9 Things Product Managers Get Wrong When Choosing a Telehealth Video Call API

The video call API or SDK that a Product Manager chooses is the foundation on which the entire clinical experience sits. And yet, many platforms are content using solutions that are “good enough”, or simply picking a solution they’ve heard of and assuming the experience will live up to the brand name.

We looked at real user feedback on review sites, developer forums, vendor migration guides, and more to pull together the mistakes that frequently come up when evaluating video call solutions.

Here are 9 of the most common mistakes product teams make and how to avoid them.

1. Not treating HIPAA compliance as a shared responsibility

Almost every credible video call API vendor is HIPAA compliant. The right question to ask is what you have to configure correctly on top of their infrastructure to make your implementation compliant.

HIPAA compliance for a video call API is a shared responsibility model, so while signing a BAA is necessary, it’s not the full story.

Your engineering team typically needs to actively configure things like disabling third-party integrations, locking rooms by default, randomizing meeting identifiers so they can't leak protected health information (PHI), and so much more.

Ask any shortlisted vendor for their HIPAA implementation guide, not just their compliance credential.

2. Focusing solely on technical elements instead of the clinical experience

Generic video conferencing user experience and a telehealth user experience are not the same thing, even though they're built on the same underlying infrastructure.

Patients are often anxious, unfamiliar with technology, and need an experience that's simple, reassuring, and tailored to clinical care. A video call API with an interface built for corporate meetings actively works against a calm, clinical experience.

When evaluating providers, look beyond whether they technically support video calls and specific features. Go one step further and prioritize video call APIs that are designed for telehealth in terms of UI and UX.

This includes features like browser-based joining (a patient shouldn't have to install an app to see their doctor), host-controlled waiting rooms so a patient never accidentally joins before their provider is ready, and a visual experience that feels like an extension of your platform rather than another third-party tool.

3. Ignoring vendor stability and roadmap risk

In 2024, Twilio announced it would discontinue its video call product, forcing many teams to plan costly migrations, revalidate applications, and revisit compliance requirements.

Although Twilio later reversed its decision after customer feedback, the episode highlighted an important reality that if video isn't a vendor's core business, its roadmap can change unexpectedly.

For telehealth providers, that goes beyond engineering resources because it can actually disrupt clinical operations and patient care.

Before choosing a vendor, evaluate whether video is a core product, how long it has been supported, and whether the roadmap is driven by healthcare needs.

Vendors who are solely focused on building WebRTC video call solutions (like Whereby), are less likely to deprioritize the product your platform depends on.

4. Underestimating real integration and engineering effort

"Get started in five minutes with a few lines of code" may be true for a prototype, but a production-ready telehealth experience requires much more.

This includes building compliant features like recording workflows, transcription services, waiting rooms, custom branding to protect PII, and more.

Before choosing a vendor, validate the hardest parts of your use case, not just a basic two-person call. Platforms with prebuilt, customizable UI components and mature web, iOS, and Android SDKs can dramatically reduce development time.

Whereby Embedded, for example, offers a prebuilt UI for teams who want to quickly integrate video and ship an MVP faster with less custom engineering. But also offers full SDKs for those looking to build the UI from the ground up with full flexibility.

5. Overlooking network resilience for real-world patients

A demo call between two developers on office fiber tells you almost nothing about how a video call API performs for a 68-year-old patient on rural DSL.

Telehealth's whole value proposition is reaching patients from wherever best suits them, which means reaching them on exactly the kind of connections video infrastructure struggles with.

This is where underlying architecture matters more than most PMs realize.

Some video call APIs are built specifically to sustain quality in less than ideal connections through global mesh networking using SFUs that optimize automatically to deal with challenging network conditions, rather than assuming consistently strong bandwidth. For example, video quality might be lowered to reduce bandwidth or even stopped altogether to prioritise audio.

So test any shortlisted vendor under throttled bandwidth and on real mobile devices before signing the contract, not just on your office network. Look for features like in-meeting diagnostics so users can self-troubleshoot, live connection indicators to highlight challenging network conditions, and audio-only mode that enables the call to continue even in suboptimal conditions.

We recommend building a POC with a small group of beta testers to test in real-life scenarios first before committing.

6. Ignoring where AI-powered clinical workflows are heading

Video-first telehealth products are increasingly expected to do more than transmit audio and video. Automated clinical note generation, medical transcription, and live captions are quickly becoming differentiators rather than nice-to-haves, and several major video call API vendors are actively building these directly into their developer tools.

A PM who picks a video API purely on today's feature set with no visibility into whether the vendor is investing in HIPAA-compliant transcriptions, live captioning, or clinical documentation risks having to find a second vendor for these features later, or rebuild integrations that could have been native from day one.

So ask vendors directly about their roadmap for AI-powered clinical features, and whether those features (like transcription or captioning) are already available as HIPAA-compliant, native additions.

Solutions that allow for bespoke AI integrations are also worth considering for any specific use cases your platform might need now or in the future. Whereby’s assistants are a great example of AI-enablement with future-proofed flexibility.

7. Overlooking accessibility and language needs for a diverse patient population

Telehealth is supposed to widen access to care, but that only holds if the video experience itself is accessible.

Patients with hearing loss, low vision, limited English proficiency, or older adults less comfortable with technology are exactly the populations telehealth is meant to reach, and they're often the first to be locked out by a video interface that wasn't built with accessibility in mind.

Beyond video quality and HIPAA compliance, evaluate whether a provider supports accessibility features like live captions, transcription, keyboard navigation, screen readers, and multilingual support.

Most importantly, check that the video call API is WCAG 2.1 Level AA compliant. Don't assume that offering transcriptions or captions means the full accessibility picture is covered.

8. Optimizing for price per minute instead of the total cost

Per-minute or participant-minute pricing is the headline metric most video API vendors advertise, but it's rarely what determines your final bill. The real costs often come from other add-on features like storage, transcription, live captions, and more.

For telehealth teams, compliance is another major cost that's easy to overlook. Many providers reserve HIPAA support and a Business Associate Agreement (BAA) for enterprise plans or charge a separate monthly compliance fee, significantly increasing the total cost of ownership.

Unlike many providers, Whereby offers HIPAA compliance and a BAA on all paid plans, not just enterprise tiers, and there is no additional charge for Enterprise customers. Features like Session transcriptions and live captions can also be bundled at a discount instead of being billed separately.

Don’t compare vendors on participant-minute pricing alone. Model your expected usage, including compliance, recording, storage, transcription, and any other required features, to understand the true total cost of ownership.

9. Not scrutinizing the SLA and uptime guarantees

For a telehealth platform, uptime isn't just an infrastructure metric; it's the difference between patients making appointments and missing them. Yet many teams compare video providers without looking closely at the SLA.

So request the full SLA before signing and confirm it covers the video call API itself and not just the vendor's broader platform if they focus on other verticals. Review the uptime commitment, support response times, and service credits for missed targets.

Providers with a strong operational track record, transparent SLAs, and responsive support are better equipped to support the reliability that healthcare teams depend on.

Getting it right from the start

Most of these mistakes come down to evaluating a video call API like generic infrastructure instead of a healthcare-specific, patient-facing decision. The right vendor isn't necessarily the cheapest or the most feature-dense but the one built for compliance, unpredictable patient networks, and long-term stability. A vendor that treats you like a partner, listens to feedback and allows you to inform their roadmap brings undeniable value vs one that just sees you as another customer in their database.

These are the gaps that Whereby Embedded is built to close. Find out why we’re the leading video call provider for telehealth teams globally.