The application of telemedicine represents a promising paradigm for enhancing healthcare services in remote and inadequately served areas, with the potential to bring significant benefits. In Ecuador, rural communities situated along the Cayapas River face significant challenges pertaining to the provision of healthcare services. These challenges are attributed to two key factors: geographical isolation and the lack of medical specialists in the region. This study evaluates the efficacy of a telemedicine platform implemented on Amazon Web Services (AWS) in improving healthcare accessibility in these rural areas. The study was conducted over a period of two years, between January 2020 and September 2022. The use of a telemedicine platform on AWS EC2 with a free software stack enabled the delivery of teleconsultations via a responsive Joomla template. The vulnerability analysis was based on data security standards, specifically the National Institute of Standards and Technology (NIST) 800-115 standard. The telemedicine platform demonstrated potential for enhancing healthcare delivery, connecting rural doctors with specialists, and improving diagnostic accuracy. However, the platform’s adoption was limited, with a decreasing number of teleconsultations in the previous year. The main challenges were identified as intermittent Internet connectivity, technological barriers, and the lack of willingness to adopt new technologies. Despite the promise of telemedicine, it is imperative to address the technological and training challenges that must be overcome to facilitate its widespread adoption and sustainability in rural areas of Ecuador.