Telemedicine & primary care in India, explained
By Abha Lohia · Startup Decoded
Telemedicine and primary care startups help people see a doctor for everyday problems, by video, phone, chat or at a small clinic. They earn mainly through fees, plans and partnerships.
What is telemedicine and primary care?
Telemedicine means a doctor treats a patient at a distance, using video, voice call or messages. Primary care is the first level of healthcare: the family doctor who handles fevers, blood pressure, diabetes check-ups and decides whether you need a specialist.
In India, many people skip primary care and go straight to a hospital or a pharmacy. That is costly and crowded. Startups in this area try to make the first visit easier, cheaper and closer to home, either online or in a neat neighbourhood clinic.
Practo is one of the best-known names in India for finding and booking doctors online. Even Healthcare, described in StopDown's data as a hospital and clinic operator, shows the clinic side of the same idea.
A few terms help when reading news about this area. A teleconsultation is a paid remote visit. A follow-up is a later visit for the same problem, which the guidelines treat differently from a first visit. An e-prescription is a prescription sent digitally. A health record is the history of a patient's visits, tests and medicines. Finally, an ABHA number is the optional health account ID that can link these records. When a funding story says a company is building a primary-care network, it usually means a mix of online consults, partner clinics and its own centres under one brand.
How did it grow in India?
Before 2020, telemedicine was used but sat in a legal grey zone. Then the Telemedicine Practice Guidelines of March 2020 made it clear that a registered doctor could consult by tele-means. During the COVID-19 lockdowns, millions tried a video consultation for the first time.
Phones, cheap data and UPI made it easy. A patient could book, talk to a doctor, pay and get a prescription within minutes. Some use faded when clinics reopened, but many people kept using it for follow-ups, minor illnesses and long-term conditions.
The government also built its own tools. Its eSanjeevani service offers free consultations through public health centres, which shows how large the demand is and also sets a free benchmark for private services.
How do these businesses make money?
The simplest model is a fee for each consultation. The patient pays, the platform keeps a share and the doctor gets the rest, or the platform employs the doctor on a salary.
A second model is a subscription or plan: a family pays a fixed amount for unlimited chats or several consults a year. A third is selling to employers, who buy health benefits for staff. A fourth is a marketplace where doctors pay to be listed, and a fifth is a chain of clinics that earns fees for visits, tests and medicines under one roof.
Many platforms add services beside the consult, such as medicine delivery or lab tests, because the consultation itself rarely earns enough on its own. This is why the line between telemedicine, pharmacy and diagnostics is often blurry.
What rules apply?
The main rule is the Telemedicine Practice Guidelines, 2020, issued under the National Medical Commission framework. Under them, only a registered medical practitioner can give a tele-consultation. The patient must consent, the doctor must keep records, and the doctor decides whether a remote consult is suitable at all.
The guidelines sort medicines into lists. Some common drugs may be prescribed after a first remote consult, others only after a follow-up, and some, such as certain controlled drugs, may not be prescribed remotely. The doctor must also give a prescription in a set format.
Clinics must follow state registration rules. Health data falls under the Digital Personal Data Protection Act, 2023, whose Rules were notified in November 2025 and are being phased in. Voluntary links with the Ayushman Bharat Digital Mission, such as ABHA numbers, let patients carry records between providers. Rules can change, so check the current text before building a product.
Who are the customers?
Patients are the main customers. Many are working adults in cities who want a quick consultation without taking time off, or older people who need regular check-ups and prefer to avoid a trip to a hospital. Parents use it for children's minor illnesses at night.
Employers are a second group, buying plans for staff. Insurers are a third: some pay for tele-consults as a cheaper first step before a hospital visit. Small towns are a growing market, since a good doctor may be hours away.
Language matters. A platform that offers consultations in Hindi, Tamil, Bengali and other languages can reach many more people than one built only for English speakers.
How should you judge one, and what are the risks?
Ask whether patients return, whether doctors stay, and whether the company earns more from each visit than it spends. A high number of downloads says little if few patients complete a second consultation.
Also check how the company handles cases it cannot treat. A good service has a clear route to a lab, a specialist or a hospital, and it keeps a record so the next doctor knows the history. Voluntary use of ABHA numbers can help here.
Finally, look at clinical quality: how doctors are chosen, how long a consult lasts, and how mistakes are reviewed. Faster is not better if the doctor has no time to listen.
Quality is the largest risk. A rushed video consult can miss a serious sign that a doctor would catch in person. Platforms need clear steps for when to send a patient to a hospital, and doctors who are properly registered.
