Abstract: Described are systems and methods directed to a multi-channel communication system that enables real-time or near real-time communication between two or more individuals, such as a patient and a clinician in which at least one of the individuals uses one device for audio/video communication and another device for exchange of data, such as annotated images. For example, a patient may utilize a patient device to communicate with a clinician via a first clinician device. In addition to the first clinician device, the clinician may also use a second clinician device to annotate and share visual data, such as templates or patient images, with the patient, without disrupting the audio/video communication between the patient device and the first clinician device.