BU Health Sync+: A Self-Hosted VPS Architecture for Real-Time, API-Driven Telemedicine Service Delivery

Abstract

This paper presents BU Health Sync+, a purpose-built, self-hosted Virtual Private Server (VPS) architecture for real-time, API-driven telemedicine service delivery. Unlike contemporary cloud-native platforms that rely on managed cloud services, BU Health Sync+ emphasizes institutional control, data sovereignty, and cost-effective scalability. The system integrates real-time video communication through LiveKit with an integrated TURN server, real-time messaging via Laravel Reverb, a FHIR-compliant RESTful API gateway, and a modular microservices architecture to support teleconsultation and electronic health record management. Developed based on a systematic review of contemporary telemedicine platforms, the proposed architecture addresses key challenges related to data privacy, interoperability, low-latency communication, and infrastructure cost while maintaining clinical effectiveness and compliance with applicable healthcare regulations.