Background and objective:
The vulnerable population and marginalized communities are prone to receive undignified care, lack of timely care and unresponsiveness from the health systems. The health inequities in low-resourced settings lead to a lack of access to healthcare services and lack of reliable health information. The telecare program was implemented to examine the feasibility and acceptability of using community led telemedicine models to solve for health inequalities and health illiteracy in vulnerable communities such as lgbtq population and slum dwellers where digital illiteracy and digital divide is significant.

Methods:
The program was carried out from jul’21-dec22 in 9 different locations across 6 indian states. Communities belonged to lgbtqia, indigenous communities, migrant workers,slum dwellers and rural population. A team of community health workers were recruited for last mile health access. They advocated and facilitated the program on-ground. Qualified nurses, doctors, counselors, welfare officers and triage-aid agents were connected digitally through a health-tech platform.

Results:
Program reached over 82,000 individuals. 2,075 medical cases were treated and 508 health information calls were facilitated. There was a positive uptake of the community-lead telemedicine services among the members. Presence of community health workers on-ground earned trust among the members, changing their health seeking behavior and solved for digital illiteracy and digital divide which were the pivotal factors for failure of telemedicine models.⡢ The cost of delivering one quality medical case was estimated at inr 96, similar quality consultations are priced over inr 400 in tier 2 cities.

Conclusion:
Telecare addresses health inequities and substantially bridges the access gap in low-resource and discriminated communities by providing personalized health information and building resilient healthy communities. The program demonstrated a new model of care that provides dignified and quality care to unheard voices and is scalable, adaptable and agile to other vulnerable health populations.