Design, Develop & Hosting of Online Patient

Consultation System Through Mobile App & Web Portal

“Tele-Consultation”
Dhanush at Glance
Dhanush InfoTech is a globally recognized leader in the Healthcare, IT Solutions, Services & Products arena

• Incorporated in 2008 with handful consultants, currently has grown to 3000+ Healthcare & IT professionals
• Built capabilities in Product Development, Medical services Delivery and Operations Management by developing innovative
technology based solutions for Public Primary Healthcare, Screening and Monitoring of Vital parameters
• Solutions are built on future-proof technologies to ensure Modularity, Scalability, User friendliness, Advanced Analytics and
Flexible Integration.
• Experience in the Public, Primary Healthcare domain by partnering with Central , State Governments and UN Bodies in Providing
Quality Healthcare services
• Vast experience of working in Africa, Australia over last 10 years in Development and Delivery of Innovative Healthcare Services
and Solutions
Healthcare Snapshot

Mother & Child Wellness (ANMOL)

Telemedicine & Running PHCs (PHC Upgrade)

Health & Wellness Centers (Sub center)

Hospital Information Management System (HIMS)

Child Screening (RBSK)

VMed– Telemedicine based Video Consultation

 Our Understanding &
Requirement of Scope
 Our understanding of Scope
Develop a telemedicine Mobile App (Android & iOS) and Web Portal:

• Patient Registration for online consolation

• Patient Profile and Activities and old Patient report upload

• In build Video conferencing based Audio-Video-Textual Consultation with a Consultant (one to one basis)

• Automatic Notifications to Patent and Consultant through SMS/ /Email

• Patient can able to download Prescription

• Configurable master data like no. of daily slots, no. of Consultant with, Department, waiting slots, consultation time limit etc. through
Administration level- Admin panel

• Dynamic and configurable Dashboards

• Reports generation faculties for different level.

• Integrated Payment Gateway all kind of payments like UPI, Credit/Debit Card, Net Banking

• Video Consultation module has auto adjustment feature and can toggle between audio / video in case any bandwidth issues.
 Our understanding of Scope
• Option to save the video of consultations for future references

• When Consultant posts the prescription patient gets a notification automatically.

• Common Medicine can be added to the system. Which can be used during prescription by consultant for time saving.

• Common symptoms can be key-in well in advance which can be used during diagnosis by consultant for time saving

• Any user can share the App on popular social media and WhatsApp etc.

• In case any user needs any help, they can refer to the FAQ section

• User manuals for Patient, consultant and Admin.

• For Video Consultation / the video calls the minimum required bandwidth.

• Hosting of the Application

• Support of operations and maintenance of the Application for a period of 3 years from Go-Live.
Architecture & Technical
Approach

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 VMed – Application Architecture

• VMed a Robust Telemedicine Solution released in 2015,

has been installed in more than 500 locations,
especially Labs & pharmacies

• Built on robust WebRTC Application platform, Designed

to handle thousands of concurrent Audio and Video
transactions

• VMed is built on simple Principle of “ Clarity of

Consultation”, even in low bandwidth scenarios

• Doctor will be able to see the patient on Video and

simultaneously will be able to review the past medical
 VMed – System Architecture

VMed a Robust Telemedicine Solution released in 2015, has been installed in more than 500 locations, especially Labs & pharmacies
 Technical Approach

Dhanush uses a Teleconsultation implementation framework for development and implementation of customized Ayurveda telemedicine
Solution
Telemedicine/ Telehealth Service Implementation Model

Strategy

• Ensuring strategy is defined, maintained and then implemented

Design

• Consistent approach to design & Development

Transition

• Pilot to Go Live

Operation

• Support responsive & stable services

Continual Quality improvement

• Continual Improvement of the service based on evaluation & feedback

Exit & Transition

• Exit of service provider with proper transition and sustainability

Type of Teleconsultation
 Teleconsultation – Process Flow
Patient to Doctor (Video Consultation)

Once connected to Video

Download from Play Patient is connected to doctor via
call, at scheduled time
Store Video call as soon as call is
the call is sent to the
received by Doctor
selected doctor

Video Call Prescription is

Patient or AAIA Select Doctor/ Schedules Doctors appointment list has the generated and
Family VMed APP Appointment details of the patient, a telephonic sent o Patient on
Member call is placed between doctor and his/her mobile no
of Patient Based on Symptoms, patient VIA SMA and PDF
location etc. System link
suggests available doctors
Workplan & Maintenance of
Quality

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 Workplan

Month 1 Month 2 Month 3 Dhanush proposes following indicative timelines for

Key Milestones
W1 W2 W3 W4 W5 W6 W7 W8 W9 W10 W11 W12
proposed engagement. Dhanush project manager
would liaise with AIIA in the first week to discuss the
Project Inception
tasks and dependencies and finalize the project plan

Design & Development of Web with time required. The goal of the project plan
& Mobile Application finalization would result in high-level milestones as

UAT depicted below.

