Disrupting rural healthcare with user friendly mobile triage

Healthcare is a major concern among rural and tribal people in India, as it is in every developing country throughout the world. Healthcare facilities are not easily accessible, affordable, or readily available. India and the rest of the world struggle to find general physicians in government hospitals and primary healthcare centers (PHCs), in contrast to urban areas where people have access to high-quality healthcare through private hospitals. A lack of access to specialists is another major concern in areas where the need for care of pregnant women, chronic elderly patients, dependent children, and workers with occupational health difficulties is of the utmost importance.

Due to the lack of regular staff at government hospitals and PHCs, most rural communities either obtain medical care from nearby unqualified healthcare providers (Quacks) or they must go a long way, spending a lot of time and money visiting doctors who reside in big cities.

People have used Telemedicine services more than ever since the COVID-19 outbreak began. A new study from the University of Maryland School of Public Health discovered that people in rural regions encountered higher challenges to adopting these telemedicine techniques than those in urban areas. Shortage of Medical professionals, Distance and Transportation, Social Stigma, and Privacy Issues are some of the key problems in Rural areas which can be addressed using telemedicine. Unfortunately, due to a lack of knowledge and technology device access people do not get the opportunity to utilize the telemedicine model of consultation.

To use the existing Telemedicine platforms the rural community needs to take the support of individuals who has the knowledge to understand and access such platforms using a mobile phone. This becomes the biggest barrier for the rural community to even explore this alternative. Additionally, rural communities believe in meeting their Health workers in person rather than meeting them virtually. Among these challenges, a support system in the form of Health workers can make a true difference in adopting telemedicine in Rural communities. The most crucial necessity of vital checks for the Doctor is not addressed in the current telemedicine platforms so the Health workers again will become an enabler who can connect the Remote Doctor with the Local Health worker and ensure the quality of treatment is enhanced.

Regardless of how simple we make the technology in terms of ease of access, people in rural communities cannot use the same technology on their own. Can you imagine a pregnant woman in a remote area calling a gynecologist on her own? Do you believe she will be able to identify the doctor based on her qualifications and make an online payment to schedule a telemedicine consultation? I don't believe this is even remotely possible. We recognized that telemedicine may perform miracles in the inner villages if it is aided by someone from the area who is familiar with connecting and talking with professional doctors.

Good health is a basic human right that should be accessible to everyone, no matter their location or circumstances. Unfortunately, access to quality healthcare remains a challenge for many people living in rural areas, where medical facilities are often limited, and specialists are few and far between.

Consider a situation where a routine visit to an Outpatient Department (OPD) in a city hospital is replicated in a remote rural setting. In such an environment, the local health worker is the first point of contact for patients and is responsible for providing initial care and treatment. However, due to the limited resources and expertise available in rural areas, it can be challenging for these health workers to diagnose and treat patients effectively.

To address this challenge, a unique triage process has been integrated into a simplified mobile application. This innovative approach serves as a bridge between rural patients and specialist doctors based in the city. The application allows the health worker on the ground to gather essential information about the patient's condition and transmit it to the specialist doctor, who can then provide guidance on the appropriate course of treatment.

By empowering the local health worker with this triage process, patients in rural areas have access to the same quality of care that they would receive in a city hospital. This helps to close the gap between urban and rural health services, providing a brighter and healthier future for all. Additionally, the use of technology in this manner helps to reduce the burden on the health worker, allowing them to focus on providing quality care to patients, rather than struggling with complex medical equipment or processes.

In conclusion, by providing rural patients with access to quality health care, we can help to improve the health and well-being of communities in remote areas. The use of a mobile application that integrates a unique triage process is a step towards ensuring that everyone has a chance at good health, no matter where they live.

In this model of care as the Doctor is not physically required to be present in remote areas the cost of healthcare services can be reduced to almost 40%.

