How Ayushman Bharat and Telemedicine Are Transforming Rural India

Introduction 

India has made great progress, but certain areas—particularly healthcare infrastructure at the primary level—still require major development. Despite numerous efforts by the government, some gaps remain.
The biggest challenges include doctor shortages, lack of equipment, poor health records, and the long distances patients must travel to access care. This causes overcrowding at district hospitals and delays in treatment.

To address this, the government launched Ayushman Bharat, aiming to provide free, easy, and reliable healthcare to all, especially the rural poor.
A key feature of the scheme is telemedicine through e-Sanjeevani, which brings online consultations directly to villages.

This model focuses on Health and Wellness Centres (HWCs), digital records, and access to specialists. It’s a major step towards ensuring that every Indian, regardless of location, can access quality healthcare.

India has witnessed significant economic growth and development in other aspects over the past years, but the health field hasn’t witnessed the same level of growth. Despite remarkable achievements in improving life expectancy, there has been improvement in child death, maternal death, and infectious diseases such as malaria and tuberculosis, and in dealing with other health priorities. But the progress rate has fallen short of many national and global targets.
Although the government has taken many steps to improve conditions, such as adopting the three-tier system for providing basic, preventive treatment to people at different levels and in different settings, challenges remain.

Even though there are different healthcare programs and schemes run by the Government of India through the National Health Mission, the primary rural population does not have full access to them.
But what are the factors that lead to such general problems? Here we can list a few, such as –

• Not enough doctors and specialists for the rural population, with only one government hospital for two or three villages. For example, if there is any serious accident, the person has to rush directly to the district hospital or nearby city.
• The doctors and healthcare workers at health centers don’t have enough training, resources, or access to advanced technology.
• In rural areas, it’s also hard for people to get medicine and treatment close to where they live. Consequently, district and urban hospitals become crowded since individuals have no option but to travel long distances to obtain treatment. This puts a great burden on those hospitals, and patients end up waiting for extended hours or days before they receive care.
• Another problem is that health records are not well kept at village and small-town levels. Without good records, it becomes challenging to follow up on patients’ histories, which is crucial in providing appropriate treatment. There is also a lack of continuity of care, meaning that patients do not necessarily receive follow-up treatment after their first visit. This results in poor health outcomes.

To address such important healthcare issues at the primary level, the government has decided to use information technology more effectively, such as:

• The Ayushman Bharat Scheme, which has provided a new opportunity to enhance healthcare by establishing Health and Wellness Centres (HWCs)
• Introduction of e-Sanjeevani
• Introduction of Electronic Health Records

The Ayushman Bharat

Full name – Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)

The Ayushman Bharat is a major healthcare program introduced and launched by the Government of India. Its main goal is to provide free and affordable healthcare to poor and vulnerable families across the country. The scheme has two components:

• The Ayushman Bharat scheme has provided a new opportunity to enhance healthcare by establishing Health and Wellness Centres (HWCs). These centres are intended to offer a range of services at the primary level such as treatment of common diseases, geriatric care, mental health services, and emergency services.
• In 2018, the government pledged to upgrade approximately 1.5 lakh primary and sub-health centres into HWCs. These centres would serve not only mothers and children but also adults suffering from conditions such as diabetes, high blood pressure, and mental illness.
• In tribal and hilly regions, the centres are designed to cater to smaller populations due to challenging geography.
• One of the most important components of this plan is the use of telemedicine through a platform called e-Sanjeevani.

E-Sanjeevani

e-Sanjeevani is a government-run online doctor consultation platform in India. It was developed by CDAC (Centre for Development of Advanced Computing). It helps people talk to doctors over the internet, especially in rural or remote areas.

