DIGITAL DISPENSARY FOR
MICHELIN
Proposal submitted by Apollo
Telemedicine Networking
Foundation to Michelin
atnf.org +91 9840711657
Chennai ruban_t@apollohospitals.com
Introduction
In India, Non-Communicable Diseases (NCDs) like cardiovascular diseases, diabetes and
respiratory ailments have become a significant health concern, causing 60% of all deaths
and impacting people of all ages. This challenge is worsened by an urban-rural healthcare
divide despite 86% of clinical interactions occurring in rural areas.
Apollo extends reach to the remotest communities of Meghalaya through its Telehealth centre
In an ever-evolving health landscape, access to quality healthcare remains a cornerstone of
a thriving society. Addressing the shifting burden of disease and bridging healthcare
disparities between urban and rural areas have emerged as critical imperatives in India.
Non-communicable diseases (NCDs) have become a prominent concern, impacting
populations across age groups and contributing significantly to mortality rates.
Non-Communicable Diseases (NCDs) have surged, impacting both urban and rural
populations, with communities facing heightened vulnerabilities. Inadequate healthcare
access and occupational hazards contribute to their health burdens, perpetuating the
urban-rural healthcare divide.
The teleclinics of the Apollo Telemedicine Networking Foundation, aim to transform
healthcare access for underprivileged communities. Through telemedicine services,
healthcare delivery is now possible at the remotest locations, while bridging the urban-
rural gap. With timely medical interventions, consultations and awareness, one can
envision mitigating NCDs' impact and advancing the well-being of the targeted
communities.
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Michelin
Michelin is a leading global tire manufacturing company, established in 1889 in
Clermont-Ferrand, France. It is renowned for producing high-performance tires for cars,
motorcycles, trucks, and more. Michelin pioneered several innovations, including the
radial tire, which revolutionized the industry by improving fuel efficiency and durability.
The company operates production facilities worldwide and maintains a strong
commitment to sustainability by reducing its environmental impact through advanced tire
technologies. Michelin is also known for its iconic Michelin Guide, which rates
restaurants and hotels. Its focus on quality, innovation, and road safety sets it apart as an
industry leader.
Snapshots of the CSR activities of Michelin
CSR Activities of Michelin
Michelin is committed to corporate social responsibility (CSR) initiatives aimed at
enhancing the quality of life in communities where it operates. The company's CSR
activities focus on sustainable development, addressing critical issues such as education,
water access, and healthcare initiatives.
Education and Skill Development: The company supports educational programs and
training camps for teachers, benefiting over 1,300 school children through computer
training and after-school support.
Water Management: Michelin has implemented water management initiatives,
including regular water testing and restoration of irrigation channels, positively
impacting over 500 families.
Health Initiatives: The company organizes health camps to address local health needs
and improve overall community well-being.
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Apollo Telemedicine Networking Foundation | India’s Pioneer in Telemedicine
Apollo Telemedicine Networking Foundation is a part of Apollo Hospitals group which
has been providing quality healthcare for over 40 years, touching more than 200 million
lives across the world. ATNF is India’s pioneer in the telemedicine space and has
impacted over 20 million lives over the last two decades. Harnessing the medical practices
honed by Apollo Hospitals, India’s largest and most preferred private healthcare group,
Apollo Telemedicine Networking Foundation specializes in using Healthcare IT in
innovative ways to deliver quality healthcare services across regions and has in-depth
experience in establishing and operating telehealth care as a turnkey solution in
strengthening public health systems.
12A | 80G | FCRA | CSR-1 | NGO
Darpan
Projects across geographies
Operating across 20+ states and having
worked with over 50 major corporate majors,
PSUs, and state governments, Apollo
Telemedicine Networking Foundation's
capabilities are targeted at creating rural
health interventions- leveraging the power
held by telemedicine. With India's prevailing
physician gap, Apollo's telemedicine-driven
innovations have saved millions of lives since
its inception.
Healthcare Services for Communities
1. Digital Dispensary Service
2. Mobile Medical Units
3. Specialty Teleconsultations
4. Non-Communicable
Diseases Screening
5. TeleOphthalmology Services
6. Cancer Screening
7. Social Health Education
8. TeleLaboratory
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Proposed Location for Deployment
ATNF proposes to provide its Digital Dispensary services in the village of Kannankottai,
Tiruvallur District of Tamilnadu, as suggested by Michelin. These services aim to deliver
essential healthcare, including primary care, preventive measures and SHE sessions.
