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When Telehealth Grows Up: A Video Infrastructure Transformation.

HomeWhen Telehealth Grows Up: A Video Infrastructure Transformation

When Sessions Health's telehealth video infrastructure hit its limits, we stepped in to scale it to 5,000 concurrent sessions using enterprise-grade Jitsi architecture on AWS.

Sessions Health is a comprehensive practice management EHR platform built specifically for mental health professionals. At the core of their product is a HIPAA-compliant video session experience connecting therapists with clients in private, reliable 1:1 video calls every single day.

As the platform grew, so did the demands on its video infrastructure. Sessions Health had been running a self-hosted Jitsi Meet deployment, but with adoption accelerating, the existing setup was straining at around 500 concurrent sessions. The team needed a clear path to support 10× that volume (up to 5,000 concurrent sessions) without sacrificing call quality, security, or reliability.

Dan Root, Co-Founder, Sessions Health
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The WebRTC.ventures team brought real expertise to a complex problem. They assessed our existing setup, designed a production-grade solution, and collaborated closely with us from implementation through deployment. Exactly the kind of partner you want for critical infrastructure work.

The Needs

Sessions Health’s platform serves mental health professionals and their clients, a context where a dropped call or degraded video quality can meaningfully disrupt a therapeutic relationship. At around 500 concurrent sessions, infrastructure bottlenecks began affecting reliability, putting critical therapy sessions at risk during peak hours. They needed:

  • Massive Scalability. Support growth from 500 to 5,000 concurrent 1:1 video sessions without degradation in call quality or system stability.
  • Reliable Connectivity. Ensure all users, including those on mobile or cellular networks behind restrictive NAT environments, can reliably connect to sessions.
  • Real-Time Observability. Per-call quality metrics (jitter, packet loss, connection quality) surfaced through dashboards so issues can be identified and resolved proactively.
  • Production-Grade Infrastructure. A fully automated, repeatable infrastructure built for high availability that could be deployed, scaled, and recovered without manual intervention.

The Solution

WebRTC.ventures began with a comprehensive assessment of Sessions Health’s existing Jitsi Meet deployment, then designed and implemented a fully modernized architecture capable of supporting enterprise-scale telehealth video.

  • Full infrastructure audit & performance assessment
  • Terraform IaC for all AWS components
  • Multi-region JVB deployment with OCTO
  • Graceful scale-in via drain handler Lambda
  • Custom CloudWatch metrics for application-aware autoscaling
  • Isolated coTurn deployment with EIP pool management
  • Peermetrics integration for session troubleshooting
  • Load testing with Loadero (up to 5,000 concurrent sessions)
  • End-to-end QA including NAT traversal & mobile edge cases
  • Comprehensive deployment documentation & guidelines
  • Ongoing managed service contract for proactive support and continuous improvement

Improved Observability with Peermetrics

WebRTC.ventures integrated our Peermetrics solution to provide real-time visibility into video call performance. The open source platform allows the team to monitor key metrics such as packet loss, jitter, and latency, helping engineers quickly identify and troubleshoot issues affecting call quality.

Combined with AWS monitoring tools, Peermetrics provides clear insights into both infrastructure health and media performance, enabling faster issue resolution and a more reliable telehealth experience.

Tech Stack

  • Jitsi Meet

  • Jitsi Videobridge
  • Jicofo

  • coTurn TURN server

  • Amazon EC2 / Amazon ECS

  • Terraform

  • Grafana

  • Loadero

  • Ruby on Rails

  • Ember.js

  • JSON Web Token (JWT)

  • Peermetrics

Let's turn your project into another story of success.

Contact WebRTC.ventures today!

Client:

Sessions Health

Type of Application:

Telehealth, Mental Health Practice Management, Video Conferencing

Features:

  • Scalable Jitsi Video Bridge (JVB) infrastructure
  • Multi-region deployment
  • Graceful instance scale-in/out
  • NAT traversal via coTurn
  • JWT-based secure authentication
  • Infrastructure as Code (Terraform)
  • Real-time call quality monitoring
  • AWS auto-scaling & high availability
  • Peermetrics integration for observability
  • Load testing & QA automation
  • Ongoing managed support contract

How We Helped:

  • Assess
  • Build
  • Test
  • Manage

WebRTC Services

WebRTC.ventures is one of the few agencies in the world dedicated to WebRTC development. This dedication and experience is why so many people trust us to help bring live video application dreams to life.

  • Assess
  • Build
  • Integrate
  • Test
  • Deploy & Manage

Let’s convert your app into another story of success!

Contact WebRTC.ventures today.
We’re one of the few agencies in the world dedicated to WebRTC development. This dedication and experience is why so many people trust us to help bring live video application dreams to life.

Let's get started!

Contact us today
info@webrtc.ventures

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