Policy Update
Aditya Sharma
Background
India’s healthcare sector faces persistent structural challenges that undermine its ability to serve a population of over 1.4 billion people. The doctor-to-patient ratio stands at 1:1,596, well below the World Health Organization’s recommended 1:1,000 , while public health spending remains at just 1.4% of GDP, among the lowest globally (Ministry of Electronics and Information Technology). These constraints are particularly pronounced in rural and underserved regions, where access to trained medical professionals and adequate infrastructure is limited.
Recognizing the limitations of conventional healthcare delivery models, the Centre for Development of Advanced Computing (C-DAC) Noida, India’s premier R&D institution under MeitY, developed the iMedDesk: AI-Assisted Medical Services Framework. Established in 1988, C-DAC has evolved from pioneering supercomputing into a comprehensive solutions provider, with more than two decades of expertise in health informatics. Its prior achievements include the nationally deployed eSanjeevani telemedicine platform, eSushrut Hospital Management Information System, and AI-powered diagnostic tools for conditions ranging from pneumonia to cervical cancer.
The iMedDesk framework builds upon this legacy to tackle the twin challenges of information asymmetry, where patients often lack reliable health information, and doctors face overwhelming caseloads, limiting individualized care. By integrating artificial intelligence (AI), natural language processing, and multilingual speech technologies, iMedDesk aligns with India’s Digital India mission and the National AI Strategy, seeking to democratize access to healthcare knowledge while supporting clinical decision-making.
Functioning
The iMedDesk framework operates through a layered AI architecture that strengthens communication between patients and providers while streamlining clinical workflows. Its Natural Language Understanding (NLU) engine enables patients to pose queries in both English and Hindi, which are parsed, translated, and converted into structured responses. This multilingual approach addresses India’s linguistic diversity, with customized medical speech recognition and synthesis ensuring accuracy in specialized terminology.
The Patient Enquiries Chatbot, integrated into the AIIMS Gorakhpur mobile app, serves as the primary patient-facing interface. By continuously learning from real-world interactions, the system improves over time, ensuring increasingly precise responses. On the provider side, the Doctor Desk module delivers clinical decision support with tools for diagnostic assistance, investigation management, encounter documentation, and medication planning. The framework also integrates generative AI for contextual guidance during consultations and includes an innovative voice-based discharge summary system for inpatient care, which leverages SNOMED-CT standards to improve accuracy and consistency.
Performance
Since its deployment, iMedDesk has demonstrated measurable outcomes in India’s digital health ecosystem. At AIIMS Gorakhpur, the chatbot has been actively fielding patient queries through the hospital’s mobile application, with real-time monitoring feeding algorithm refinement (MeitY, 2024). The framework has been tested at Sarvodaya Hospital as a service-based solution, providing critical insights into scalability in real-world settings.
Its performance is reinforced by integration with existing C-DAC platforms. For instance, eSanjeevani, which has delivered over 344 million consultations across 131,152 Ayushman Arogya Mandirs, offers a robust foundation for expansion. With daily consultations exceeding 425,000 patients and peak capacity at 630,315, iMedDesk benefits from this established digital infrastructure. Similarly, integration with eSushrut, which serves over 70,000 patients daily across 80 hospitals, highlights its compatibility with nationwide health informatics systems.
Impact
The iMedDesk framework has advanced India’s digital health transformation across multiple dimensions. Multilingual chatbot services have expanded access to healthcare information, especially for rural and semi-urban populations with limited literacy or digital fluency. This innovation reduces inequities caused by language and information barriers.
For providers, AI-assisted clinical decision support reduces administrative burden, improves diagnostic accuracy, and enhances efficiency. By enabling teleconsultations and data-driven workflows, iMedDesk addresses shortages of medical professionals while supporting evidence-based practice. Economically, its efficiency gains lower administrative costs and enhances hospital resource management, while its training and decision-support tools empower healthcare professionals to deliver more effective care.
Moreover, the framework strengthens India’s position as a leader in healthcare AI innovation, with potential for future technology transfer to other developing nations seeking scalable, cost-effective health solutions.
Emerging Issues
Despite its achievements, iMedDesk faces significant implementation challenges. Many healthcare facilities, particularly in rural areas, lack reliable electricity, internet access, and digital infrastructure. Studies indicate that fewer than half of India’s Health and Wellness Centres have backup electricity facilities, undermining AI deployment.
Data quality and interoperability remain systemic obstacles. Fragmented electronic health records, inconsistent data entry practices, and absent integration frameworks hinder algorithm effectiveness. Regulatory uncertainty further complicates adoption, as the Digital Information Security in Healthcare Act (DISHA) remains unenacted since 2017, leaving questions around liability, algorithm validation, and patient privacy unresolved.
Additionally, the digital divide threatens equitable access. As of 2023, nearly 45% of India’s population lacked internet connectivity, raising concerns that AI tools may disproportionately benefit urban populations. Ethical considerations such as informed consent, algorithmic bias, and explainability must also be addressed in a multilingual, multicultural society with diverse literacy levels.
Way Forward
To maximize its transformative potential, iMedDesk must expand beyond technical innovation to systemic integration. Strategic partnerships with telecom providers and alignment with the Ayushman Bharat Digital Health Mission can expand rural connectivity and interoperability. Enhancing data governance frameworks, potentially through federated learning, will improve AI training while safeguarding patient privacy.
Multilingual expansion beyond English and Hindi to India’s 22 scheduled languages, coupled with cultural competency features, will enhance inclusivity. At the same time, investment in digital literacy for both providers and patients will ensure more effective use. Regulatory clarity through AI governance frameworks for healthcare , covering validation, liability, and data protection—is urgently required.
Finally, sustainability will depend on robust training programs that preserve clinicians’ autonomy and empathy while equipping them with AI-driven tools. By incorporating future technologies such as blockchain for secure data exchange and IoT for continuous patient monitoring, iMedDesk can cement its role as a transformative force in Indian healthcare.
References
About The Contributor: Aditya Sharma is a Research Intern at the Impact and Policy Research Institute (IMPRI) and is in the first year of his Master’s degree in Environmental Economics from the Madras School of Economics. His interest lies in analysing various programs and policies that are centered around sustainability and development.
Acknowledgement: I sincerely thank Aasthaba Jadeja and Bhaktiba Jadeja for assigning this work and providing consistent support throughout.
Disclaimer: All views expressed in the article belong solely to the author and not necessarily to the organisation.
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