

Manipur: Smart OPD at Scale
Bringing specialist care to PHC/CHC doorsteps with a hub–spoke tele-OPD and EMR
In districts across Manipur, HMN working with Parivar Seva Sanstha and SBI-Foundation deployed Smart OPD to connect PHCs/CHCs/HWCs (spokes) with district-hospital specialists (hubs). Nurses capture vitals and history, escalate to specialists over secure video, and issue e-prescriptions/referrals into a longitudinal EMR. In steady state, the network delivers ≈200 tele-consults/day and has crossed ~70,000 consultations, cutting travel and time-to-care for remote communities.
Objectives
Provide same-day specialist access from local PHC/CHC without travel.
Reduce avoidable referrals and duplicate investigations.
Build longitudinal EMRs to improve adherence and follow-up.
Standardize clinic workflows & SLAs for measurable quality.
Solution Deployed
Smart OPD (Virtual OPD + EMR)
Digital registration & consent, queue/tokening, nurse triage, secure video with specialists.
Point-of-care devices (BP, SpO₂, thermometer, glucometer; optional ECG/fetal doppler) stream results into EMR.
Multilingual e-prescriptions, structured e-referrals and investigations; alerts for follow-ups.
Patient & Provider Apps
Citizen notifications (SMS/WhatsApp) for appointments, medication refills, and lab results.
Operational console for rosters, workload balancing, and daily KPIs at facility/district level.
Field Enablement & Support in partnership with Parivar Seva Sanstha
On-site implementation managers, job-aids (English + local language), and refresher trainings.
Integrated helpdesk/ticketing for devices, network, and workflow issues.
Implementation & Workflow
Hub–Spoke model:
PHC/CHC/HWC (spoke) registers patient → vitals & symptoms → nurse triage → video connect to hub specialist → e-Rx/e-referral → scheduled follow-up.
Rollout cadence:
Weeks 0–2 (readiness & SOPs), Weeks 3–6 (pilot spokes), Weeks 7–12 (scale-out), followed by stabilization sprints with daily huddles and issue closure.
Data discipline:
EMR completeness checks, exception lists (no-shows, overdue follow-ups), and action dashboards.
What Impact Did It Create?
Access:
Same-day specialist consults in remote blocks; median tele-connect typically <10 minutes during staffed hours.
Efficiency:
Nurse-led resolution of routine cases; right-case escalation eases district OPD crowding.
Continuity:
EMRs and digital prescriptions reduce lost papers and repeat tests; better follow-through on care plans.
Experience:
Shorter queues, clearer instructions, automated reminders → higher adherence.
At-a-Glance Results
~70,000 tele-consults delivered; steady-state ≈200/day across spokes.
25–35% (indicative) reduction in avoidable physical referrals in stabilized facilities.
<5 minutes median token issue time from registration; <10 minutes median queue-to-video during staffed windows.
High nurse adoption reflected in consistent device capture and EMR completeness.
Voices & Moments from the Field
“Earlier, patients waited weeks to see a specialist; now they’re seen the same day from our PHC.” — PHC Medical Officer
“The SMS reminders help patients return on time; we’re seeing fewer drop-offs.” — Staff Nurse
“I saved a day’s travel and wages; the medicine list came to my phone.” — Patient (Rural Block)
Why HMN
A field-tested tele-OPD stack that works in low-resource settings, pairs nurse-led triage with specialist video, and writes everything to a governance-grade EMR. HMN brings on-ground enablement, measurable ELOs/SLAs, and rapid iteration—so Manipur can deliver hospital-grade capability without forcing patients to travel.
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