How to build a HIPAA-compliant telehealth app with Tellescope, AWS Chime, and Expo

Creating HIPAA-compliant, mobile-first telehealth applications often requires trade-offs: between rapid iteration and long-term maintainability, between native SDKs and a unified developer experience, and between backend abstraction and UI flexibility.

In this article, we share how Vinta Software built a modern, open-source video conferencing demo for telehealth using:

• Tellescope: a backend platform for patient communications and workflow automation
• AWS Chime: HIPAA-compliant video calling infrastructure
• Expo Modules API: for building custom native modules in the Expo ecosystem

The result is a scalable, developer-friendly architecture that balances native performance with React Native productivity. View the GitHub repository.

Why Tellescope is a strong backend for telehealth

Tellescope offers an API-first platform that empowers teams to build modern patient experiences with full control over design and workflows.

Key features include:

• Secure multi-channel communication (video, SMS, email, chat, phone);
• White-labeled scheduling and outcome tracking;
• Developer-centric SDKs and backend tooling;
• Native integration with EHRs like Medplum;
• Built-in HIPAA compliance and scalability support.

This combination allows teams to move fast without compromising on security, extensibility, or integration standards.

Why we rebuilt AWS Chime integration

Tellescope’s earlier video call demo was based on amazon-chime-react-native-demo, which is now an outdated project with a few important limitations to consider:

• No support for Expo or managed workflows;
• Required manual native linking;
• Used legacy React Native lifecycle patterns.

These limitations hindered modern development teams — particularly those utilizing TypeScript, over-the-air (OTA) updates, and modular stacks — from rapidly and effectively integrating video features.

Instead of relying on monolithic or legacy patterns, we rebuilt the demo from scratch using the Expo Modules API and native Android SDKs. This enabled a more maintainable, idiomatic, and scalable integration.

Building the integration using Expo and AWS Chime

We created a custom native module, expo-aws-chime, using the Expo Modules API. This approach allowed us to wrap the AWS Chime SDK and expose it via React Native primitives:

• React hooks (useChimeMeeting);
• A context provider for session states (ChimeMeetingProvider);
• A native view component for rendering video tiles (ExpoAWSChimeView).

We then integrated this module with Tellescope’s API, using the SDK to:

• Authenticate as a provider;
• Create or retrieve a patient (EndUser);
• Initiate a CalendarEvent to start a video call.

Patient Journey (in testing)

To simulate a full interaction during development, the following flow is used:

1. The provider logs in via the mobile app (currently Android);
2. The app creates a Calendar Event and starts a video session with a selected patient;
3. The developer opens the patient's view via Tellescope’s impersonation feature in the browser;
4. The patient joins the video call from the browser portal.

This setup enables full end-to-end testing of HIPAA-compliant video sessions using mobile + web.

The app UI uses NativeWind for styling and Gluestack UI v2 for components.

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Why AWS Chime is still a solid video solution for healthtech

Even though the official React Native demo was deprecated, the core AWS Chime SDKs remain actively maintained, secure, and production-ready. Their continued use in healthcare solutions is justified by:

• HIPAA compliance and enterprise-grade SLAs;
• Fine-grained media-level control for video/audio;
• Seamless backend integration with Tellescope.

By using the Expo Modules API, we preserved these infrastructure benefits while removing the maintenance burden of outdated React Native patterns.

Future improvements and opportunities for healthtech teams

This proof-of-concept lays the groundwork for expanding the demo into a more robust and production-ready foundation for mobile telehealth. Based on common clinical and infrastructure needs, next steps could include:

• iOS support, following the same Expo Modules pattern;
• Clinical documentation workflows, such as drafting SOAP notes from calls;
• AI-powered summarization, to extract actions, medications, or risks from conversations;
• Speech-to-text transcriptions, enabling asynchronous review and compliance logs;
• EHR-like timelines and event extraction, surfacing structured follow-ups like referrals or re-evaluations from unstructured call data;
• Integration with asynchronous tools, such as secure messaging or automated pre-call intake.

Each of these directions addresses real-world constraints of digital care delivery while leveraging the modular, API-first foundation established in this implementation.

Secure patient-provider messaging is another natural extension for supporting asynchronous care scenarios. In the Medplum Chat App example, we've also explored how to build FHIR-native, compliant chat functionality using Medplum and React Native.

If your product roadmap focuses on broader care coordination, diagnostics, or longitudinal records, FHIR-native tools such as Medplum and lab integration APIs like Junction present exciting opportunities ahead. These platforms can enhance your mobile app’s backend capabilities while ensuring the patient experience remains personalized and compliant.

For teams looking to extend this architecture into fully customized EHR solutions, Medplum’s flexibility also supports frontend-driven innovation. In our Medplum Design System guide, we've documented how to bridge design and FHIR constraints using Mantine, Storybook, and Figma.

This demo is open-source and designed to support teams eager to explore HIPAA-compliant video and backend integration for mobile health platforms.

If you're building digital health infrastructure and need a HIPAA-compliant foundation for video communication and backend integrations, our team can provide technical expertise and proven delivery.

Need to accelerate your telehealth roadmap?
Talk to our team about your use case.