Telehealth Session Intermittent Issues: Patient and Provider Not Joining the Same Waiting Room

In some cases, patients may click the telehealth link from the appointment email and appear to be waiting, but when the provider joins, both parties do not enter the same virtual waiting room.

This behavior is expected when a VPN, proxy, or onion network is being used by the patient or provider.

DocVilla’s telehealth system creates a secure, end-to-end encrypted, HIPAA-compliant video tunnel between the provider’s IP address and the patient’s IP address. If either party’s IP address changes during the session, the secure connection is interrupted.

Common causes include:

• VPN (including Apple and Google VPNs) or proxy services that rotate IP addresses to hide/mask IP addresses

• Mobile device user setting to mask/hide IP address of the user

• Network changes (if the patient is traveling) during the session

When the patient’s IP address changes (for example, switching between different geographic locations due to a VPN), the original video tunnel is broken and both parties may end up in different waiting rooms.

DocVilla displays a warning to both patients and providers advising against the use of VPNs during telehealth visits. Unfortunately, there is no additional remediation available on our end in these scenarios.

A new telehealth link is not required.

If this occurs:

1. Ask the patient to hang up or close the session.

2. Have the patient click the same telehealth link again.

3. Ensure the patient has disabled any VPN or proxy services before rejoining.

Once the IP address is stable, the connection will re-establish successfully.

• Advise patients not to use VPNs or proxy services during telehealth visits.

• Recommend patients use a laptop or desktop computer instead of a mobile phone.

• Avoid switching networks (Wi-Fi to mobile data) during the session.

• If using a mobile device, ensure VPNs and network optimization tools are turned off.

Laptops generally maintain a more stable IP address, resulting in a smoother and more reliable telemedicine experience.

• Sending multiple SMS links is not required. Patient just needs to click on the video link again.

• There is no additional system-side remediation available when VPNs or unstable IP addresses are in use.

• You can check the telemedicine logs in a consult and see the IP address of the patient. If the the IP on the patient side is changing, then it means they are using a VPN and there is nothing that DocVilla can do in such cases.

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