Training
From 4th Month to 36th Month – Application Support
Go-Live
& Maintenance will be provided
 Quality Assurance Model
Product development life cycle (PDLC) at Dhanush embraces a diligent phase of product testing and quality assurance for
all the projects that our teams develop over a variegated industry domain. Quality Assurance methodologies adopted at
Dhanush ensure seamless app performance and functionality in today’s fast-changing technology landscape.
Support & Maintenance Process

Approach: Dhanush “Application

Maintenance” team will analyse the
customers’ requirements, product, change
request, the team will set the principles and
approach to be followed for each
application that needs to be maintained. The
team reviews the plan with the customer
and agrees with confidence that the plan is
perfect.

Create: Dhanush “Application

Maintenance” team which is made up of
“Support specialists” will be allocated to
the customers "Application Maintenance"
and each deliverable will be engineered
keeping in view the customer’s
requirements.
Case Studies

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Electronic Urban Primary Health Centers (eUPHC)
• Electronic Urban Primary Health Centers (eUPHC) is a innovative concept introduced by National Urban Health Mission (NUHM) for
delivering advanced primary healthcare services for urban poor population .
• Dhanush has won the eUPHC project which was introduced first time in the country and successfully executed the eUPHC program for a
duration of 5+ Years and increased the no. of footfalls of UPHC’s from less than 10 to more than 100 during this period.
• eUPHC solution was implemented in 4 districts of East Godavari, Vizainagaram, Visakhapatnam, Srikakulam of Andhra Pradesh in 62 UPHCs
and at 12 UPHCs in 3 Districts ( Lucknow, Varanasi and Gorakhpur) of Uttar Pradesh
• Dhanush has provided services to more than 40 lakhs beneficiaries and conducted 1.2 million of tele-consultations.
• eUPHC Program includes end-to-end management of eUPHC including,
o Providing MBBS Doctor at UPHC and Premedical Staff including Pharmacist , Lab
Technician and ANMs
o Teleconsultation with Specialist Doctor, covering Specialties like cardiology, endocrinology,
Gynecology, General Medicine
o Medicine dispensing, Diagnosis and Reports
o Patient Referral to Secondary or Tertiary Hospitals
o Organizing outreach programs
o Providing IEC to Public on Health aspects
• Dhanush PHC team has actively participated in screening Vaccination, Treatment services during
recent COVID pandemic, where in the process 3 Dhanush eUPHC Staff have lost their lives,
while discharging the Covid Duties.

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 Uttarakhand Telemedicine Program

• Uttarakhand Health Systems Development Project [UKHSDP] is conceived as a strategic initiative to enhance people’s access to quality
health care services in the state of Uttarakhand. The Project is financed by the World Bank and implemented by Uttarakhand Health and
Family Welfare Society [UKHFWS].
• Dhanush has won the Uttarakhand Telemedicine project to setup a Telemedicine system following the HUB & Spoke Model to ensure
quality health care delivery to the people in Uttarakhand and successfully implementing Telemedicine program in 400 Health Centers
(Spokes) with 4 Medical Colleges (HUB’s).
• Telemedicine based Primary Healthcare Program includes:
o Implementation of Telemedicine Application at 400 PHCs (Spokes) with
Specialist Doctor Hubs set up at Medical Colleges along with customization
and enhancements of Telemedicine Application as per state Governments
requirements
o Rolling out the Hub & Spoke Model to be setup across the state for provision of
Telemedicine facility on turkey basis.
o Training of the solution for the paramedical and Medical staff of state
Government along with suitable training material
o Application Support & Maintenance of the system

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 eSubCenter/ Health & Wellness Centers