According to the WHO 2020 world health statistics report, over 40% of all countries have fewer than 10 medical doctors per 10,000 people, more than 55% have fewer than 40 nursing and midwifery personnel per 10,000 people, more than 68% have fewer than five dentists per 10,000 people, and more than 65% have fewer than five pharmacists per 10,000 people.

It is obvious that there are not enough physicians to go around; thus, we must discover a means to minimize their friction while still maximizing their outcomes. The fact that most of them prefer to reside in cities rather than villages is another significant problem, particularly for rural areas.

Caare solution empowers health workers in local areas to use simplified Mobile apps so that they can become a bridge between the Patient and the Specialist Doctor. A Health worker at the patient's home can simplify the process for the patients and doctors can get the crucial vitals of patients allowing them to give a better treatment plan. Caare's innovative mobile app is increasing access to rural communities by empowering community health workers to facilitate telemedicine through a simple app.

Below are some of the social & economic benefits of our solution.

•A dedicated front-line worker for a village concept can open a job opportunity for a health worker in their own area.

•A facilitated telehealth intervention will aid in the development of front-line workers' skills and provide the groundwork for telehealth services, which might eventually become the standard method for obtaining healthcare services in remote regions while negating all obstacles.

•Telehealth can increase the accessibility of resources to areas with poor access to essential services in neighboring villages. Rural areas will be able to readily access health care right at their front doors.

•The government or other organizations might utilize the information provided by the village's health workers to track the progress of healthcare programs.

•Disease mapping can be done of the respective Gram Panchayat through Primary and secondary data sources for the action plan of the Government.

Our concept has been successfully applied to a few significant nonprofit organizations, including the Mobius Foundation, WISH Foundation, and Sundesh Foundation. My team and I traveled to these remote places to put our idea into action. Many foundations have already agreed to employ our strategy to solve the lack of doctors in their health initiatives. One of the key reasons many find our model unique is due to the fact that we are not forcing the doctors to move from their location, and similarly, we are asking the patients to reach out to city hospitals for their primary healthcare needs. As a lean team, we have been able to successfully implement a few pilots and are now signing long-term deals with large foundations and corporations. This alone can showcase our capability as a team to deliver the solution for marginalized communities.

We have successfully treated more than 500 Patients through our pilot platforms with various foundations.

We signed a confidential disclosure agreement with Abbott Diagnostics Medical Pvt Ltd to meet the requirements of underserved populations, Abbott will pair the Caare hybrid telemedicine platform with its Rapid Diagnostic Test Kits. The first pilot is now being worked on in the western region of India.

Additionally working with the District Magistrate of Prayagraj, the largest district of the biggest state in India, Uttar Pradesh on a pilot where we are digitizing 38 Subcentres under the Handia Block of Prayagraj. Sub-Centre is the most peripheral and first contact point between the primary health care system and the community. The District Magistrate has agreed to give us access to the ANMs (Auxiliary Nurse and Midwife) at the Subcentre level to whom Caare Platform access is provided so that the rural patient's primary healthcare issues are addressed and medicines are dispensed. This model will reduce the burden on the Primary Healthcare centers and also improve the efficiency of community healthcare centers. We are waiting for the final approvals to initiate the project. We are expecting to provide care for a minimum of 400 rural patients a day once we start on the new project.

MIT, known for its cutting-edge research and innovation, is the ideal venue to showcase and advance our solution for basic healthcare in marginalized locations. By joining this program, we will have the opportunity to take our solution to places where it is most needed, addressing the healthcare disparities faced by marginalized communities around the world.

One of the key strengths of MIT is its global reach and reputation as a leader in research and development. As a renowned institution with a strong emphasis on interdisciplinary collaboration, MIT provides a unique platform for us to communicate and share our solutions with a global audience of researchers, policymakers, and industry leaders. The diverse and vibrant community at MIT, comprising students, faculty, and staff from various backgrounds and expertise, provides a fertile ground for meaningful discussions, exchange of ideas, and collaborative efforts to advance your solution.

