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India has already proved that telemedicine is not a futuristic experiment. It is a working public service at national scale. The question now is whether the country will treat it merely as a digital convenience, or as a serious instrument of health-system reform. In a sense, it replicates for health services delivery what India’s digital services outsourcing business has already achieved for overseas clients.
The numbers are striking. eSanjeevani, the Union government’s national telemedicine service, had served over 311 million patients by 10 November 2024. By 30 November 2025, 1,81,873 Ayushman Arogya Mandirs were operational with teleconsultation facilities available, alongside 41.93 crore teleconsultations and 494.71 crore cumulative footfall. That is not a pilot. It is one of the largest government-led telemedicine platforms in the world.
Yet the real significance of telemedicine in India lies not in the headline numbers, but in what it can fix. India’s public health system still struggles with distance, specialist shortages, overcrowded hospitals, and a painful reliance on out-of-pocket spending. For millions of families, the cost of illness is not just consultation fees. It includes transportation cost, lost wages, repeat trips, caregiver accommodation costs, and the hidden expense of delay. Telemedicine does not eliminate all these burdens, but it can reduce them sharply for a large share of routine care: follow-up visits, chronic disease management, triage, prescription renewal, mental health support, maternal and child health counselling, and specialist advice that does not always require a physical visit.
Beyond primary care, the next layer of telemedicine lies in higher-acuity services such as tele-ICU, tele-radiology, and remote diagnostics, improving last-mile access while extending specialist reach across geographies.
MoHFW’s own telemedicine guidelines emphasize timely access, continuity of care, reduced travel, and lower burden on referral facilities. WHO likewise notes that telemedicine is especially valuable for underserved communities and places where access to brick-and-mortar care is limited.
This is where telemedicine can become a powerful tool against out-of-pocket expenditure. For rural population who must otherwise travel to a district hospital for a five-minute review of blood pressure or diabetes medication, the true cost of care is the journey. If that consultation can happen through an Ayushman Arogya Mandir with a community health officer facilitating the visit, the household saves transport costs, wage loss, and often the expense of unnecessary escalation to higher facilities. In public finance terms, telemedicine can also improve system efficiency by reserving in-person specialist time for cases that truly need physical examination or intervention.
Its equity value is even greater. In theory, every health reform promises universality. In practice, access is shaped by geography, income, gender, disability, and digital literacy. India’s telemedicine model has one important strength over many app-based global models: it does not rely only on a patient owning a smartphone and knowing how to navigate a health platform. The Ayushman Arogya Mandir model offers assisted teleconsultation, with local staff helping patients connect to doctors. That makes telemedicine more inclusive for rural populations, Geriatric patients, women with mobility constraints, and those who are digitally excluded. This assisted model is one reason India’s public telemedicine architecture deserves attention internationally.
India’s telemedicine ecosystem is also shaped by private sector participation, including digital health platforms and hospital-led teleconsultation services. A more deliberate integration of such capacity with public systems can strengthen access, especially in urban and peri-urban areas, and reduce system burden.
Still, India’s telemedicine story is not yet a best-practice story. It is a scale story. The difference matters.
Global leaders show what the next phase should look like. Australia moved telehealth into permanent Medicare-backed care from 1st January 2022, embedding it into routine primary care rather than treating it as an emergency-era exception. NHS England has gone further in some areas by linking virtual care to defined clinical pathways and measurable outcomes; its virtual wards model is tied to hospital avoidance and system performance, with guidance to keep occupancy consistently above 80 per cent, and NHS analysis reported 9,000 hospital admissions avoided in one year in South East England.
In the United States, the Veterans Health Administration delivered more than 11.6 million telehealth encounters, with more than 9.4 million taking place in Veterans’ homes or other offsite locations, showing how teleconsultation becomes even more powerful when combined with remote monitoring and care coordination. OECD’s broader lesson is similar: the strongest telemedicine systems have stable financing, clear governance, embedded workflows, and rigorous measurement of outcomes, not just usage counts.
A critical enabler in these systems is sustainable financing. Telemedicine has been embedded into routine care through insurance coverage, bundled payments, and reimbursement parity with in-person services. In India, this will require alignment across the broader health financing ecosystem, including public schemes such as Ayushman Bharat, private insurers, and provider networks, so that teleconsultation becomes a standard, reimbursable component of care.
By that yardstick, India’s next challenge is obvious. It must move from teleconsultation as access to teleconsultation as integrated care. That means seven things. First, improve reliability: broadband, devices, and uninterrupted workflows at Ayushman Arogya Mandirs. Second, ensure that teleconsultation does not end with advice alone; medicines, diagnostics, and referral pathways must actually work. Third, build stronger specialty access and chronic-care pathways, especially for diabetes, hypertension, mental health, pediatrics, obstetrics, and geriatrics. Fourth, start measuring what really matters: avoided travel, reduced out-of-pocket spending, better adherence, fewer unnecessary referrals, shorter waiting times, and improved health outcomes. Fifth, integrate telemedicine into health systems performance metrics, including throughout, efficiency, and quality care. Sixth, invest in future-ready human resources for health. Telemedicine requires digital fluency, protocol-based decision-making, and effective remote patient communication. Training community health officers, nurses, and doctors to operate within teleconsultation workflows is critical for quality and consistency of care. Seventh, build community awareness and trust. Adoption of telemedicine depends not only on availability but on user confidence in the quality and reliability of care. Targeted community engagement, digital literacy efforts, and consistent service experience will be essential to drive sustained utilization. The broader financing frameworks should include currently excluded but feasible components such as OPD consultations.
Government may buy managed services from the infrastructure providers for telemedicine networks, instead of setting their own networks and issue vouchers like e-RUPI for telemedicine consults. Broadly, the telemedicine coverage and use will also be benefitted from incentives and nudges for digital health coverage.
India should be ambitious here. Telemedicine is not a substitute for hospitals, doctors, or physical infrastructure. But in a country of India’s scale, it can make scarce clinical capacity travel farther than patients have to. It can reduce the economic cruelty of seeking care. And it can bring public healthcare closer to the constitutional promise of equal access.
The first chapter of India’s telemedicine story has already been written in impressive numbers. The second must be written in better equity, lower household costs, and a wider, more dependable basket of services. That is when telemedicine will stop being seen as a digital add-on and start being recognized for what it really is: one of the most important public health multipliers India has.
(Author is with Rodic Digital & Advisory)
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