eSanjeevani – National Telemedicine Service

eSanjeevani was rapidly rolled out nationally to tackle unprecedented challenges hurled by the COVID-19 pandemic and it has shaped into the world’s largest government-owned telemedicine system. eSanjeevani has been conceptualised by the Ministry of Health & Family Welfare, Govt. of India and since 2020 it has been acting as a parallel stream of the Indian healthcare delivery system for citizens across the country. It is facilitating several prestigious national initiatives like Ayushman Bharat Scheme, Digital India, Ayushman Bharat Digital Health Mission, etc.

eSanjeevani has been indigenously designed, developed, deployed, operationalised, and maintained by the Health Informatics Group at C-DAC’s branch in Mohali (Punjab). It has already served over 155 million patients (as on date 4 September, 2023) nationwide. The service has been operationalized through 1,31,772 HWCs (as spokes) which are served by 13,725 hubs and 238 online OPDs serviced by more than 1,90,598 doctors, 124 medical specialists and super-specialists and health workers as telemedicine practitioners. eSanjeevani is operational in all states and UTs in India. On 19 July 2023, this mammoth telemedicine platform touched its peak by serving over 515,530 patients in a day and on a daily basis it is serving over 350,000 patients. eSanjeevani has been augmented to serve over 1 million patients per day. 

eSanjeevani – which is seen as one of the crown jewels of Digital India leverages the might of Information Technology to enable remote consultations with doctors, specialists, and superspecialists. It is a primary healthcare innovation that bridges the digital health divide by extending the reach of quality health services to the masses in the country living in rural areas and in isolated parts of the country.

eSanjeevani is nationally operational in two modes:

1. eSanjeevaniAB-HWC: A provider-to-provider telemedicine system (for assisted teleconsultations) under the Ayushman Bharat Scheme of Govt. of India, operating in a hub and spoke model. Health & Wellness Centres act as the spokes, and these spokes are linked with hubs set up in Medical Colleges/District-Level Hospitals, etc. These hubs are populated with doctors and specialists. eSanjeevaniAB-HWC has also been customised in the form of specialised telemedicine networks such as tele-stroke management and telenephrology in specific regions.
2. eSanjeevaniOPD: A Patient-to-Doctor, telemedicine system to enable people to get outpatient services in the confines of their homes. eSanjeevaniOPD was launched as soon as COVID-19 touched Indian shores. The key aim of eSanjeevaniOPD was to provide safe health services to the populace. Since then, it has continued to grow even in the post-lockdown scenario. People have taken well to this service as it allows them to consult doctors, bypassing avoidable elements such as: travel, waiting time, risk of infection, etc. eSanjeevaniOPD has actively eased off the burden on the hospitals, which can thereby cater to more serious patients. In many states, eSanjeevaniOPD is enabling health services round-the-clock 365 days a year.

eSanjeevani is an out-and-out, state-of-the-art intervention that makes use of a wide range of native cloud services. At present around two dozen cloud services are being used to ensure that eSanjeevani auto scales as per the inflow of the traffic. The cloud services also empower eSanjeevani to seamlessly support thousands of consultations per day. eSanjeevani has digitised many aspects of healthcare consequently making diagnosis and treatment convenient such as automated ePrescriptions. Moreover, eSanjeevani technology is designed in such a way that it encourages replicability and interoperability. Numerous innovative processes and workflows have been designed within eSanjeevani, e.g. eSanjeevani practitioners prescribe medicines based on real-time availability of medicines in government’s warehouses in patient’s locality, in this case, medicines too are dispatched to the patients. This automates the entire service, end-to-end i.e. from consultation to delivery of medicines. eSanjeevani enables seamless, wireless import of results (PoCT and RDTs) from IoT-based medical devices.

The main stakeholders/ beneficiaries of this initiative are:

• Citizens in the country, including those who are residing in rural and isolated areas and were so far not privileged enough (for one or the other reason) to avail health services at a secondary or a tertiary health facility.
• Doctors and healthcare workers.
• Health Administrators and policy-makers who are committed to ensure the provisioning of health services to the populace of their region.

The eSanjeevani - National Telemedicine Service has created a huge social impact across India and a made telemedicine a familiar modality for seeking health services especially amongst the masses, thereby it has been duly recognised on multiple forums:

• ‘Digital India Award’ – 2020, ‘Innovation in Pandemic’ (Platinum) conferred by the Honourable President of India
• Digital Technology Sabha 2020 award for ‘Excellence’.
• SKOCH Award 2021 (Gold) in the category ‘Health’.

Considering the scalability and the ruggedness ‘eSanjeevani’ offers, MeitY has offered to the whole world eSanjeevani as a Digital Global Good, which is now one of the 12 population scale state-of-the-art applications in IndiaStack (https://www.indiastack.global/esanjeevani/). As the Internet is the only prerequisite for using the National Telemedicine Service, eSanjeevani has democratised healthcare services in the country.  This one of its kind of telemedicine platform is being augmented further and is continually evolving.

Use Cases

• Provides specialised health services to rural and isolated areas across India.
• Facilitates free quality health services to all citizens in the confines of their homes.
• Helps to control infectious diseases by avoiding unnecessary visits to the hospitals.
• Facilitates faster decision making by policy makers w.r.t. optimised utilisation of human resources and medical infra. for better utilisation.
• Digitization of health records of patients for ease of usage in the future.
• Extends health services to inmates in prisons.

Salient Features

• Cloud-based real-time telemedicine system.
• Enables Video-Audio consultations between the Doctor and the Patient.
• Seamlessly integrated with numerous healthcare IT applications.
• Based on Hub & Spoke architecture.
• Modelled on EHR & Telemed Practice Guidelines of MoHFW.
• Ayushman Bharat Digital Mission (ABDM) compliant.
• Complies with SNOMED-CT and Generic Drugs nomenclature.
• Interfaced with Made in India diagnostic devices.
• Double hop consultations.
• Automated feedback mechanism