‘TETRA’ uses a novel strategy anchored by non-physician health workers (NPHWs) equipped with a tablet computer with embedded decision prompt systems (mHealth tool) linked to point-of-care devices for blood pressure and blood sugar measurement and guided remotely by a physician via Skype, screen individuals for hypertension and diabetes, facilitate a telemedicine consult, print a physician ordered e-prescription and distribute medication at the doorsteps of beneficiaries across six villages in Telangana (India). The NPHWs follow-up individuals with hypertension and diabetes once in three months and provide a continuum of care.

• Eligible Individuals: 2456
• Hypertension: Screened: 1751; Prevalence: 23.6%; Newly detected: 38.9 %
• Diabetes: Screened: 1686; Prevalence: 11.2 %; Newly detected: 28.6 %

Clinical Improvement at 24 Months

• Blood sugar control improved in 34.1 percent of 189 individuals, corresponding to 64 individuals
• Blood pressure control improved in 54.0 percent of 414 individuals, corresponding to 224 individuals
• Improvement in known hypertensives increased by 12 percent, with a 95 percent confidence interval of 7.9 to 16.0 percent