Teleconsultation services provided at the Keonjhar DD
Tiruvallur district
Tiruvallur district also spelled as Thiruvallur
district, has a mixture of urban and rural
characteristics. It is bounded on the north by
Tirupati and Chittoor districts of Andhra
Pradesh, on the east by the Bay of Bengal, on the
southeast by Chennai district, on the south by
Kanchipuram and Chengalpattu districts, on the
northwest by Vellore and on the west by Ranipet
district. The total geographical area of the district
is 3,394 sq km and the population density is 1,098 Map of Tiruvallur district
per sq km.
According to the census of 2011, the population of Tiruvallur was 37,28,104, consisting of
18,76,062 males and 18,52,042 females. The literacy rate in Tiruvallur is 84.03 %, with
89.69% of males and 78.32% of females being literate. The sex ratio in the city is 987
females per 1000 males.
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Health Indicators of the Targeted Location
Maternal and Child Health Tiruvallur
Mothers who consumed iron folic acid for 180 days or more
53.5
when they were pregnant (%)
Mothers who had at least 4 antenatal care visits (%) 85.4
Children under 5 years who are underweight (weight-for-age)
20.6
(%)
Anaemia among Children and Adults
Children age 6-59 months who are anaemic (%) 58.4
All women age 15-49 years who are anaemic (%) 56.8
Hypertension among Adults
Elevated blood pressure or taking medicine to control blood
26.4
pressure (%) - Women
Elevated blood pressure or taking medicine to control blood
32.4
pressure (%) - Men
Blood sugar level among Adults
Blood sugar level - high or very high or taking medicine to
22.5
control blood sugar level (%) - Women
Blood sugar level - high or very high or taking medicine to
23.4
control blood sugar level (%) - Men
Source:NFHS-5
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Low Health-Seeking Behaviour
Screening of Cancer among Adults Tiruvallur
Ever undergone a screening test for cervical cancer (%) 10.8
Ever undergone a breast examination for breast cancer (%) 7.9
Consumption of Tobacco and Alcohol among Adults
Women age 15 years and above who use any kind of tobacco (%) 1.7
Men age 15 years and above who use any kind of tobacco (%) 18.3
Women age 15 years and above who consume alcohol (%) 0.1
Men age 15 years and above who consume alcohol (%) 26.7
Source:NFHS-5
Disease Profile
Tiruvallur District faces a diverse disease profile, with both communicable and non-
communicable diseases impacting public health. While significant progress has been made
in combating infectious diseases such as tuberculosis and polio, non-communicable diseases
(NCDs) like diabetes, hypertension, and cardiovascular diseases are emerging as major
health concerns. The prevalence of these conditions is attributed to lifestyle factors,
including poor diet, lack of physical activity, and tobacco use.
Additionally, maternal and child health remains a priority, with ongoing efforts to improve
healthcare access and education. The district has implemented various health programs
aimed at increasing awareness and early detection of diseases. Despite advancements in
healthcare infrastructure, challenges persist in ensuring equitable access to medical
services for all residents, particularly in rural areas. Comprehensive strategies focusing on
prevention, early diagnosis, and community engagement are essential for addressing the
evolving health landscape in Tiruvallur.
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Digital Dispensary
The flagship service model of Apollo
Telemedicine Networking Foundation,
the Digital Dispensary is a 360-degree Tele General
Consults Physician
solution for handling the healthcare
needs of people in underserved rural
20+
communities. Using paramedics, Point Outreach
Specialty
Activity
of Care Diagnostic Devices and ICT, Services
Apollo's telemedicine setup allows Digital
rural beneficiaries to receive quality Dispensary
medical care from Apollo Hospitals' 65+
Generic Diagnostic
highly qualified doctors virtually. Drugs Laboratory
They also get instant diagnostics
courtesy of the laboratory, speciality Electronic
Social Health
Medical
and super-specialty doctors, and Education
Record
essential drugs against a doctor's
prescription. All of it is unlimited and
free for patients.
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How do Teleconsults work?