MIT's emphasis on cutting-edge technologies and innovation aligns well with our vision to develop solutions that can enhance basic healthcare in marginalized locations. Moreover, the strong emphasis on entrepreneurship and innovation at MIT will enable us to explore avenues for commercialization, scale-up, and implementation of our solution to make a tangible impact on the ground.

MIT's commitment to social impact and sustainability also aligns with our goal of addressing healthcare disparities in marginalized locations. Through various initiatives and programs focused on global health, social entrepreneurship, and sustainable development, MIT provides a conducive environment to promote and amplify the social impact of your solution. This includes opportunities for fieldwork, partnerships with local organizations, and collaborations with global health stakeholders to implement our solution in real-world settings.

Furthermore, MIT's network of alumni, partners, and collaborators spans the globe, providing you with access to a wide range of resources, expertise, and opportunities for the dissemination and scaling of our solution. The prestigious reputation and global recognition of MIT will lend credibility and visibility to our work, helping us to effectively communicate and advocate for our solution to a wider audience, including policymakers, funding agencies, and other stakeholders.

In summary, MIT provides an ideal venue for us to communicate, develop, and enhance our solutions for basic healthcare in marginalized locations. With its global reach, emphasis on innovation, commitment to social impact, and network of resources and expertise, MIT will empower us to take our solution to places where it is most needed and make a meaningful difference in improving healthcare access and outcomes for marginalized communities worldwide.

The solution of a powerful and efficient triage process integrated into a user-friendly mobile application, used by local health workers in remote rural areas to duplicate a routine visit to an Outpatient Department (OPD) in a city hospital, is highly innovative for several reasons:

1. Bridging the healthcare gap: This solution addresses the significant healthcare gap faced by remote rural areas, where access to quality healthcare is often limited or nonexistent. Empowering local health workers with a mobile application that enables efficient triage, brings essential healthcare services closer to the community, helping to bridge the gap between rural and urban healthcare.

2. Technology-enabled triage: The integration of a triage process into a mobile application makes the solution highly efficient and convenient. Local health workers can use the mobile app to assess and prioritize patients based on their symptoms, medical history, and other relevant information. This enables them to provide timely and appropriate care, optimizing the use of limited healthcare resources in remote rural areas.

3. User-friendly interface: The user-friendly interface of the mobile application makes it accessible and easy to use for local health workers, who may not have extensive medical training. The app likely includes features such as simple navigation, clear instructions, and intuitive design, making it usable even in low-resource settings with limited technical expertise.

4. Scalability and replicability: The solution is replicable and scalable, as it can be easily deployed in various remote rural areas with different healthcare settings and resource levels. The mobile application can be adapted to local contexts and customized as per the specific needs of the community, making it a flexible and adaptable solution that can be implemented in different regions and countries.

5. Empowering local health workers: The solution empowers local health workers by equipping them with a powerful tool to provide timely and appropriate care. It leverages their existing knowledge and skills while augmenting their capabilities with technology, enabling them to play a critical role in delivering healthcare services to their communities. This empowerment of local health workers can lead to increased efficiency, improved patient outcomes, and enhanced community engagement.

6. Potential for impact: The solution has the potential to significantly enhance healthcare access and outcomes in remote rural areas. Optimizing triage, can help identify patients who require urgent care, facilitate timely referrals to higher-level healthcare facilities, and prevent unnecessary visits to distant hospitals. This can result in improved patient outcomes, reduced healthcare costs, and better overall healthcare management in underserved areas.

In summary, the integration of a powerful and efficient triage process into a user-friendly mobile application, used by local health workers in remote rural areas, is highly innovative as it addresses healthcare disparities, leverages technology, is scalable and replicable, empowers local health workers, and has the potential for significant impact in improving healthcare access and outcomes in marginalized communities.

