Conventional development of telemedicine systems usually leads to a medical information driven paradigm that tends to fail in capturing suitable abstraction when developing conference-oriented telemedicine systems for assisting the proceeding of telemedicine practices. By reviewing publicly available telemedicine systems through commonality and variability analysis, we have identified common design concerns and tried to provide a framework for supporting reuse-based development. Based on identified common design concerns, a generic model of conference-oriented telemedicine systems and layered architecture are illustrated as a basis for analyzing typical design problems encountered when developing similar systems. As the main part of our work, we have proposed seven commonly occurring design problems and realized a framework implementation to provide a general resolution to these design problems based on the generic model and layered architecture of conference-oriented telemedicine systems. Finally, the details of the proposed framework are explained and a comparison with related telemedicine systems is given.