The verdict in three sentences
For a 30-physician clinic in Miami, a custom telemedicine platform costs about 16,500 to 30,000 USD (10 to 18 million FCFA) when built with a nearshore or offshore team, while local Miami agencies typically quote two to three times more, with a realistic timeline of 4 months. Consumer video tools are fine for a pilot, but they do not handle patient records, card prepayment before the visit or the requirements of HIPAA, starting with a signed Business Associate Agreement. The real opportunity is remote patients: someone in Bogotá or Orlando paying 60 to 120 USD for a follow-up visit quickly pays back the platform.
Generic tool or dedicated platform: what you are really buying
A clinic's telemedicine runs on three flows: booking with prepayment, the video visit itself, then follow-up (prescription, visit summary, lab results). A generic tool only covers the second, and poorly from a confidentiality standpoint.
| Criterion | Consumer video + messaging | Off-the-shelf telehealth SaaS | Custom platform |
|---|---|---|---|
| Upfront cost | Almost zero | 2,500 to 5,000 USD setup | 16,500 to 30,000 USD |
| Subscription | 0 to 25 USD/month | 40 to 100 USD per provider per month | Hosting and maintenance only |
| Prepayment and refunds | Manual, outside the tool | Basic | Built into booking |
| Patient records | None | Standard templates | Tailored to your specialties and forms |
| Data hosting | Vendor servers, no BAA | HIPAA hosting with BAA | HIPAA-eligible cloud you control |
| Time to launch | 1 day | 4 to 8 weeks | 4 months |
For 30 physicians, a SaaS at 60 USD per provider is about 1,800 USD a month, or 21,600 USD a year, with limited customisation. Over three years, custom becomes competitive once the clinic exceeds 300 virtual visits a month.
Budget line by line
Most of the cost sits in secure video and patient records. The rest is classic business software.
| Module | 2026 range (USD, nearshore) | Watch-outs |
|---|---|---|
| Booking and calendars for 30 physicians | 2,500 to 4,000 | Time zones for remote patients, SMS and WhatsApp reminders |
| Card, Apple Pay and Google Pay prepayment | 1,500 to 3,000 | Mandatory prepayment, refund on cancellation |
| Encrypted video (WebRTC) | 4,000 to 7,500 | Audio-only fallback for weak connections |
| Patient records and visit notes | 4,000 to 8,000 | Role-based access: physician, nurse, front desk |
| E-prescriptions and result sharing | 1,500 to 3,000 | Physician signature, timestamped PDF |
| Compliance, security and audit logs | 2,500 to 4,500 | HIPAA risk assessment, access logs, backups |
| Total | 16,500 to 30,000 | 4-month delivery, clinical acceptance testing included |
Add recurring costs: HIPAA-eligible hosting at about 80 to 250 USD a month, video traffic depending on volume, and maintenance. At Kolonell, application maintenance ranges from 35,000 to 120,000 FCFA a month (about 50 to 180 EUR) depending on service level, and our complex custom applications start at 7 million FCFA (about 10,670 EUR); the final quote depends on the scope we validate together.
HIPAA and health data: the concrete obligations
Video visits, records and messages all contain protected health information (PHI). Before go-live, the clinic needs a documented risk assessment, a Business Associate Agreement with every vendor that touches PHI (hosting, video, email, SMS), and written security policies. In practice, the platform must provide encryption in transit and at rest, strong authentication for clinicians, a log of every record access and explicit patient consent to telehealth. If you treat patients outside Florida, check state licensure rules for each physician. These items represent 10 to 15% of the budget, but they prevent a blocked launch or penalties that can reach tens of thousands of dollars per violation category.
Mini case study
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Dr. Morales, medical director of a 30-physician multispecialty clinic in Coral Gables (hypothetical persona), targets 400 virtual visits a month: 250 out-of-area patients at 90 USD and 150 local follow-ups at 45 USD. Monthly revenue reaches 22,500 + 6,750 = 29,250 USD. With a platform at 23,000 USD and 650 USD of monthly running costs (hosting, video, maintenance), and assuming a 30% net margin on these visits, i.e. 8,775 USD, the net monthly gain is about 8,100 USD. The investment pays back in roughly 3 months after launch.
FAQ
How much does a telemedicine platform cost in Miami in 2026?
With a nearshore or offshore team, budget 16,500 to 30,000 USD for a 30-physician clinic with encrypted video, patient records and payments. Local Miami agencies usually quote 50,000 USD and more for the same scope.
Does the video work on weak mobile connections?
Yes, if the platform includes adaptive bitrate and an audio-only mode. A video visit uses about 300 to 500 MB per hour at medium quality, versus 30 MB in audio only.
Do we need a Business Associate Agreement before launch?
Yes, every vendor that stores or transmits PHI must sign a BAA. Major cloud providers sign one at no extra cost on eligible services, and you should plan 2 to 4 weeks to collect them all.
How do out-of-area patients pay?
By card, Apple Pay or Google Pay through a processor like Stripe, with HSA and FSA cards accepted when eligible. Processing fees are usually around 2.9% plus 0.30 USD per transaction.
Can we keep the clinic's existing calendars and EHR?
Yes, syncing with Google Calendar or with your EHR through its API is possible. It usually adds 800 to 2,500 USD depending on the API available.
Let's scope your project. Send us the number of physicians, the specialties involved and your target volume of virtual visits, and we will return a scope, an indicative budget and a 4-month plan. Detailed quote within 48 h. WhatsApp +221 77 596 93 33.
Mohamed Bah
Fondateur, Kolonell
Passionate about digital and entrepreneurship in Africa, Mohamed has been helping Sénégalese businesses with their digital transformation since 2020. Founder of Kolonell, he believes every SME deserves a professional and accessible online présence.