Here are some potential steps that could be taken to implement the solution in the next 5 years:

1. Needs assessment: Conduct a comprehensive needs assessment of remote rural areas to identify the specific healthcare challenges and gaps that need to be addressed. This may involve engaging with local communities, healthcare providers, and other relevant stakeholders to understand their healthcare needs and priorities.

2. Technology development: Collaborate with experts in healthcare technology, mobile application development, and user experience design to develop a robust and user-friendly mobile application for triage. The application should be designed to work offline, considering the potential limitations of internet connectivity in remote rural areas. It should also be adaptable to different languages and cultural contexts to ensure inclusivity.

3. Training and capacity building: Develop training programs for local health workers to familiarize them with the mobile application and the triage process. This may involve providing training on how to use the application, conducting assessments, and prioritizing patients based on their symptoms and medical history. Ongoing support and mentoring may also be provided to ensure that local health workers are proficient in using the application.

4. Community engagement: Engage with local communities to raise awareness about the mobile application and the benefits of the triage process. This may involve conducting community outreach programs, organizing health camps, and leveraging local networks and leaders to promote the adoption of the solution. Involving the community in the design and implementation of the solution can help build trust and ownership, leading to increased acceptance and sustainability.

5. Piloting and evaluation: Conduct pilot programs in selected remote rural areas to test the effectiveness and feasibility of the solution. This may involve evaluating the impact of the triage process on healthcare outcomes, patient satisfaction, and healthcare resource utilization. Feedback from local health workers, patients, and other stakeholders should be collected and incorporated into the refinement of the solution.

6. Scaling up: Based on the outcomes of the pilot programs, refine and scale up the solution to other remote rural areas. This may involve expanding the implementation to more health facilities, training additional local health workers, and leveraging partnerships with local and international organizations to support the scaling-up process. Continuous monitoring and evaluation should be conducted to ensure the sustainability and effectiveness of the solution.

7. Policy advocacy and funding: Advocate for supportive policies and funding from relevant stakeholders, such as governments, NGOs, and philanthropic organizations, to sustain and expand the implementation of the solution. This may involve showcasing the impact and value of the solution through evidence-based data and success stories and advocating for policy changes that promote the use of mobile health technologies in remote rural areas.

In conclusion, by leveraging the strengths of local health workers, engaging with communities, and utilizing innovative technologies, this solution has the potential to significantly enhance healthcare access and outcomes in marginalized areas.

We are a participant in villgro.org's ongoing IMMpact Training Programme, which will provide a practical understanding of the various elements of measuring and managing impact through in-depth sessions with industry experts and leading professors from Harvard Business School and The University of Chicago Booth School of Business.

https://villgro.org/immpact/

We're just getting started with the Global Impact Investing Network's (GIIN) IRIS+ six impact theme model. We are convinced that by the conclusion of the programme, we will have a thorough understanding of the Impact measurement.

The scenario described, where a powerful and efficient triage process is integrated into a user-friendly mobile application for local health workers in remote rural areas, has the potential to positively impact the theory of change in several ways:

1. Improved access to healthcare: The use of a mobile application for triage can help bridge the gap in access to healthcare services between urban and remote rural areas. By equipping local health workers with a tool that allows them to conduct triage effectively, the application can help identify and prioritize patients based on their symptoms and medical history, enabling timely and appropriate healthcare interventions. This can lead to improved access to healthcare for remote rural communities, where access to healthcare facilities and trained healthcare providers may be limited.

2. Efficient healthcare resource utilization: The integration of a powerful and efficient triage process into a mobile application can optimize the utilization of healthcare resources in remote rural areas. By accurately identifying the severity of patients' conditions and prioritizing their care, the application can help local health workers make informed decisions about the appropriate level of care needed. This can prevent unnecessary referrals or hospitalizations, and ensure that patients receive the right care at the right time, leading to more efficient utilization of healthcare resources.