• eSubCenter/ Health & Wellness Centers) an initiative to upgrade the existing subcentres into e-Subcentres to enabling access of MBBS
doctors through Telemedicine, Diagnostics with latest Medical equipment and Dispensation of Medicines through Automatic Drug
Vending Machine at the Subcenters
• Dhanush has won this project which was implemented first time in the country and successfully upgrade the existing subcentres into e-
Subcentres (e-Health & Wellness Centres) for 3,010 Centers in 5 districts of East Godavari, West Godavari, Srikakulam, Vizianagaram,
Visakhapatnam for providing primary healthcare services
• eSubCenter Program includes end-to-end management of eSubCenter including
o MBBS Doctor Consultation through Telemedicine
o Medicine dispensing through Automatic Drug Vending Machine
o Lab / Diagnostics Services by using latest Medical equipment such as Multipara
Monitor, Glucometer and Non- Invasive Haemoglobin meter with required
consumables (Glucometer Strips, Pregnancy Kits, Malaria Kits)
o Capture the detailed Electronic Medical Record (EMR) of the patient using stare
of the art solution for error-free data capture
o Screening services for the population of Age group 30 and above, The clinical
services include screening and advisory services for Key NCDs like Diabetes,
Hypertension, Cardiovascular diseases, Cancer and Stroke
o Above Subcenters includes 40 Subcenters in Tribal and Deep Forest Agency areas

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 MMU Services Offered to Buxar region

Dhanush has commenced this Program, consists of 5 numbers of Fully equipped Mobile Medical Units (MMU) with Advanced Life Supporting
system, carrying Medical Doctor, Lab Technician and ANM, which will be visiting the six segments of Buxar Parliamentary Constituency
namely, Berhampur, Buxar, Dumraon, Rajpur, Ramgarh and Dinara.
• Dhanush is providing the Essential medical services through OPD, being provided at Mobile Medical Unit and adopt below Services
Model to run the Consulting and OPD services at the field level and capturing the detailed information of the patients who avail the
Medical services at the Mobile Medical Unit.
• Services Offered
o Doctor Consultation thru VMed Application in the Field with the MBBS / AYUSH Doctor
available in the MMU
o Diagnosis tests & Lab Reports
o Specialist Consultation through Telemedicine Solution
o Medicine Dispensation, Healthcare awareness Programs including Yoga, COVID
precautions
o Referral Services
o Maintain the database of electronic medical records of all the Patients
o Dashboard & Reports for real time tracking and monitoring of the program

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 Telemedicine Services Offered to Vedanta
Foundation
• Dhanush in collaboration with Vedanta Foundation as a Health Partner providing Quality primary
healthcare services – preventive and diagnostic services at 600 Nand Ghars spread across the states
of Odisha, Chhattisgarh, Karnataka & Jharkhand
• Covering a large part of community from the beneficiaries of Nand Ghar, where in Nand Ghars are
Vedanta’s flagship social initiative and each Nand Ghar caters to a population of 1,000 beneficiaries.
• To provide healthcare at Nand Ghar doorstep for rural communities, leveraging contemporary
technology such as ICT and telehealth. Where in Dhanush is a pioneer in providing Telehealth in
INDIA.
• Primary beneficiaries which includes women, children and old people as part of this program
o For every 25 Nand Ghar’s one Arogya Mithra is assigned where in he/she covers all the
Nandghar beneficiaries twice in a month and giving the services of primary health care,
teleconsultation, non - invasive diagnostics and dispensing OTC medicines etc.,
o Tele Consultation is facilitated by the Arogya Mitras in the local language of the beneficiaries
o Teleconsultation with specialist doctors (Gynecologist, Pediatrician, General Medicine)
o Periodically conducting Health Camps
o Provide real-time dashboard for monitoring of the program

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 Dhanush Services at SVHMS Digital Healthcare
Center
In Association with Swami Vivekananda Health Mission Society (SVHMS), Dhanush has
established Digital Healthcare Center in Dehradun at Dharmawala and provided following
services
• Provision of necessary Hardware Infrastructure
• Provision of Software License along with Integration of Telemedicine Software with
Medical devices
• Provided Training to Doctors and Healthcare Staff on usage of Telemedicine Application
• Providing Application Support and Maintenance services for Telemedicine Solution
• Supported SVHMS in getting required Internet Connectivity at the Centers by coordinating
with local Internet Service Providers
• Set up Specialist Doctor HUB at Yatharth Super Speciality Hospital, Noida for
Teleconsultation
• VSAT based Internet connectivity thru ISRO
• Cloud Server access services to SVHMS

