A three-tier hub and spoke system is  implementing  in the state through the e-Sanjeevani Telemedicine platform. According  to the scheme,   super specialty services  will be available in all the  Family Health Centers  and there no need to depend on the medical collages for the  treatment . In addition, the involvement of private hospitals with KASP will be ensured in the future. The services of a private specialist doctor will be used in the districts not having  medical colleges. This is made possible through the e Sanjeevani Doctor to Doctor service. Specialty services are provided through District General Hospitals and super specialty services are provided through Medical Colleges. Family Health Centers and Urban Primary Health Centers operate as Spook. District hospitals , general hospitals and medical colleges will also function as hubs. During the first phase, a doctor at Spoke Hospital will performs the preliminary examination. If there is a situation where the patient needs to be referred to a specialist doctor, he / she will be connected to the doctor at the hub of the district, general and medical college through the doctor-to-doctor service. This will enable the services of specialist doctors without having to go to medical colleges and district hospitals for speciality and super speciality treatment.

The medicines and tests are prescribing through this process is available from Government hospitals at free of cost. Palliative care staff, aspirants and staff nurses conducting home visits can also provide patients with the services of doctors through doctor-to-doctor. Currently, about 5,000 consultations have been completed through  the Doctor to Doctor service. By considering the popularity of doctor to doctor service , the Hub and Spoke system is being rolled out across the state.