Last mile connectivity is a major challenge in delivering healthcare services in rural areas. However, a Mangaluru-based cardiologist is making efforts to connect this gap in cardiac healthcare physically through GAP (gram panchayat and anganwadi project) and digitally through an app.

Padmanabha Kamath, an interventional cardiologist who has been connecting rural areas in some districts of Karnataka with a network of ECG (electrocardiography) machines through the Cardiology At Doorstep (CAD) Foundation, is now planning to address this last mile connectivity challenge with the help of gram panchayats (GPs) and anganwadis.

Started in 2018, CAD has installed 445 ECGs at primary health centres (PHCs), small clinics in rural areas, and Jan Aushadhi Kendras in 25 districts of Karnataka. The operators in these agencies record the ECG of patients, transmit the details to a WhatsApp group of cardiologists formed by Kamath, and receive their expert opinion on the same. All this is done free of cost.

Kamath told BusinessLine that in spite of his best efforts, last mile connectivity remained a challenge for people living in rural areas.

“Imagine, what if there is no hospital, no clinic, no Jan Aushadhi Kendra in the vicinity. How are you going to bridge the gap? That was what was plaguing my mind. With this background, I started exploring the GPs and anganwadis because they are the face of the village most of the time,” he said.

Following this, Kamath started exploring the GPs and anganwadis that could be brought into the GAP fold. In April, the first such ECG machine was installed in an anganwadi at Ampar (a remote village of Udupi district in Karnataka).

Stating that CAD has installed 55 ECGs under GAP till now, he said he is confident of bringing a total of 100 GPs and anganwadis under GAP by December. Karnataka Bank has come forward to sponsor 50 ECGs in Udupi district, and MRPL 40 ECGs in Dakshina Kannada district. The Karnataka Panchayati Raj Department has also given positive feedback on this initiative, he said.

CAD GAP is aiming at equipping anganwadis and GPs with basic preventive healthcare and early detection tools such as ECG, BP and blood sugar test kits, and training ASHA, anganwadi workers, and volunteer members of the villages to operate simple health testing tools and get telemedicine advice within the shortest possible time through the digital platform.

Kamath said the launch of an app -- ‘Hruthkukshi’ -- was a step in providing last mile digital connectivity. The app is available on Google Play. (‘Hruthkukshi’ means ventricle in Kannada. Ventricle is the central pump of the body, where blood gets collected and distributed to various organs.)

Though WhatsApp groups formed by him under the CAD network have been helping many people, it lacked the flexibility of an app.

He said the app has been developed to interact instantly with doctors to provide an opinion on an ECG report uploaded in rural areas by telemedicine operators. These operators can access results via mobile app and inform patients accordingly.

In addition, the app has a provision to record the patient’s health problem in his language and upload it.

The patient records what he/ she feels in the app, as some people are not familiar with typing.

Stating that a villager in a remote corner of Karnataka may know only Kannada, he said: “I understood his problem. One barrier is removed with this option. The patient has communicated effectively with me.”

‘Use heart to connect’ was the theme of World Heart Day (which was celebrated on September 29). Kamath said he celebrated it through CAD’s GAP and ‘Hruthkukshi’. While GAP makes an effort to make last mile connectivity in rural areas, ‘Hruthkukshi’ has made an effort to harness digital technology to prevent cardiovascular endpoints.

“I am not here to show that it is rocket science. I am just telling you that we can actually leverage technology and save a lot of lives,” he added.

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