3. Enhanced healthcare outcomes: The use of a user-friendly mobile application for triage can potentially lead to improved healthcare outcomes in remote rural areas. By enabling local health workers to identify and prioritize patients based on the severity of their conditions, the application can facilitate timely and appropriate healthcare interventions. This can lead to early detection and management of health conditions, reducing morbidity and mortality rates, and improving overall health outcomes in remote rural communities.

4. Empowerment of local health workers: By providing them with a tool that enhances their decision-making ability and clinical skills, the application can boost their confidence and competence in providing healthcare services. This can also contribute to capacity building and professional development, empowering local health workers to play a more prominent role in their communities healthcare delivery system.

5. Innovation in healthcare delivery: The use of a mobile application for triage in remote rural areas represents an innovative approach to healthcare delivery. By leveraging technology to enable local health workers to conduct triage efficiently, the application can disrupt traditional healthcare delivery models and bring about positive change. This innovative approach has the potential to inspire other healthcare providers, organizations, and policymakers to adopt similar solutions, leading to a broader impact on healthcare delivery in marginalized locations.

In summary, the scenario of a powerful and efficient triage process integrated into a user-friendly mobile application for local health workers in remote rural areas can positively impact the theory of change by improving access to healthcare, optimizing healthcare resource utilization, enhancing healthcare outcomes, empowering local health workers, and driving innovation in healthcare delivery. This can ultimately lead to positive changes in healthcare systems, outcomes, and equity in marginalized locations.

Some of the key technologies that are involved in the core technology of this solution include:

1. Mobile platform: The solution would require a mobile platform, such as a smartphone or tablet, that local health workers can use to access the triage process. The mobile platform would serve as the primary interface for the application, allowing health workers to input patient data, access medical information, and receive guidance on triage decisions.

2. Data collection and management: The mobile application would need to collect and manage patient data to conduct triage effectively. This could involve capturing patient information, such as demographics, medical history, and symptoms, through digital forms or other data collection methods. The data would be stored securely and managed in a database or cloud-based system to support real-time triage decision-making.

3. Clinical decision support system: The core technology would include a clinical decision support system that provides guidance to local health workers in making triage decisions. This could involve using algorithms and rules-based logic to analyze patient data and generate recommendations on the urgency and priority of care based on established clinical guidelines or protocols.

4. User-friendly interface: The mobile application would need to have a user-friendly interface that is easy to use and understand for local health workers with varying levels of digital literacy. The interface would likely include intuitive navigation, clear instructions, and visual aids to support the triage process.

5. Connectivity and communication: The solution would require connectivity to enable remote rural health workers to access the triage process and communicate with other healthcare providers or facilities if needed. This could involve internet connectivity, mobile networks, or other means of communication, depending on the available infrastructure in the remote rural area.

6. Security and privacy: The core technology would need to prioritize security and privacy to protect patient data and comply with applicable regulations. This could involve measures such as encryption, authentication, and access controls to safeguard the confidentiality and integrity of patient information.

7. Integration with existing healthcare systems: The mobile application would need to integrate with existing healthcare systems, such as electronic health records (EHRs) or health information exchange (HIE) systems, to enable seamless information exchange and coordination of care. This could involve interoperability standards and APIs to facilitate data exchange and integration with other healthcare systems.

Overall, the core technology that powers the solution described in the scenario would likely be a mobile application that integrates a powerful and efficient triage process, along with data collection and management, clinical decision support, user-friendly interface, connectivity and communication, security and privacy, and integration with existing healthcare systems. These technologies would work together to enable local health workers in remote rural areas to conduct triage effectively and provide timely and appropriate healthcare interventions to patients.

The simple approach to inclusivity in the context of the described solution for remote rural healthcare could involve the following principles:

1. Accessibility: Ensuring that the mobile application and its triage process are designed to be accessible to all users, including those with disabilities or limited digital literacy. This could involve using clear and simple language, providing visual aids, offering options for different font sizes or color contrasts, and accommodating different input methods (e.g., touch or voice commands).

