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A comprehensive digital platform to support the patient journey and cascade of care for Tuberculosis treatment and support

Ni-kshay portal plays an indispensable role in India's ambitious endeavor to achieve nationwide TB elimination by 2025. The digital platform aids over 2.5 million individuals seeking TB care annually in India, spanning both the public and private sectors, effectively covering almost the entire TB-affected population. Moreover, it has received global recognition as the premier digital system for TB management in the public health sector.

Video credits: Ministry of Health and Family Welfare, Government of India

Ni-kshay streamlines the tracking of TB patients, making it easier for healthcare providers to monitor their treatment progress. It enables creating a digital case file and monitoring the continuum of care—including presumptive TB case screening, diagnostic management, notification of TB case, drug prescription, direct benefit payments, treatment adherence support, outcome monitoring, and post-treatment follow-up.It provides real-time data and analytics, facilitating more informed decision-making for healthcare professionals. This digital platform also enhances communication and coordination between various stakeholders in the healthcare system, including healthcare providers, laboratories, and government agencies, which is critical for effective TB control.

Furthermore, Ni-kshay India plays a crucial role in reducing the stigma associated with TB by ensuring patient confidentiality and privacy. It also empowers patients by providing them with access to their own health records and treatment information through a mobile application - “TB Aarogya Saathi”. 

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Everwell Health Systems has worked closely with the NTEP (National Tuberculosis Elimination Program) since 2018 to design this comprehensive system. The technical architecture of Ni-kshay has evolved over the years.

 

Ni-kshay works as both a case management and aggregate reporting system. It functions as a one-stop comprehensive integrated platform designed as a set of independent modules to digitize TB treatment workflows in real-time. This makes the entire system interoperable and scalable to meet the increasing demands on the healthcare system. 

 

A healthcare worker can register a person as a presumptive case when they approach a clinic with symptoms. A diagnostic test can be requested and connected diagnostics are used to log the test result within the respective module. For a positive test result, the provider initiates the person on treatment on Ni-kshay. Medications are dispensed and each prescription is recorded on the platform. Clients are provided with treatment support using preferred digital adherence technologies.

Ni-kshay ecosystem

Providers can view real time treatment details on individual cases or in aggregate to understand who has taken medication, where test results are pending, and reach out to persons affected by TB through various virtual care mechanisms, and finally, declare treatment outcomes. Ni-kshay strives for continuity of care, allowing multiple treatment episodes to be linked to the same case file, supporting both transfer-in and transfer-out capabilities to track migrating patients across the country seamlessly.

A set of modules is created on top of the treatment lifecycle to enable various government initiatives and processes such as Direct Benefit Transfers, contact tracing, and comorbidities management. The platform is integrated with various health information systems, laboratories (Ni-kshay LIMS) and drugs and consumables supply chain management (Ni-kshay Aushadhi) to facilitate real-time updates, ensuring accurate and up-to-date patient information.


Program managers and policymakers can use available aggregate reports and dashboards to determine timely actions or interventions needed within their specified jurisdictions. Data on notifications is available in the public domain (reports.nikshay.in). The system holistically captures public and private sector patients and DSTB (Drug Sensitive TB) and DRTB (Drug Resistant TB) and works as a single integrated system for the whole country. TPT (TB Preventive Treatment) clients are also managed on the platform.

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