Adoption and utilization of India's eSanjeevani national telemedicine service.

Telemedicine is increasingly used to expand access to primary healthcare, especially in low- and middle-income countries with workforce and infrastructure constraints. India's eSanjeevani platform, launched in 2019, is the world's largest government-led telemedicine initiative. The objective of this study was to analyse the adoption and utilization patterns of eSanjeevani, India's national telemedicine service, from its national rollout in November 2019 through September 2023. We analysed aggregated programmatic data from the Centre for Development of Advanced Computing and official government sources, assessing teleconsultation volumes by platform type, state, age group, gender and diagnostic category. Over 163 million consultations were conducted across all 28 states and 8 union territories. The provider-assisted eSanjeevani Ayushman Bharat - Health and Wellness Center (AB-HWC) model accounted for >93% of usage. Utilization was highest among women and adults aged 25-45. The platform supported consultations for both acute conditions (e.g. fever, headache, diarrhoea) and chronic diseases, particularly diabetes and hypertension. The findings provide an overview of adoption and utilization trends during the platform's expansion phase, offering a foundation for future research on patient-level outcomes, continuity of care and equity in access. The early implementation of eSanjeevani reflects the rapid scale-up of a government-led telemedicine platform in India and highlights patterns in its utilization across states, population groups and health conditions. While this study does not assess outcomes or implementation processes, it provides a foundational overview of usage trends during the programme's expansion phase. We suggest that future research should focus on patient-level outcomes, continuity of care and equity in access, as well as the platform's integration into broader primary healthcare delivery systems.