Telehealth Platform: Scaling for COVID-19 Surge

Rapidly testing and scaling a telehealth platform from 10,000 to 2M daily consultations during the COVID-19 pandemic.

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December 10, 2021 Healthcare

Client

A US-based telehealth provider

The Challenge

When COVID-19 hit, the telehealth platform was designed for 10,000 daily video consultations. Demand surged to 200,000 within weeks and was projected to reach 2M. The platform needed to scale 200x while maintaining HIPAA compliance and video quality.

Our Solution

In an accelerated 8-week engagement, we performed rapid scalability testing, video quality validation under various network conditions, security assessment for the expanded attack surface, and cross-platform testing as the service expanded to include web, iOS, Android, and smart TV applications.

The COVID-19 pandemic created an unprecedented surge in telehealth demand. What was a convenience feature became a critical healthcare delivery mechanism overnight.

Our rapid response team worked around the clock for the first two weeks, identifying and resolving scalability bottlenecks as fast as they appeared. The most critical finding was that the video signaling server couldn’t handle the connection rate, requiring an architectural redesign of the session establishment flow.

We implemented automated canary deployments with real-time quality monitoring, allowing the team to push infrastructure updates multiple times daily with confidence.

Security was not compromised for speed — we conducted continuous penetration testing throughout the engagement, ensuring that the expanded attack surface from new clients and APIs remained secure.

Key Results

1

Platform successfully scaled to handle 2M daily consultations

2

Video call quality maintained at 720p+ for 98% of sessions

3

HIPAA compliance maintained through rapid scaling

4

Platform availability of 99.95% during peak pandemic demand

5

Patient wait times reduced from 45 minutes to under 5 minutes

Technologies Used

Twilio VideoAWS Auto ScalingWebRTCAppiumK6PagerDuty

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