Zoom RTMS for AI Scribe

If your practice uses AI Scribe on Zoom video visits, you can optionally set up Zoom's Real-Time Media Streams (RTMS) so AI Scribe captures both the provider and the patient directly from Zoom's servers, instead of relying on your device's microphone. This is especially helpful if providers wear headphones on calls, since a microphone alone often can't pick up what the patient is saying in that case.

This is separate from the video call integration setup — RTMS uses its own Zoom app, with its own credentials, in addition to the app you already created for hosting Zoom meetings.

RTMS is entirely optional. If you skip this setup, or Zoom doesn't have it available for a particular call, AI Scribe automatically records through the device microphone instead — video visits are never blocked on RTMS being set up.

Prerequisites

The video call integration with Zoom already set up.
The Zoom Developer Pack, which RTMS requires.
Zoom account owner or admin access.

Steps

To create your Zoom RTMS app:

Go to https://marketplace.zoom.us/
Sign in
Click on the "Develop" dropdown in the upper right and click on "Build App"
Choose "General App" as the app type, then select "User-managed" for how the app is managed
Set "RTMS App" as your app name and hit "Create"
On the App Credentials tab, copy the Client ID and Client Secret
Set the OAuth Redirect URL to https://cloudrun.{{project_id}}.avonhealth.com/v2/zoom/rtms/oauth/callback
Copy the Secret Token
Create an RTMS webhook subscription:
- Under event types, select RTMS Started in Meeting and RTMS Stopped in Meeting
- Set the Event notification endpoint URL to https://cloudrun.{{project_id}}.avonhealth.com/v2/zoom/rtms/webhook
- Hit Save
In the "Scopes" tab, add the following scopes:
- Under Meetings:
  - meeting:read:meeting_audio — get all real-time audio streams of a user's meetings
  - meeting:read:meeting_transcript — get all real-time audio transcripts of a user's meetings
- Under RTMS:
  - rtms:read:rtms_started — triggered every time a meeting host or participant starts a real-time stream
  - rtms:read:rtms_stopped — triggered every time a meeting host or participant stops a real-time stream

Where the steps above say {{project_id}}, use the project ID your Avon contact gives you — it's specific to your account, not something you choose yourself.

Copy the Client ID, Client Secret, and Secret Token and paste them in the Onboarding Typeform that was sent to you, or send them directly to your Avon contact.

Update your existing Server-to-Server app

Go back to the Server-to-Server OAuth app you created for the video call integration (the one used to call Zoom's REST API) and add one more scope:

meeting:update:participant_rtms_app_status:admin

This lets Avon tell Zoom to start RTMS for a specific meeting when a provider begins an AI Scribe recording.

As the Zoom account owner or admin, go to https://zoom.us/account/setting#tab-zoomapps and:

Make sure Share realtime meeting content with apps is turned on
Under Auto-start apps that access shared realtime meeting content, select "RTMS App"

Get the authorization link and have providers install the app

Once your Avon contact has confirmed the Client ID, Client Secret, and Secret Token have been added to your account:

On your RTMS app's page in the Zoom Marketplace, go to Add your app, under the Local Test section, to find the generated Authorization URL.
Before sharing it, verify the app itself is configured correctly: click the Local Test dropdown in the top right corner and select Add your app. If everything is set up correctly, you'll see "App installed."
Share the Authorization URL with every provider who will use AI Scribe on video visits — each provider needs to open it and click Authorize themselves, since the app is user-managed rather than account-wide.

How it works during a visit

Once set up, there's nothing extra to do in Zoom for each individual visit. When a provider presses Scribe Now during a video visit, Avon automatically requests RTMS for that Zoom meeting. If Zoom confirms it's available, audio streams directly from Zoom, separated by participant. If it isn't available for that call, AI Scribe falls back to the device microphone automatically.

Troubleshooting

Only one side of the conversation was captured: RTMS likely wasn't active for that call and AI Scribe fell back to the device microphone, which mainly picks up whoever is near it. Confirm that specific provider has authorized the RTMS app (see Get the authorization link and have providers install the app).
The transcript shows a generic "Speaker" instead of a name: RTMS wasn't the audio source for that visit, or the participant's Zoom display name didn't match the name on file for the appointment.
RTMS worked before but stopped working: Check that Share realtime meeting content with apps is still on and your RTMS app is still selected under auto-start apps — these account settings can be changed later by another admin.