2. User-centric design: Involving end-users, such as local health workers and patients, in the design and development process to understand their needs, preferences, and challenges. This could involve conducting user research, usability testing, and incorporating feedback to make the mobile application intuitive, easy to navigate, and user-friendly.

3. Language and cultural sensitivity: Taking into consideration the linguistic and cultural diversity of the remote rural areas where the solution is implemented. This could involve providing language options that are commonly spoken in the local community, using culturally relevant visuals and examples, and being mindful of cultural norms and practices in the design and content of the application.

4. Connectivity options: Considering the limitations of internet connectivity in remote rural areas and providing offline functionality, where feasible. This could involve designing the mobile application to work offline or with low bandwidth, allowing local health workers to use the solution even in areas with limited or unreliable internet access.

5. Training and support: Providing comprehensive training and ongoing support to local health workers to ensure they are proficient in using the mobile application and its triage process. This could involve providing training materials in local languages, offering on-site or remote support, and addressing any barriers or challenges that local health workers may face in using the solution.

6. Affordability: Ensuring that the solution is affordable and cost-effective for local health workers and the healthcare system in remote rural areas. This could involve leveraging existing hardware or infrastructure, using open-source or low-cost technologies, and considering sustainability models that are feasible in the local context.

7. Equity: Ensuring that the solution is accessible and available to all patients in remote rural areas, regardless of their socioeconomic status, gender, age, or other factors. This could involve addressing disparities in access to healthcare and tailoring the solution to meet the unique needs of diverse patient populations.

By incorporating these principles of accessibility, user-centric design, language and cultural sensitivity, connectivity options, training and support, affordability, and equity, the solution can be designed and implemented in a way that promotes inclusivity and ensures that it reaches and benefits all individuals in remote rural areas who need healthcare services.

The business model for our solution could follow a combination of revenue streams and sustainability strategies to support its implementation in remote rural areas. Here is a possible outline of the business model:

1. Licensing or Subscription: The mobile application could be licensed to local health institutions, NGOs, or government entities in remote rural areas for a fee or on a subscription basis. This could generate revenue to cover the costs of developing and maintaining the technology, providing updates and support, and ensuring ongoing access to the solution.

2. Service Fees: Local health workers or healthcare providers could be charged a nominal fee for using the triage process within the mobile application. This could be based on a pay-per-use model or a tiered pricing structure depending on the volume of patients or services provided. The fees could help cover the costs of utilizing the solution and generating revenue for sustainability.

3. Partnerships and Grants: Collaborations with relevant stakeholders, such as local health authorities, international organizations, or corporate sponsors, could be established to secure funding through grants, sponsorships, or partnerships. This could provide resources to support the implementation and expansion of the solution in remote rural areas.

4. Data Analytics and Insights: Aggregated and anonymized data collected through the mobile application could be analyzed to generate insights and trends on healthcare needs, outcomes, and resource allocation. These insights could be valuable to local health authorities, NGOs, or research institutions, and could be monetized through data licensing or data analysis services.

5. Value-added Services: Additional value-added services could be offered to local health workers or healthcare providers to enhance the functionality and effectiveness of the solution. For example, premium features such as advanced analytics, remote consultations with specialists, or training modules could be offered at an additional cost to generate revenue.

6. Social Impact Investment: Attracting social impact investors who are interested in supporting innovative solutions that address healthcare disparities in remote rural areas. This could involve securing investment or impact funding from socially responsible investors who align with the mission and vision of the solution.

7. Philanthropic Donations: Donations from philanthropic organizations or individuals who are passionate about improving healthcare access in marginalized areas could also be a potential source of funding. This could involve fundraising efforts, crowdfunding campaigns, or charitable contributions to support the implementation and sustainability of the solution.