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Telemedicine - Services offered to Greater Chennai
Corporation
• GCC has launched the Telemedicine Services to all the inhabitants of the Greater
Chennai in Technical partnership with Dhanush Healthcare

• GCC VMed App provided by Dhanush has been made available to all the citizens who
can download the same from either Play store (Android) or App store ( iPhone)

• People can reach the Doctor’s hub through Video Consultation by calling the Doctor’s
available on the App from 9:00 AM till 8:00 PM on all days

• Patient can upload the required Documents / past reports / Prescriptions for Doctor’s
review and doctor upon consultation and review will issue the plan of care or
prescription though the App
Greater Chennai Corporation
• The entire TM Consultation is recorded as a Electronic Health Record (EHR)

• With the Success of GCC – VMed, the Municipalities of Salem, Coimbatore and
Pondicherry have adopted VMed in serving their Citizens with Quality Telemedicine
services
Pondicherry Municipality Salem City Municipal
Corporation
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 Telemedicine – Services Offered to Shree Ram
Arogya Mitra Abhiyan
• Shree Ram Arogya Mitra Abhiyan launched in the State of
Telangana, Chhattisgarh, Uttar Pradesh (6 Districts), Gujarat,
Madhya Pradesh and Haryana

• Team of MBBS & Specialist doctors trained on VMed for

conducting the Tele Consultations using the VMed platform

• Doctors are selected from across the states to serve better by

consulting in local language

• 2500+ Arogya Mitras are trained across the states to actively

connect with patients in villages and urban poor

• The project is reaching out to around 2 Crore+ urban &

village population across the states from the states and
targeted districts

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 VMed - Services offered to Abhaya Foundation

Project : COVID Call Centre & Telemedince Solution for Abhaya Foundation
Client : ABHYA FOUNDATION, Telangana
Description: Dhanush through its Cutting edge Telehealth Solution (VIDMED) empowered ABHYA
Foundation to start Telemedicine services, through which they are providing free telemedicine consultation
with doctors. After a consultation, with the help of volunteers, it is ensured that the required medicines,
oxygen concentrator, SPO2 devices, etc., are delivered to patients’ homes. VIDED telemedicine Solution
abides with protocols that are in line with the Telemedicine Practice Guidelines issued by the MOHFW

Key Modules
• Toll free contact number with recording and
IVRS for COVID Patients
• Telemedicine Solutions on Audio, video call
functionality
• System to track request, completion for
oxygen concentrators
• SMS Functionality to share details of
hospitals, doctors, oxygen concentrators etc.,
• Dashboard – Number of Call, Consultations,
Grievances etc.

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Organization Staffing & Key
Personal

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Organizational Staffing
Implementation Team
VMED Application

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Key Features- Snapshot
 VMed – Key Differentiators
Why VMed for Ayurveda Doctors :
VMed platform is 100% legal and safe to practice medicine as per Telemedicine practice
100% Legal & Safe
Guidelines stipulated by CCMI & NITI Aayog

Security & Privacy Encrypted Technology, ensuring complete privacy of the patient, Data security

Easy Consultation Patient can reach the Doctor either by App or through Call Center

Multiple Payment
Patients can remit payments for consultation, Pharmacy or Lab easily through the App
Modes

Most user friendly consultation interface, you can complete the entire consultation in few clicks,
Ease of Usage
no burden of data entry

VMed facilitates capturing AYUSH Specific details Prakriti Analysis, Roga Pariksha, Pancha Karma
AYUSH Specific details
details, AYUSH Specific Medical details

High Quality Consultation

Experience
Excellent video / audio quality, just like seeing Doctor in their office

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 VMed – Key Differentiators (Contd)

Why Ayurveda VMed

• Professional Assistance : Doctors get Smart alerts on Drug interactions and can see the entire past Medical History of the patient available
on VMed, like, Prescriptions, Radiology Images, ECGs, Videos ( 2D Echo, Sonography )

• Expansion of Practice : Helps the growth of the practice by sending patient reminders about appointment, refills, investigation

• Advanced Devices : The Prescription written on paper using a Special pen can be automatically sent to the VMed system and also will be
emailed / WhatsApp to patient , thus easing the use of VMed

• Configurable Platform: built on Configurable design principles, platform can handle

various Current business requirements or Future Enhancements which can be configured,
rather than coding/testing / deployment cycles

• Easy Administration: with Real time monitoring and dash boards, business operations
through VMed can be supervised for suitable corrective interventions required

• Statutory Compliance: VMed takes care of Tax laws and other Revenue management
compliance factors automatically in the system for all the financial transactions happening
through the Payment gateway

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 Patient Registration

Patient Registration Overview

• Download the VMed Application from Play Store/ App Store
and Install

• Register into the Application by providing basic details like

Name, Date of Birth, Age, Email, Address, Mobile Number to
generate OTP for confirmation and other necessary related
information.

