eSanjeevani, the government of India’s national telemedicine service, recorded more than 47 crore cumulative teleconsultations by July 2026. This impressive figure does not answer how many people the service actually reached. At the 16th BRICS Health Ministers’ Meeting, India presented its Digital Health Architecture as a model for extending care to underserved areas. At the 18th BRICS Summit in the capital, Indian again emphasised the importance of digital health technologies.The case for telemedicine is straightforward: since India’s healthcare is not merely about how many doctors it has but where medical expertise is located and who can access it. In principle, telemedicine has the potential to eliminate geographical limitations to healthcare access.Beyond ‘consultation via telemedicine’A teleconsultation can be the first time people on either side of a digital device are meeting, or it could be a follow-up, or the fourth call a patient is making in a month. Two crore consultations could represent one crore people making two consultations each, or 20 lakh people, each making ten consultations.Since the 47 crore figure is a cumulative one, it shows that the eSanjeevani platform is in use, but it doesn’t indicate who is using it, how frequently, which specialists have been contacted or whether the consultation resulted in treatment or a referral.The overall picture also hides the geographical distribution. Data released by the government to parliament in August 2026 indicate that five states – West Bengal, Andhra Pradesh, Tamil Nadu, Uttar Pradesh and Telangana (see Fig. 1) – account for over 70% of all eSanjeevani consultations. On the other hand, Arunachal Pradesh had fewer than 10,000 and Lakshadweep less than 700 consultations.Also read: Why Telemedicine Won’t Help India’s Ailing Out-Patient Consultations MuchSome of this difference can be attributed to population, but the question remains: is telemedicine expanding faster in areas with the greatest shortage of specialists – thus fulfilling the stated goal of introducing telemedicine – or is it growing in states whose health administrations have more successfully implemented the platform?Access does not guarantee accessibilityWhile digital inclusion is generally measured by whether a person has a smartphone and can receive a signal, healthcare sets a higher standard. For people with disabilities, for instance, telemedicine can eliminate obstacles such as the unavailability of caregivers and the necessity of making hospital visits. Yet simply moving a consultation online does not automatically remove the associated obstacles.A service may be available yet still be inaccessible to a person who cannot navigate the platform, communicate with the provider or obtain the assistance necessary to complete a consultation. When these aspects are not measured, the figures do not reveal the full picture.Further, the main indicator of telemedicine in India is the number of consultations carried out. However, care also involves communication, confidence, diagnosis, referral and continuity. A consultation may be technically finished and yet still of poor quality. The connection could fail repeatedly. Communication with the provider might be inadequate. The referral might never reach the patient.For these reasons as well, the only measure of success cannot be the number of completed telemedicine consultations. In the United States, France and China, survey-based estimates of usage, repeat use and patient experience are supplemented by data from platforms: France obtains an annual figure of roughly 1.4 to 1.5 teleconsultations per user from insurance claims. China finds 2.43 from a national sample survey. The United States gives a usage rate of about 37% based on national polling. But India does not report these or similar details.From counting consultations to counting peopleIndia does not need to start from scratch, as the Ayushman Bharat Digital Mission dashboard already maintains detailed records of digital health activity at scale. A component that provides information about the individuals involved in these events can easily be introduced in the existing system.Also read: Is the Backdoor Policing of Telemedicine Platforms on Legally Sound Ground?A brief telemedicine section, if included in the next round of the National Sample Survey on health or in upcoming NFHS editions, would be an inexpensive means to achieve a great deal. It could show whether a consultation was a first visit or a follow-up, whether the patient received the care or referral they needed, and even finer details, such as whether disability assistance was offered and whether the patient would use the service again.Just four or five such questions would put the broad statistics in context. It would combine official record-keeping with on-ground survey, potentially leading policymakers to ask better questions about the healthcare system. From ‘how much telemedicine is being provided?’ to ‘for whom, for what purpose and with what result is telemedicine being used?’.This is particularly important since eSanjeevani’s hub-and-spoke structure is supposed to link local health workers with remote specialists. For instance, we know that the Ayushman Bharat Health and Wellness Centre model accounted for more than 93% of eSanjeevani usage between the national launch in November 2019 and September 2023.India has built digital health infrastructure on a mass scale and shared this achievement with the world at the BRICS summit. It must now share more granular figures about the number of unique persons reached by this infrastructure, the type of care they received and whether the experience made them willing to use the system again.Annanya Rana is a research student and Megha Jacob is an assistant professor in the Department of Economics, Jesus and Mary College, University of Delhi.