Primary Teleconsultation:
Patients seeking treatment are connected with well-trained
Patient
General Physicians from Apollo Hospitals via comes to
the Digital
Dispensary
teleconsultations at the digital dispensaries. The paramedic
streamlines the entire procedure, explains the consultation Record
details in
EMR
results in the regional language, does diagnostic tests if
requested by the doctor and hands them a printed or e-
prescription based on the doctor's orders. Teleconsultation Paramedic
schedules a
teleconsults
Process
Specialty Teleconsultation:
Followed by
On an appointment basis, the DD offers consults with doctors teleconsultation
with the doctor
with specialty and super specialty services. The paramedic
Lab tests &
ensures a hassle-free teleconsultation with specialist doctors, medicines
will be handled
informs patients of consultation outcomes, updates prescriptions promptly
in the Electronic Medical Record and follows up as per the
doctor's instructions.
Some of the Specialties are as below:
General Medicine | Obstetrics & Gynaecology | Cardiology | Paediatrics | Orthopaedics |
Dermatology
*More specialties can be added or reduced as per the actual need
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Diagnostics and POCT Services
ATNF proposes the installation and deployment of advanced diagnostic equipment for
assisting specialist teleconsultants in informed clinical decision-making. The advanced
diagnostic services will be enabled through a combination of Point of Care Diagnostic
(PoCDs) equipment, Semi-auto analyzers, and Rapid tests. The objective is to provide a
wide range of laboratory tests covering multiple specialties to benefit the population.
Based on the requirements, if needed, additional laboratory tests can also be included.
Equipment Test
HbA1C (Blood Glucose Levels), TSH (Thyroid Function),
HbA1C and TSH (F100)
and other tests
Semi Auto Analyzer Various blood tests (e.g., CBC, BMP, LFT, RFT)
Microscope Microscopy of blood smears, urinalysis, etc.
Vertex Mixture Preparation of samples for testing
Culturing bacteria, growing samples for microbiological
Incubator
tests
Glucometer Blood glucose level
Haemometer Hemoglobin level
Nebulizer Medication delivery for respiratory conditions
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Pharmacy Services
Dispensing of medicines is essential for the delivery of a continuum of medical care to the
patients who seek medical intervention, hence Apollo dispenses medicines at the Digital
Dispensary.
Free medicines are dispensed by the ATNF to the
patients and ensure the availability of over 65+ essential
medicines at the digital dispensary as per disease load in
the strategic location identified.
All the drugs will be procured, stocked and supplied as
per a pre-defined list and a pre-agreed-upon quantity
will be dispensed to the public. It is to be noted that all
the prescriptions will only be dispensed against a valid
prescription given by the doctor and a printed copy will
be given to the patient as well as a soft copy.
Some of the types of medicines dispensed based on their therapeutic effects are as follows:
Antibiotics Analgesics
Antivirals Antihypertensives
Antifungals Antiseptics
Antiparasitics Anti-Inflammatories
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NCD Screening
Apollo promotes preventive healthcare among disadvantaged and marginalized groups to
improve the overall health and well-being of the community. Beneficiaries are notified
about NCDs at their doorsteps; screened for the prevalence of non-communicable diseases;
sorted into risk buckets; and enrolled for confirmatory tests if their results indicate ‘high
risk’.
Some common types of non-communicable diseases are:
Cardiovascular Diseases (CVDs)
Cancer
Chronic Respiratory Diseases
Anemia
Diabetes Non-
Musculoskeletal Disorders
Communicable
Diseases
Neurological Disorders
Mental Health Issues
Malnutrition
Digestive Diseases
Hypertension and many more
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Social Health Education sessions (SHE)
Social Health Education (SHE) plays a very important role in providing awareness on
health issues in the community. However, the approach towards delivering health
education must be specific, systematic and accessible to the local communities.
For achieving better outcomes with Non-Communicable Diseases (NCDs), health
education will be provided through dedicated social workers and allied health workers.
Special focus will be provided to awareness sessions on health issues pertaining to women,
children and adolescent girls regarding pregnancy and child birth, importance of ante-
natal and pre-natal care, importance of nutrition, immunization for children, menstrual
hygiene, breast and cervical cancer awareness, etc.
Audio-Visual content and graphical illustrations in the vernacular language will be deployed
to seamlessly communicate with communities. The program would be implemented on an
outreach mode, where the Apollo staff will visit villages as per a pre-agreed upon roster
and impart programs based on theprevailing disease burden there.
