Audio is probably one of the more important factors and is often under-invested in or overlooked altogether. Audio quality has a significant effect on the perception of the quality of the experience and impacts the users experience much more than video. It is pretty obvious that both the clinical provider and the patient should be able to clearly understand each other when talking; this is often harder to accomplish in a video exam environment. Most microphones for traditional room video conferencing capture a lot of background noise, so one option is to consider a lapel microphone or a desktop directional microphone if you are going to be providing services from a specific location.
Clinical exam rooms are rather standard in design and made for keeping things clean and free of germs. This means lots of hard surfaces, which sound bounces off quite well. This can lead to echoing or feedback at times. If possible, having sound-absorbing materials on the wall or in the corners of the room can help to reduce the feedback and echo issues.