log table. The scheduling engine handles physician availability windows, patient booking, timezone conversion, and automated reminder notifications via Twilio. Stripe handles both one-time consultation payments and recurring subscription billing.
"NovaMed launched on schedule and has performed flawlessly through our first year of operation. The team's approach to compliance and clinical workflow design gave us a platform we could confidently present to regulators."
The Results
NovaMed launched on schedule and immediately onboarded patients at a pace 60% above the client's internal projections. The regulatory review was completed without findings, with the compliance team citing the completeness and auditability of the platform's prescription and consultation audit logs.