Introduction:
Telemedicine canvas was developed to be used as a template to design and develop telehealth interventions in a given geographical or cultural context. Villages in the tribal area of nashik district, maharashtra in india, have little to no access to primary health care services. The areas are poorly connected to the main city of nashik and at times completely cut off during the monsoon season. Telemedicine will enable the villages to access good quality primary healthcare without the need to travel long distances.

Aim:
To design and develop telehealth services for tribal communities materials and methods: a community needs assessment was conducted to identify the scope of work, context, challenges, and opportunities through in-depth interviews with community members, health workers, and local health providers. The implementation team, doctors, and internal evaluation team conducted a workshop to map priorities, opinions, and perceptions using the telemedicine canvas. The workshop was followed by a baseline survey to gather data for socio-demographic, gestational, wash, health access, and expenditure data from the community.

Findings:
The community needs assessment helped focus the discussions during the workshop and helped define the goals and scope of work of the program. Discussions guided by the telemedicine canvas helped develop a theory of change, requirements for the software application, and baseline survey. The implementation model designed for the tribal areas was to implement the digital solution with health workers as intermediaries in-field. The model consists of both telehealth (education and awareness) as well as telemedicine (consultation by qualified doctors).

Conclusion:
The canvas provides a framework to map out internal and external challenges of the ecosystem, opportunities, and perceived end-user needs. It provides a useful framework to develop user needs for the technology solution, identify and plan for potential barriers to implementation, and training modules for health workers.