There are two main types of services in e-Sanjeevani:

1. e-Sanjeevani OPD – allows patients to talk directly to doctors from home using a phone or computer
2. e-Sanjeevani AB-HWC – connects health workers at HWCs with doctors in larger hospitals for support and advice

Impact of e-Sanjeevani

• This system enables physicians in cities or district hospitals to offer advice and treatment to village patients via video calls and online reports.
• A study revealed that although telemedicine projects existed in many states, they were operating independently and could not communicate with one another. To address this, the Ministry of Health selected e-Sanjeevani as the national platform to ensure consistent quality care across India.
• The government developed guidelines for setting up this system, including the required equipment, staff training, and budgeting. Under this model, medical colleges and district hospitals act as hubs, while HWCs serve as spokes.

States can also establish additional hubs if necessary or collaborate with private or charitable hospitals. HWCs will be equipped with computers, internet, cameras, and diagnostic tools to conduct telemedicine consultations effectively.

• Health workers at these centres, known as Community Health Officers (CHOs), will be trained to operate technology and provide basic treatment before connecting patients with doctors via video consultation.
• e-Sanjeevani is user-friendly and works on desktops and mobile phones.
• It integrates with diagnostic equipment to collect data such as blood pressure, blood sugar, and heart rate.
• Health data is retained online, allowing for better treatment in follow-up visits.
• Patients receive SMS reminders for appointments and prescriptions.

Benefits expected from the model include:

• Helping villages with a shortage of doctors. Even without a nearby specialist, patients can get expert advice.
• Reducing the burden on district hospitals as more patients are treated locally.
• Establishing proper health record systems.
• Ensuring continuity of care and follow-up treatments.

Government’s Implementation Strategy

• Every hub in a medical college will have MBBS doctors and specialists available for consultation.
• These doctors will assist in training CHOs and help with patient reports.
• PHCs (Primary Health Centres) will act as telemedicine centres, either providing consultations directly or linking patients to specialists.
• CHOs at sub-health centres will be the first point of contact and will handle initial check-ups and treatment.
• In emergencies, they can contact hub specialists and dispense medicines via e-Sanjeevani.

Telemedicine

Telemedicine allows people to access healthcare without going to a clinic or hospital. It uses video calls, mobile phones, and internet to connect doctors and patients.

Initially, this service focuses on three key areas:

• Heart care
• Women’s health
• Children’s health

To support these services, health centres will receive kits for basic tests on-site, reducing the need to travel. This saves time, money, and effort.

The central government will provide funding and tech support. CDAC Mohali, the developer of e-Sanjeevani, will handle training and maintenance. States will set up centres, hire doctors, train staff, and monitor performance. Villages will also see awareness drives and health camps.

If a centre is underperforming, state authorities will intervene and implement improvements.

Health centres will be equipped with a computer, internet, camera, and testing kits. The government advises using existing infrastructure to save costs.

The goal is to make quality healthcare available to all, even in remote villages, without long-distance travel or high expenses.

Digital health records will allow doctors to track patient history, which supports better treatment.

In the coming years, more centres will be upgraded and connected. Early diagnosis and treatment for chronic conditions like diabetes and hypertension will become more accessible, helping people lead healthier lives.

Conclusion: A Step Toward Health for All

India’s adoption of telemedicine and the Ayushman Bharat scheme marks a crucial step in addressing long-standing rural health challenges.With more Health and Wellness Centres, trained personnel, digital records, and virtual doctor access, even remote communities now have a chance at better healthcare.

As connectivity and services improve, families will benefit from timely check-ups, accurate diagnoses, and better management of chronic diseases like diabetes and hypertension. Ultimately, the goal is simple: to ensure every Indian can receive affordable, quality care—right where they live.

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Written by Team Member(s) and Ms. Sonal Rai.

References:

1. National Health Mission. (n.d.). Retrieved from https://nhm.gov.in/
2. Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana. (n.d.). Retrieved from https://www.myscheme.gov.in/schemes/ab-pmjay
3. Ayushman Bharat Digital Mission. (n.d.). Retrieved from https://en.wikipedia.org/wiki/Ayushman_Bharat_Digital_Mission
4. National Health Mission. (n.d.). Retrieved from https://www.ibef.org/government-schemes/ayushman-bharat