Telemedicine in Argentina: Technical Lessons from Building Segimed

Telemedicine in Argentina went from a niche service to a necessity during the pandemic—and it’s here to stay. Patients now expect remote consultations, instant access to their medical history, and the ability to find providers near them. Segimed is our technical answer to that demand.

What Segimed Does

Segimed isn’t just "a Zoom for doctors." It’s a full patient-provider relationship system built for healthcare:

• Real-time WebRTC video consultations (no downloads required)
• Digital medical records with full clinical history
• Instant chat between patients and providers using Socket.io
• Medical facility geolocation with interactive maps
• Clinical dashboards for data visualization
• Appointment scheduling with automated reminders

The platform has been live in production as a digital health solution since launch.

Technical Decision #1: WebRTC for Video Consultations

Early on, we faced a key question: use a managed video service (like Twilio, Daily.co, or Agora) or go native with WebRTC?

We chose native WebRTC for three core reasons:

1. Cost: Managed video services charge per minute of connection time. In healthcare, where consultations run 20–40 minutes, that adds up fast. WebRTC only needs a TURN server for relay (when direct P2P fails), which costs a fraction in comparison.

2. Privacy: Patient video data never leaves your infrastructure. In healthcare, this is critical for compliance with data protection laws.

3. Control: We can add features like consented recording, screen sharing for test results, and virtual waiting rooms without relying on third-party limitations.

The trade-off? Native WebRTC requires more custom code and testing. But for a telemedicine platform handling thousands of consultations, the long-term savings in licensing fees far outweigh the upfront development cost.

Technical Decision #2: PostgreSQL for Digital Medical Records

Medical records aren’t strictly structured. While fields like patient ID, date, diagnosis, and provider are fixed, clinical data varies by specialty (e.g., a cardiologist logs ECGs, a dermatologist records lesion photos).

We use PostgreSQL with JSONB fields to bridge the gap:

• Structured fields (patient, provider, date, type) stored in standard columns with indexes
• Specialty-specific clinical data stored in a JSONB column, defined per specialty
• Full-text search across clinical content using tsvector
• Row-level security (RLS) ensures each provider only sees their patients’ records

This gives us the best of both worlds: structured data where we need it, flexibility where required, and high performance thanks to GIN indexes on JSONB fields.

Technical Decision #3: Maps with Leaflet + OpenStreetMap

For geolocating medical facilities, we chose Leaflet with OpenStreetMap over Google Maps for three key reasons:

• No usage fees: Google Maps charges at scale. OSM is free.
• Full customization: We can style the map to match the platform’s design language.
• Open data: OSM data can be enriched with our own medical info—specialties offered, availability, ratings, etc.

Patients can search by specialty, view real-time availability, and book appointments directly from the map.

Technical Decision #4: Socket.io for Real-Time Chat

Medical chat isn’t like a WhatsApp conversation. It has strict requirements:

• Persistence: Every message is saved to the medical record
• File attachments: Patients can share symptom photos, PDF studies, etc.
• Clinical alerts: The system can auto-insert alerts based on vitals or trends
• Offline-first: If a patient loses connection, messages sync when they’re back online

Socket.io gives us WebSockets with automatic polling fallbacks, reconnection handling, and room isolation for secure conversations. Combined with PostgreSQL persistence, every chat is logged as part of the patient’s medical file.

Unique Challenges of Digital Health Platforms

Regulatory Compliance

In Argentina, Law 27.706 on Telemedicine sets strict requirements: digital informed consent before consultations, secure data storage, and professional accountability. Segimed enforces:

• Digital consent signed pre-consultation
• Full audit logs for every access to medical records
• Encrypted storage and transmission of health data

High Availability

A healthcare system can’t go down. Our infrastructure includes:

• Vercel edge functions for minimal latency across Argentina
• PostgreSQL with 6-hour backups and point-in-time recovery
• Real-time monitoring with alerts: if video fails, the team is notified in under 2 minutes

UX for Non-Tech-Savvy Patients

Many users are older adults unfamiliar with video calls. Our consultation flow is designed for simplicity:

1. One-click "Join Consultation" button
2. Camera/mic permission prompt with clear instructions
3. Virtual waiting room until the provider joins
4. Seamless in-call experience

No apps to install, no meeting codes, no configuration.

Full Technology Stack

Why Telemedicine Is a Growth Opportunity in Argentina

The digital health market in Argentina and LATAM is expanding rapidly. Clinics and private practices that don’t offer remote consultations are losing patients to those that do—and many legacy systems (often running on outdated PHP or .NET) can’t keep up with today’s demand.

If you’re in healthcare and need to modernize consultations, medical records, or workflows, let’s talk. We’ve built Segimed in production and can adapt it to your needs or build a custom solution from scratch.

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By Esteban Aleart, Founder & Lead Engineer at PairProgramming.