The COVID-19 pandemic has accelerated the shift towards digital communication in healthcare, with telehealth becoming a normative approach to providing care. Building a custom-built telehealth platform is crucial for organizations to have control over patients' and providers' experiences and integrate the platform seamlessly into existing workflows. A modern telehealth platform should facilitate a synchronous experience with features such as a waiting room, audio-only sessions, recording capabilities, and integration with electronic health records or wearables. Understanding the provider and patient experience is vital in determining whether to develop a web application or desktop application, and leveraging tools from Twilio can help build high-quality video platforms while ensuring HIPAA compliance.