CHANGE - CVD
Reconceptualising Primary Health System for Cardiovascular Care using Multicomponent Digital Health Model
CHANGE – CVD is a patient-centric, community-based cardiovascular health initiative that brings together trained health professionals, cutting-edge digital health tools, and primary care capacity building to serve underserved rural populations across India. Developed by the Centre for Chronic Disease Control (CCDC), the CHANGE – CVD initiative builds on a multi-component digital health framework—integrating hand-held portable point-of-care (POC) diagnostic devices, Clinical Decision Support Systems (CDSS), telemedicine, and Electronic Health Records (EHR) into routine primary healthcare delivery. To deliver comprehensive, accessible primary cardiovascular healthcare and optimize specialist referral pathways in rural areas through an enhanced primary care network—integrating skilled human resources, advanced eHealth technology, point-of-care diagnostics, and clinical decision support over an 18-month implementation period. Operating across 10 Rural Health Training Centres (RHTCs) affiliated with five premier medical institutions in four states—Kerala, Punjab, Tamil Nadu, and Karnataka—the programme strengthens village clusters where specialized cardiovascular infrastructure has historically been scarce.
Team Details (PI, Co-PIs, Secretariat)
Prof. Raman Krishna Kumar
Head, Capacity Building, CCDC, Chnical Professor & Head, Dept. of paediatric cardiology Amrita Institute of Medical Sciences and Research Center, Kochi
Prof. Dorairaj Prabhakaran
Executive Director, Centre for Chronic Disease Control (CCDC)
Dr Arun P Jose
Deputy Director & Head - BRIDGE Centre for Digital Health
Mr Nikki Pandey
Lead - Partnership and Enzagement. BRIDGE Centre for Digital Health, CCDC, New Delhi
Dr Nimra Shireen
State Program Manager, BRIDGE Centre for Digital Health, CCDC, New Delhi
Ms Aakrushi Brahmbhatt
Research Fellow, BRIDGE Centre for Digital Health, CCDC, New Delhi
Mr Deepak Kumar
Program Coordinator, BRIDGE Centre for Digital Health, CCDC, New Delhi
Project Execution
The CHANGE–CVD project is being implemented across ten Rural Health Training Centres (RHTCs) affiliated with Amrita Vishwa Vidyapeetham, Dayanand Medical College & Hospital, Madras Medical College, JSS Academy of Higher Education & Research, and St. John’s Medical College. The project is designed to strengthen heart disease screening, diagnosis, treatment, and referral services at the primary healthcare level using a combination of digital health technologies and trained healthcare teams.
Healthcare providers, including doctors, nurses, and frontline workers, receive structured training on cardiovascular disease screening, use of digital tools, telemedicine processes, and patient management. Philips Lumify handheld ultrasound devices are introduced at participating centres to support early identification of heart-related abnormalities and improve timely referrals to higher healthcare facilities when needed.
The project also uses the DigiSetu assisted telemedicine platform for patient registration, clinical data recording, teleconsultation, referral coordination, and follow-up tracking. In addition, the mPower electronic clinical decision support system (eCDSS) helps healthcare providers follow standard treatment guidelines and make informed decisions during patient care.
Referral pathways between primary, secondary, and tertiary healthcare facilities are being strengthened to improve continuity of care and access to specialist consultation. Together, these interventions aim to improve delivery of quality cardiovascular care in rural and underserved populations.
Potential Impact
The CHANGE–CVD project has the potential to improve access to quality heart disease care in rural and underserved communities by supporting early detection, timely treatment, and better referral systems. The use of digital health tools, telemedicine, and handheld diagnostic devices may help healthcare providers identify high-risk patients earlier and improve follow-up care. The project is also expected to strengthen the skills and confidence of primary healthcare workers in managing cardiovascular diseases. By improving coordination between healthcare facilities and increasing access to specialist consultation, the initiative may contribute to better blood pressure and diabetes control and overall improvement in cardiovascular health outcomes.
