On July 23, 2025, ACCESS Health co-hosted a full-day workshop on care coordination at CMC Vellore’s Bagayam Campus alongside the Department of Community Medicine. The day started with registration and an opening prayer by Revd Giftus Joshua, followed by welcome remarks and introductions from Dr. Dorothy Lall of CMC Vellore. Dr. Vikram Mathews, Director of CMC Vellore, delivered the welcome speech, and Dr. Venkat Raghava, Head of Community Medicine, offered a welcome note. Setting the stage for discussion, Dr. Santosh Mathew’s keynote highlighted the challenges of fragmented patient pathways in India’s health system.
A high-level panel discussion, moderated by Dr. Santosh Mathew, Country Lead – Public Policy and Finance, Gates Foundation, brought together policymakers from state governments to discuss system-level barriers. Vikas Marmot IAS (Mission Project Director, Kuppam, Andhra Pradesh), Sumit Kumar IAS (District Collector, Chittoor, Andhra Pradesh), Dr. Jerard M. Selvam (Additional Director, NHM Tamil Nadu), and Dr. Bijoy E (Joint Director, SHA and SPM, NHM Kerala) shared insights on how governance structures and protocols affect timely referrals and follow-up.
During the morning’s experience-sharing session, implementers highlighted on-the-ground innovations. Dr. Suranjeen Pallipamula from JHPIEGO, Dr. Arun Jose from CCDC, and Dr. Sushilkumar Patil representing PATH’s Satara model outlined efforts to incorporate diabetic foot care, retinopathy screening, and renal services into cohesive patient journeys. Building on these case studies, Dr. Adithyan and Dr. Ashwin led a scoping review discussion to draft the key elements of a coordinated-care framework.
After lunch, six research teams presented ideas – ranging from Arike Health’s community navigation prototypes by Dr. Athul Joseph Manuel to AI-driven referral analytics from Dr. Parvez Memon (JHPIEGO) and Dr. Gitismita Naik (AIIMS Kalyani). Ashfaq Ashraf C (IISC), Dr. Ashmitha Prasad (Manipal Academy), and Amit Kushawaha (Karkinos Healthcare) also shared, moderated by Dr. N. Krishna Reddy, CEO of ACCESS Health International. Open group discussions saw Dr. Dorothy Lall refine the draft framework, while Dr. Oommen John focused on identifying priority research areas and scaling pathways.
Ending the workshop, Dr. Santosh Mathew delivered closing remarks, and Arun Nair expressed the vote of thanks. Based on these discussions, ACCESS Health will finalize the care coordination framework for pilot testing in selected states, compile a repository of digital and operational models, and create a Community of Practice to share learnings and refine solutions, ensuring every patient moves smoothly from initial contact through specialized follow-up.