Under the strategic background of the Internet and big data, the technical means of telemedicine show strong advantages in the consultation and treatment of various acute and chronic diseases so that the majority of patients can enjoy high-quality medical resources and save unnecessary costs. The resulting medical management decision-making has also become a research topic widely concerned by experts and scholars in relevant fields at home and abroad. In this article, the multiagent optimization decision-making problem in telemedicine has not formed a systematic research system, and there is a lack of corresponding decision-making analysis methods. In view of this, based on the optimal decision theory and decision-making method in telemedicine, this article focuses on the preferences and behavior strategies of participants in the context of telemedicine and makes a phased and in-depth foundation for management and the decision-making of each link of telemedicine. Theoretical research and specific decision analysis methods have certain theoretical and practical significance. The design ideas and implementation process of the acquisition converter and client software are introduced in detail. In order to support the system with good scalability and maintainability, not only is a communication plug-in designed above the transmission layer, but also a transcoding plug-in is designed to support the protocol conversion of medical equipment. The design idea and implementation process of acquisition converter and client software are introduced in detail.