Karma Healthcare Trust: Nurse-assisted telemedicine for rural communities

For the 700 million people living in rural India, the government is the predominant health service provider. Yet India’s public health budget is one of the world’s lowest, and the country has just one-sixth as many doctors as it needs, most of them in its 20 most populous cities. Only 32% of rural residents seek care at government-run primary healthcare facilities.[1]

Healthcare is difficult for many in India to access also for lack money to pay for it. About 90% of the country’s poorest people have neither government nor private health insurance, and 59% of health expenditures overall are borne out of pocket. Organisational, social and cultural barriers further hamper access in rural areas.

Karma Healthcare Trust offers comprehensive primary healthcare solutions to rural communities in India through a combination of on-the-ground interventions and cutting-edge technology. With its partners, it runs nurse-assisted telemedicine clinics that deliver evidence-based preventive and curative healthcare services supported by qualified tele-doctors, diagnostics and referrals as well as technology-assisted quality control.

Each Karma Healthcare Trust clinic is equipped with a laptop, a large screen television, a web camera, an internet connection and a printer along with medical devices. After asking the patient about their symptoms, the on-site nurse offers a video-enabled consultation with a suitable doctor based in the  city. This may be a general physician, an internist, an orthopaedist, a dermatologist, a gynaecologist, a paediatrician or a mental health counsellor. The doctor provides a complete consultation, including prescriptions, diagnostic tests and results and ongoing support if necessary, without the patient’s having to leave their village.

Karma Healthcare Trust wants to provide primary and preventative healthcare access to roughly 2.5 million underserved people in India by 2027 through 100 nurse-assisted telemedicine clinics as well as to demonstrate to the Indian government and other stakeholders that its approach is scalable.

In this project specifically, it will open four new clinics, each managed by a nurse and a tele-doctor, in underserved and marginalised communities in Gujarat and Madhya Pradesh. It’s estimated that at least 100 000 people will gain access to quality primary healthcare and at least 24 000 people over the project period will experience improved health resilience as a result of the clinics’ services, which include:

• Timely, quality primary healthcare provided by tele-doctors and guided by Karma's technology system
• Risk assessment and screening for chronic high-burden non-communicable diseases (NCDs) such as anaemia, hypertension and diabetes
• Behaviour change communication and outreach campaigns targeted at specific NCDs
• Access to at least two new value-added services, such as a health insurance product (eg a health card that covers outpatient treatment cost) or a subscription package

60 Decibels - Karma Healthcare Report

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