• After successful registration, SMS will be sent to registered

mobile number for confirming registration along with
username and password for logging into the VMed
Application.

• After signing in the VMed Application, Patient can view & edit
his personal details

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 Call a Doctor for Video Consultation
Video Consultation with Ayurveda Doctor
• Patient can consult the Doctor using the Audio / Video Conference
feature of Dhanush Ayurveda VMed Telemedicine Solution
• Video call in two ways 1)Two Way video Call 2)Tri party Call
• Two Way Call :Patient can do the video call directly to the respective
doctor from the mobile application
• Tri party video Calling : when patient call to agent via Toll free
number, based on patient video call choice, a SMS link will be sent
to the patient, when patient click on that link can join the Tri party
call. where doctor agent and patient can communicate, later point of
time agent can disconnect from the call for patient privacy
• Electronic Medical Record (EMR) of the patient records the same,
for future reference.
• Doctor reviews Clinical Record
• Patient assessment in Review of System (ROS) and Physical
Examination Two way call Tri Party call
• Treatment Plan and e-Prescription

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 Call a Doctor for Audio Consultation

Audio Consultation with Doctor

• Patient with the help of agent can consult the Doctor

using the Audio Conference feature of Dhanush
Ayurveda VMed Telemedicine Solution

• Agent can chose the availability of the doctor and can

initiate audio call like
o Direct audio call or book audio call so that
doctor can call back

• Electronic Medical Record (EMR) of the patient

records the same, for future reference.
o Doctor reviews Clinical Record

o Patient assessment in Review of System (ROS)

and Physical Examination
o Treatment Plan and e-Prescription

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VMed - Doctor side Flow of Solution
 Video Consultation with Doctor

• Doctor can have a Video conferencing with patient and prescribe Plan of Chikitsa.

Patient Side • Doctor can view the clinical details such as chief complaints, History of Present Illness,
Previous Past History, Vitals, Investigations suggested, Diagnosis, Drug/Medicine, Advice
• Doctor can prescribe Plan of Chikitsa
• Tri party video Calling : when patient call to agent via Toll free number, based on patient
video call choice, a SMS link will be sent to the patient, when patient click on that link can
join the Tri party call. where doctor agent and patient can communicate ,later point of
time agent can disconnect from the call for patient privacy
Doctor Screen

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 Plan of Care Overview – Details

Plan of Care (POC) Overview

• Doctor can view the clinical details such as patient history and attachments
• Follow up : If in case doctor want to do follow up consultation then doctor will select this
option so that system will auto fill all the details from previous consultation so that doctor
can update the details and save the prescription

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 Plan of Care Overview – Covid-19

Covid-19 : Covid-19 protocol is automated, symptomatic scores will be auto populated ,Treatments Mentioned As Per The Stages like
preventive, Mild, Moderate, Sever and post covid-19 rehabilitation

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 Plan of Care Overview – Plan of Chikitsa(POC)

Detailed Plan of Chikitsa(POC) :

• Capturing the details of

o Chief Complaints

o Diagnosis

o Drugs/ Medicines

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 Plan of Care Others

Plan of Care Details

• Capturing the details of

o Vitals

o History of past illness

o Past History

o General Assessment

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 Plan of Care Overview – Others ( Contd)

Plan of Care Details

• Capturing the details of

o Pancha Karma Procedure/

Investigations

o Advice

o Referral/Lab preferred
/Pharmacy preferred

o Roga Pariksha

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 Offline Consultation
• Patient to Doctor Audio call from Social media

• Doctor can create new

patient

• Doctor can search patient

• Doctor can do offline POC

and save the record

• Patient will get SMS

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 Appointment for Audio call
Patient Side Doctor Screen

Doctor Call Back

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 ePrescription

Below is the screenshot of ePrescription

• After completion of Doctor

consultation, Patient can view his
recent consultation related details such
as Vitals, Investigations and Drugs/
Medicine.

• Patient can view ePrescription details

given by the consulted doctor

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