Evaluating the Quality of Telemedicine Consultations in India’s eSanjeevani Ayushman Bharat Health and Wellness Center Platform: Insights from a Prospective Observational Study
Abhishek J. Arora, Lakshmi Jyothi Tadi, Govindrao N. Kusneniwar, Tulasi Hansadah, Marquis Banylla Marthong, Ismail PathanAbstract
Background:
Telemedicine has become an essential strategy to improve access, equity, and efficiency in healthcare delivery. India’s eSanjeevani platform, initiated in 2019, rapidly scaled during the coronavirus disease 2019 pandemic and continues to deliver large-scale digital consultations. This study evaluated the quality, safety, and effectiveness of patient care provided through the eSanjeevani Ayushman Bharat Health and Wellness Centre (AB-HWC) hub at AIIMS Bibinagar, Telangana.
Methodology:
A prospective observational study was conducted between August 2024 and February 2025. Data from 1100 teleconsultations conducted across 1657 health facilities in 33 districts were analyzed. Consultations covered multiple specialties and superspecialties. Parameters assessed included distribution of consultations across healthcare levels, timeliness of initial assessments, appropriateness of investigations, adherence to e-prescription standards, language of interaction, and provider feedback. Descriptive statistics and thematic analysis were employed.
Results:
Urban primary health centers (35.1%) and Basthi Dawakhana clinics (27.4%) accounted for the largest share of consultations. Orthopedics, dermatology, and general medicine were the leading specialties, while endocrinology and gastroenterology dominated superspecialty care. Initial clinical assessments were completed within 2–3 min in nearly 70% of cases, reflecting operational efficiency. However, appropriateness of investigations was suboptimal, with only 12.3% fully appropriate and 39.5% requiring specialist guidance. All consultations demonstrated 100% compliance with e-prescription standards, and no medication errors were detected. Patient interactions were largely bilingual, with Telugu used for local communication. Provider feedback emphasized the strengths of diagnostic support and prescription safety but noted challenges with waiting times, data entry, and demand for additional specialties.
Conclusion:
The eSanjeevani AB-HWC hub-and-spoke model provides timely, safe, and linguistically inclusive teleconsultations, reinforcing its value in strengthening public health systems. High efficiency and prescription safety are major achievements. Addressing gaps in diagnostic appropriateness, specialist availability, and operational processes will further enhance the effectiveness of telemedicine services in India.