How we developed and launched the telemedicine platform for the Grand Duchy of Luxembourg

Healthcare is one of the most rapidly growing industries in the world

As numerous studies show, the market is growing by 7% annually, and by 2023, its volume will reach $9,725.4 billion. At the same time, the global market of telemedicine services will increase to $41.2 billion by the end of 2021.

The situation

The COVID-19 pandemic, which began in 2020, has played a large role in the rapid growth of the telemedicine industry. The first cases of coronavirus infections in Europe were recorded in January 2020, and by the spring, the healthcare industry around the world was forced to bear a great burden.

Patients’ problems

During the lockdown, most clinics and medical offices were closed. Luxembourgers, as well as citizens of other countries, were advised to stay at home and to avoid visiting hospitals and other medical facilities unless absolutely necessary. Patients had almost no opportunity to contact medical specialists and receive advice or the necessary treatment.

The solution brought to Luxembourg

In order to facilitate access to healthcare services for its citizens throughout the local lockdown, as well as to reduce the risk of spread of the virus, the Luxembourgish government commissioned the Agence eSanté (Health Agency), to urgently deploy a “teleconsultation platform”.

The Wagner Group was selected to supply this platform and joined forces with Gcore in order to develop and deliver it.

What is eConsult?

eConsult is a telemedicine platform. It facilitates access to healthcare by connecting patients and doctors online. Simply put, it helps patients get expert advice anytime, anywhere. For the convenience of doctors and patients, it was decided to develop a modern web application, with mobile applications having been released in the meantime.

The task

The eSanté eHealth agency commissioned technical contractors, Gcore and the Wagner Group, to develop a web application using a self-written CMS that could securely and intuitively schedule and support audio and video patient consultations for physicians and other professionals based on a dedicated calendar.

Requirements for the web application

The communication between doctors and patients had to have enhanced protection, and the information had to be stored on a dedicated and fully redundant servers hosted in Luxembourg. The telemedicine service needed to be a cross-platform solution that patients run in a browser, without the need to download third-party apps.

At the same time, the entire medical history of patients had to remain confidential and be stored in patient cards, with their data located strictly within the eConsult platform.

Four important additional features

• A built-in prescription tool for doctors.
• The ability to securely exchange medical records and test results with patients.
• Compatibility with all popular operating systems and devices, including smartphones, tablets, and laptops.
• A dedicated nurse catering module for “home nursing” organizations.

eConsult app technical features

WebRTC. Video calls in eConsult are implemented on the WebRTC real-time video transmission technology, which minimizes the delay to a maximum of 1 second.

Browser support. The application works in the following modern browsers: Chrome 70+, Safari 12+, Firefox 70+, Opera 60+. The video feature is available on computers, mobile phones, and tablets.

SFU. For communication between doctors and patients, the SFU (Selective Forwarding Unit) method is used, which allows the exchange of data through the server. All communication is encrypted. The SRTP protocol is enabled, which allows secure transmission of data in real time.

Operation via VPN. Video calls work even in corporate networks with strict security rules, where access to the network is provided via a VPN or where most of the non-standard ports are closed.

Simulcast Streaming. For video transmission, the Simulcast Streaming technology is used for adaptive delivery of a video stream to all participants in a video call, so high-quality broadcasts can be provided, even with an unstable internet connection. The server accepts multiple media streams and then decides which of these streams should be sent to each of the participants, depending on their personal bandwidth, in real time. This happens dynamically to ensure the quality of the video conference.

Project stages:

• Improving the old system and preparing it for the transition to the new one
• Creating the MVP of the new platform
• Releasing the first version of the new platform—functionality for doctors and patients
• Creating the administration platform
• Releasing the second version of the new platform—functionality for nurses
• Business analytics of new features
• Creating the mobile application—functionality for patients
• Creating the mobile application—functionality for nurses

How much time did we spent on development?

19,639 staff-hours

What solutions made it possible to speed up development?

To reduce the budget and the time spent on creating the application, we offered to integrate our own solution—a successfully functioning service of video calls and conferencing..

The results

The eConsult telemedicine platform was developed and launched in a record six months. It’s physically located in a dedicated public cloud infrastructure specially designed for the Wagner Group by Gcore Cloud and situated in the EDH Tier IV data center in Luxembourg.

The eConsult platform is available today to both healthcare professionals and Luxembourg residents and workers.

This solution allows patients to receive quality medical care remotely, which was especially important during the initial outbreak of the pandemic and will be in demand in the future.

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