World is now moving in the era of high information and communication technology. Under the term telemedicine and tele-cooperation research series are carried out presently, intended to enable and expand a distributed, group-related cooperative work within the area of medicine. For this purpose, applications are needed, which support real-time control processes, distributed applications, communication and cooperation technology, and the representation of shared information and data. Real-Time Protocols are the basis of telemedical applications. They are needed in almost all fields of telemedicine reaching from communication transmission to reliable data transfer. In a telemedical system, how these real-time protocols are used for communications, collaboration with telemedicine applications is worth to be explored and has been discussed in this research article along with the challenges of real-time applications and their solutions by using real-time protocols.