With advances and availability of information and communication technology infrastructures in some nations and institutions, patients are now able to receive healthcare services from doctors and healthcare centers even when they are physically separated. The availability and transfer of patient data which often include medical images for specialist opinion is invaluable both to the patient and the medical practitioner in a telemedicine session. Two existing approaches to telemedicine are real-time and stored-and-forward. The real-time requires the availability or development of video-conferencing infrastructures which are expensive especially for most developing nations of the world while stored-and-forward could allow data transmission between any hospital with computer and telephone by landline link which is less expensive but with delays. We therefore propose a hybrid design of applications using hypermedia database capable of harnessing the features of real-time and stored-and-forward deployed over a wireless Virtual Private Network for the participating centers and healthcare providers.