IA EA CCA
Information and Empowerment with Collective
Awareness Accountability Community Action
The Social Health Education program would be implemented with a three-level approach
1) Level 1: IA (Information and Awareness)
Provide facts, remove myths and misconceptions
2) Level 2: EA (Empowerment with Accountability)
Reduce 'at risk' behavior, increase responsible behavior
3) Level 3: CCA (Collective Community Action)
Create a group with individual involvement and facilitate a movement
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Modules Deployed in SHE Programs
The Social Health Education camps that ATNF organizes with the assistance of a
community worker and in the outreach mode, encompass a wide variety of topics that
work for people from across age groups and genders. Some of the topics touch upon:
Diabetes Cervical Cancer
Menopause Tobacco Induced Cancer
Breast Cancer Cardiovascular Diseases
Personal Hygiene Anaemia
Menstrual Disorder Hypertension
Obesity Thyroid Disorders
Stomach Cancer UTI
Human Resource Provisioning
The following human resources will be provisioned in the strategically identified location
for the smooth operations of the DD:
Staff Requirement Number Roles and Responsibilities
ANM/GNM. To administer HRAs, conduct physical
exams to facilitate teleconsultations, communicate
Paramedic Staff 1 consultation outcomes in the regional language, update
EMR, and provide patients with a printed prescription,
counsel and follow-up with patients for referral
DMLT. Responsible for handling and running the lab
Lab Technician 1
tests and verifying the results for patients
D Pharm. Advising and supplying medicines to patients
Pharmacist 1
and ensuring that the supply of medicine is within the law
BSW or MSW or sufficient experience. To conduct
awareness sessions, mobilize and triage patients.
Social Worker 1
Responsible for overall outcomes of the program and to
ensure day-to-day operations are handled smoothly
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Internet Connectivity
Dedicated internet connectivity that is required for the operation of telehealth services will
be provisioned at the requested site. This will be done through the establishment of an ILL
(Internet Leased Line) or broadband for smooth and dedicated bandwidth, or a
broadband connection as well as wireless devices for patients.
Electronic Medical Records (EMR)
The web-based EMR created when every patient is EMR
screened will include demographic and other patient
data comprising of clinical examination reports, and
physical examination reports along with the patient’s
medical history, family’s medical history, and so on.
The system will also enable the import and export of
complete patient records including images, scans and
files. This EMR will be on ATNF’s platform, which
boasts high data security and interoperability.
Online Dashboard with Complete Accountability
A dedicated project dashboard will be created and hosted by Apollo, co-branded with the
Michelin’s information and links. This dashboard will be linked to the hospital critical
care unit and the EMR will be generated, so details such as the number of patients
handled and conditions diagnosed, will be visible on the dashboard in real-time.
Michelin
Mockup of a project dashboard
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Roles and Responsibilities
Michelin
Will be the primary stakeholder and owner of the
DD program
Will fund the program throughout the project tenure
Will assist in the provision of support and clearances
for starting the program
Will guide and assist in implementing the services at
the proposed locations
Will conduct periodical reviews
Will organize volunteers, if they so wish, to take part
in community engagement
Apollo Telemedicine Networking Foundation
Will be the program implementation partner for the Digital Dispensary program
Will be responsible for end-to-end operations and management of the program
Will enable agreed-upon healthcare support services as mentioned in the scope
Will organize and conduct medical camps along with the required manpower
Will provide Social Health Education modules for community awareness
Will provide an Electronic Medical Record system
Will provide a diagnosis of diseases using laboratory investigations
Will provide cloud storage, servers, maintenance, software licenses and support
Will provide medicines and necessary investigations
Will provide central call center support
Will equip the Digital Dispensary with the required medical and IT devices
Will recruit and deploy the agreed number of staff
Will be responsible for the overall planned outcomes of the program
Will submit periodic reports to the appointed program officers of Michelin
Will maintain the data in an effective manner for Michelin
Will be responsible for equipment maintenance for the tenure of the program
Implementation Time
ATNF will complete the enablement of services in 60 days from the date of receiving the
project documentation from Michelin and begin operations.
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Sustainability Plan
The proposed project has identified the following areas for sustainability:
Training for local community enablers: The project is cognizant of how crucial it is to
train the local youth/community/existing staff to sustain services once the project is
finished. By taking this action, the company will be able to take control of the project
and ensure that the public continues to profit from it in the long run.
Transfer of Aids and Equipment in a Responsible Manner: The project places a strong
emphasis on the careful transfer of aids and equipment utilized in the project to the
company. By taking this action, Michelin will be able to continue offering the public
the high-quality healthcare services that they have grown accustomed to getting as a
result of the initiative.
Explore Community Funding and Self-paying Models: The project intends to explore
community funding and self-paying models to guarantee operational sustainability.
This strategy will lessen the project's dependency on outside financing sources and
assist in making it semi-sustainable.