Becoming financially sustainable involves developing a strategy to generate revenue and cover the costs of operations, maintenance, and growth without relying solely on external funding or grants. Here are some potential steps to achieve financial sustainability:

1. Diversify Revenue Streams: Explore multiple revenue streams to reduce dependence on a single source of income. This could include licensing or subscription fees, service fees, data licensing, value-added services, partnerships, grants, social impact investments, or philanthropic donations. Diversifying revenue streams can help create a stable and sustainable financial base.

2. Understand and Meet Customer Needs: Conduct thorough market research to understand the needs, preferences, and willingness to pay off the target customers. Tailor the solution and pricing model to meet their specific requirements and affordability. Continuously engage with customers and stakeholders to gather feedback and iterate on the solution accordingly.

3. Provide Value-Added Services: Offer additional services or features that provide value and justify the costs for customers. This could include premium features, advanced analytics, remote consultations, training modules, or other services that complement the core solution and generate additional revenue.

4. Demonstrate Impact: Highlight the impact and value of the solution in improving healthcare access and outcomes in remote rural areas. Collect and analyze data to demonstrate the effectiveness of the solution in addressing the identified problem and generating positive outcomes. This can help attract customers, partners, investors, and donors who are interested in supporting impactful solutions.

5. Develop Sustainable Cost Structure: Optimize the cost structure of the solution by identifying cost-saving measures, leveraging technology, and streamlining operations. Regularly review and update the budget, financial projections, and operational expenses to ensure efficient utilization of resources and financial sustainability.

6. Explore Partnerships: Collaborate with relevant stakeholders, such as local health authorities, NGOs, research institutions, or corporate partners, to leverage their resources, expertise, and networks. This can include partnerships for funding, co-development, distribution, marketing, or scaling up the solution, which can contribute to financial sustainability.

7. Plan for Scale and Growth: Develop a strategic plan for scaling up the solution in a sustainable manner. This may involve expanding the solution to new geographic areas, increasing the customer base, or diversifying into related markets. Plan for growth while considering the financial implications and ensuring that revenue generation keeps pace with expansion.

8. Continuously Monitor and Adjust: Regularly monitor the financial performance of the solution, track progress against financial targets, and make adjustments as needed. Stay agile and adapt the business model, pricing, or revenue streams based on market dynamics, customer feedback, or changing circumstances.

Achieving financial sustainability may require time, effort, and strategic planning. It's important to have a clear vision, realistic financial goals, and a solid understanding of the market and customer needs. Continuous monitoring, adaptation, and innovation will be key to maintaining financial sustainability over the long term.

We made a revenue of nearly 100,000 Indian rupees for successfully implementing a few pilot projects for a few NGOs, and now we have signed a year-long agreement with two foundations for their entire calendar year of programs.

We signed a confidential disclosure agreement with Abbott Diagnostics
Medical Pvt Ltd to meet the requirements of underserved populations,
Abbott will pair the Caare hybrid telemedicine platform with its Rapid
Diagnostic Test Kits. The first pilot is now being worked on in
the western region of India. Through this collaboration, we are looking to leverage on Abbott network and offer our combined solutions to their customers and our customers.

Additionally, we are working with the District Magistrate of Prayagraj, the largest district of the biggest state in India, Uttar Pradesh, on a pilot where we are digitizing 38 subcenters under the Handia Block of Prayagraj. The subcenters are the most peripheral and first contact points between the primary health care system and the community. The District Magistrate has given us access to the ANMs (auxiliary nurse and midwife) at the subcenter level, to whom Caare Platform access is provided so that the rural patient's primary healthcare issues are addressed and medicines are dispensed. This model will reduce the burden on primary healthcare centers and also improve the efficiency of community healthcare centers.

In addition, CSR proposals were filed to a few significant companies to address the concerns of tribal populations in Jharkhand.

The proposal below was made to the state government of Karnataka in collaboration with the RV Institute of Management for a technology-based healthcare initiative to deliver healthcare treatments via telemedicine. Please see below the confirmation of our consideration.