Identical Telemedicine-Enabled Clinics in Three Different Geographies: Our Learnings




telemedicine, rural health, underserved communities, social issues, primary healthcare, last mile care delivery


Background: Scarcity of primary care is felt most in underserved communities. Telemedicine (TM)-enabled clinics bridge the gap in such scenarios. There was a need to understand how the same TM model would work in different settings.

Aim: The aim was to study outcomes in three identical TM-enabled clinics in different geographies so as to understand how to scale up clinics in future.

Setting: Three totally different sites were chosen: a rural village with low socioeconomic status, a rurban (rural-urban) prosperous village, and an urban slum. The clinics planned was identical. The process of establishment, training, recruitment and treatment guidelines were the same. Any deviation was noted.

Methodology: Data were gathered through public health survey, interactions with villagers and local leaders, medical examination of individuals, feedback from patients, and household survey to understand the socioeconomic status of the community.

Main outcome measures: The article attempted to study how different social, cultural, and economic settings affected the outcome of identical TM clinics.

Results: TM, though accepted in different settings, was not sufficient to meet the healthcare needs of the community. These needs were related to the social and economic characteristics. Public health initiatives along with TM were most beneficial. In the underserved areas, infrastructure posed challenges to implementing TM, and ‘Last Mile Care Delivery’ was essential to create the full impact of TM.

Conclusion: TM-enabled clinics along with last mile care delivery are the key to improve healthcare in underserved communities. Further research into customized TM models for different geographies would help in providing the best care.

Limitations of the study: The study period was 4 months. The study was in one state of India, so the applicability of the findings to other states/countries may vary.


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Edwards N, Smith J, Rosen R. The primary care paradox – new designs and models. Brussels: KPMG; 2014.

Ayushman Bharat. Comprehensive primary health care through health and wellness centers operational guidelines. 2018. Available from: [cited 30 September 2018].

Freed J, Lowe C, Flodgren G, et al. Telemedicine: is it really worth it? A perspective from evidence and experience. BMJ Health & Care Informat 2018; 25(1): 14–18. doi: 10.14236/jhi.v25i1.957

Howden-Chapman P. Housing standards: a glossary of housing and Health. J Epidemiol Community Health 2004; 58: 162–8. doi: 10.1136/jech.2003.011569

Solar O, Irwin A. A conceptual framework for action on the social determinants of health. Discussion Paper Series on Social Determinants of Health. 2) 1. Socioeconomic factors. 2. Health care rationing. 3. Health services accessibility. 4. Patient advocacy. I. World Health Organization. Geneva: World Health Organization; 2010.

World Health Organization. Telemedicine: opportunities and developments in member states: report on the second global survey on eHealth 2009. (Global Observatory for eHealth Series, 2). WHO Global Observatory for eHealth. Geneva: World Health Organization; 2010.

Telemedicine practice guidelines enabling registered medical practitioners to provide healthcare using telemedicine [This constitutes Appendix 5 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics Regulation, 2002]. 2020. Available from: [cited 20 March 2020].



How to Cite

Mankar, S. ., & Paradkar, N. . (2021). Identical Telemedicine-Enabled Clinics in Three Different Geographies: Our Learnings. Telehealth and Medicine Today, 6(2).



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