Money is another challenge. Consultation fees in India are low, so a platform needs volume or extra services to cover doctor pay, marketing and technology. Many patients also use a service once and do not return.
Looking ahead, expect more care for long-term conditions, more tie-ups between online and offline clinics, and more use of AI to prepare a doctor's notes. Funding news continues to show interest in primary care companies, but only a small number have reached profit.
The breakdown
Business models
| Model | How it makes money | Who uses it |
|---|---|---|
| Pay per consultation | Patient pays for each video, call or chat | Tele-consult apps and doctor platforms |
| Subscription or family plan | Fixed fee for a set of consults or chats | Primary-care and chronic-care programmes |
| Employer benefits | Companies pay for staff health services | Corporate wellness and tele-consult providers |
| Clinic chain | Earn from visits, tests and medicines in owned clinics | Primary-care and multi-specialty clinic operators |
| Doctor listing and booking | Doctors or clinics pay to be listed or to use software | Doctor-booking marketplaces |
The numbers that matter
- Consultation fee compared with doctor pay and platform cost: the gap decides if each visit makes money.
- Repeat visits per patient: care for long-term conditions brings patients back.
- Cost of getting a patient: marketing spend per new patient.
- Share of consults that end in a medicine or test order: this is often where the extra income comes from.
- Doctor utilisation: how many hours a paid doctor is actually busy.
Rules and regulators
| Regulator or law | What it means |
|---|---|
| Telemedicine Practice Guidelines, 2020 | Only registered doctors may consult remotely; consent, records and prescription limits apply. |
| National Medical Commission and state councils | Regulate doctor registration and professional conduct, which tele-platforms must respect. |
| Digital Personal Data Protection Act, 2023 and Rules, 2025 | Consent, security and breach reporting for patient data, phased in over about 18 months. |
| ABDM | Optional ABHA numbers and record sharing with patient consent. |
Risks
- Patient harm from a missed diagnosis in a remote consult.
- Low consultation fees that make profit hard.
- Low repeat use outside long-term conditions.
- Prescribing limits that restrict what can be done on a first call.
- Data privacy duties that add cost and legal risk.
Telemedicine & primary care: latest on StopDown
- Genetidoc launches online forum for rare diseases 9 October 2026
- ClinikPe launches platform for small diagnostic labs 8 October 2026
- Sunfox raises $7M Series A for Spandan ECG 7 October 2026
- MyRx raises seed funding led by SteerX VC 24 September 2026
- EVERQ launches 12-episode microdrama IP 'So Dermatic!' 24 September 2026
- Kids Clinic India files for initial public offering 12 September 2026
- iKure raises $1.8 million in Pre-Series A funding 9 September 2026
- Doctors on Duty offers AI health kiosks 8 September 2026
Every Telemedicine & primary care story →
Most active investors here
- W Health Ventures (2 rounds)
- 3one4 Capital (1 round)
- Abhishek Goyal (1 round)
- ADBEEV LLP (1 round)
- ADIA (1 round)
- Agrizy founders (1 round)
- Ajay Nair (1 round)
- Al Nahyan family (1 round)
Rounds StopDown covered in the last 12 months. Activity is not a measure of quality.
Questions people ask
Is an online doctor consultation valid in India?
Yes, if the doctor is a registered medical practitioner and follows the 2020 Telemedicine Practice Guidelines, including patient consent and proper records.
Can a doctor prescribe any medicine online?
No. The guidelines sort medicines into lists, and some can only be prescribed after a follow-up or not at all through a remote consult.
How do telemedicine startups earn?
Through consultation fees, subscriptions, employer contracts, clinic services and commissions, often adding medicine delivery or lab tests.
What is the difference between telemedicine and primary care?
Telemedicine is a way of delivering care at a distance. Primary care is the first-contact doctor service, which can be offered online or in a clinic.
Which Telemedicine & primary care startups in India raised money recently?
Sunfox Technologies ($7M, Series A); MyRx (Undisclosed, seed); iKure Techsoft Private Limited ($1.8M, Pre-Series A); Even Healthcare (Rs 208.24 crore, Series B); Brilliance Cosmocare ($200,000, seed).
Who invests in Telemedicine & primary care startups in India?
Among the most active backers in StopDown's coverage over the last year: W Health Ventures, 3one4 Capital, Abhishek Goyal, ADBEEV LLP, ADIA.
Which Telemedicine & primary care companies are in the news?
Recent stories on StopDown cover Genetidoc, ClinikPe, Sunfox Technologies, MyRx, EVERQ, Kids Clinic India Ltd, iKure Techsoft Private Limited, Doctors on Duty.
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