Awareness Sessions on Menstrual Hygiene for Schools under the Spandana Sphoorty DD Program
Train and Mobilize the Community: Institutional sustainability is a crucial issue that
the project has taken into consideration. The project attempts to educate and
empower the neighborhood to take charge of the camps, screening, and ongoing
follow-ups. The best medical practices can be upheld in this way to improve patient
outcomes.
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Exit Plan
The exit plan of the proposed project is as below:
Knowledge Transfer: The implementation partner intends to end the project
responsibly, by giving the management of Michelin or any other entity selected by
Michelin or any other incoming CSR implementation partner the knowledge,
equipment purchased for the project and appropriate records. This action will
guarantee that the project's advantages continue after the implementation stage.
Continuum through Community Leaders: To maintain the program's values, a
continuum will be created through community leaders and young people who have
been trained as volunteers or community champions. With this strategy, the project
can be owned by the community, ensuring its long-term viability.
Community outreach activities by Apollo’s staff in Keonjhar, Odisha
Software and teleconsultation services: The government/ any other party may still offer
software and teleconsultation services in health centers in exchange for a small fee.
This strategy will guarantee that the project's services continue to benefit the general
public even beyond the tenure of the program.
Duration of the Project
The project will be operational for a pilot period of 1 year on the basis of satisfactory
service delivery and performance.
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Expected Outputs, Outcomes and Impacts
Program Activities Output Outcome Impact
Medical advice
Arrange is provided free More
teleconsults of charge | informed Enhanced
for 500+ health healthcare
Teleconsultations
beneficiaries consultations decisions and access for local
requiring per month better health communities
medical help (estimated indicators
number)
The program
assists those Proactive
with NCDs to healthcare,
The field team
manage them early detection
detects how
The field and reduce and
many people
team does the disease load intervention of
have NCDs |
NCD Screening screening with the help non-
200+ screenings
using POCT of communicable
per month
devices appropriate diseases like
(estimated
doctor diabetes,
number)
consultations hypertension,
and medicine etc.
dispensing
The level of
awareness and
The social
change in Increase Increased
worker
awareness with health knowledge and
conducts
the session are awareness awareness of
awareness
determined | and lead to health issues
Health Awareness sessions and
10+ SHE health- through theme-
does pre and
sessions per seeking based health
post
month behaviour camps.
assessments
(estimated
number)
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Grant needed for program management
The financials furnished below envisage the operation of the Digital Dispensary in the
mutually agreed location.
S. No. Component Year 1
One-time set-up costs include:
Medical equipment
Laboratory equipment
1 ₹ 7,60,479
ICT Equipment /devices / Connectivity
Branding and centre preparation
Training and Implementation
Project operation costs include:
Program team cost
Medicines and lab consumables
Reagents and kits
Operational costs
2 ₹ 32,25,824
Centre management, maintenance staff travel and
communication
MIS documentation and baseline
Monitoring cost
Program management
Total Cost ₹ 39,86,303
Note:
The above rates are exclusive of applicable taxes
60% of the one-time setup cost to be released in advance as mobilization
Key Performance Indicators/Project Impact
The following Key Performance Indicators may be considered to assess the impact of the
project among the target audience:
Number of consultations: 500/month | 6,000+/year | Estimated Number
Number of awareness beneficiaries: 300/month | 3,600+/year | Estimated number
Number of NCD screenings: 300/month | 3,600/ year | Estimated number
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Sustainable Development Goals
As per the United Nations Sustainable Development Goals, this particular proposal aims
to contribute to the achievement of good health and well-being.
The way forward
Apollo Telemedicine Networking Foundation is pleased to submit this proposal to
Michelin for due consideration. We would be honored to work with you to provide
healthcare services and aid in the improvement of the quality of healthcare available to the
community. On your acceptance and interest, we would be delighted to create a detailed
execution plan with the implementation methodology and the financials involved. ATNF
assures that we will roll out the project within 60 days of the signing of the due
documents.
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2 million
NCD SCREENINGS CONDUCTED
20,000
Let's make tomorrow healthier!
THANK PATIENTS
HANDLED VIRTUALLY
YOU 2 billion
TELECONSULTATIONS
DELIVERED
SAVING LIVES THROUGH THE
TELE-EMERGENCY SERVICE SINCE 2013 NO LIMIT ON DOCTOR
CONSULTS | MEDICINES |
LAB TESTS | DIAGNOSTICS
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