A modern telemedicine database schema designed for virtual healthcare platforms. Includes healthcare provider profiles with credentials, patient management, online consultation booking and tracking, e-prescription generation, and video session recording with duration logs. Ideal for building telehealth startups, virtual clinic platforms, or remote patient monitoring applications in the post-pandemic healthcare landscape.
consultations is both the booking and the clinical note. It carries scheduled_at and status like an appointment, and diagnosis, notes and fee like a visit record — which works because a telehealth consultation is one event with no separate arrival. Prescriptions and the video session both hang off it.
video_sessions is deliberately separate from the consultation it belongs to. A call can drop and be rejoined, so the session carries its own room_id, started_at, ended_at and duration_seconds. Keeping those on the consultation would mean the clinical record changes every time the connection does.
patients.timezone is a column because this is the one clinical product where the two parties are routinely in different ones. Storing it with the patient means a scheduled_at held in UTC can be rendered correctly for each side, and a reminder goes out at a time that means something to the person receiving it.
In-person care separates the booking from the encounter because a patient can fail to arrive. A video consultation has no such gap — the call either happens or the status says it did not. Merging them keeps the clinical note attached to the booking that produced it. The cost is a row that is half-empty before the call and a status column carrying more meanings than it would otherwise.
providers.hourly_rate is the current price and will change. A consultation that charged ninety dollars has to keep saying ninety after the provider raises their rate, so the fee is written onto the row at the time. This is the same reason an invoice never recalculates itself, and it is the only way a billing report run next year is still correct.
The recording itself lives in object storage; the row holds a pointer. That keeps the database small and lets retention be enforced by deleting media without destroying the session record. It also means the pointer can outlive the file, so a null-safe read path matters — and that recordings carry consent and retention obligations the schema does not express.
is_available supports the on-demand model: a patient asks for a consultation now and the system finds someone online. It cannot express working hours, time off or pre-booked slots, which a scheduled-care product needs. The flag is the right floor for an urgent-care service and the first thing to replace for a booking-led one.