Table 2.

Final ImTeCHO model

Intervention and delivery components	Specific technology inputs through ImTeCHO	Specific actions/outputs from users to follow technology inputs	Timing of delivery
Scheduling job-aid	The system generates and displays ‘ASHA's Daily schedule/task list’ for each user on mobile or web interface. ASHA's Daily schedule/task list, which is updated daily, has a list of reminder alerts displaying names of beneficiaries with services due and administrative tasks with due dates for each task.	ASHAs log in to the ImTeCHO application every day and complete scheduled tasks on time by visiting beneficiaries at home, along with completing administrative tasks.	Mainly during stabilization and maintenance phase
	The system tracks the status (complete or pending) of each task. The system removes a task from ‘ASHA's Daily schedule/task list’ once the ASHA complete the task. The color of text displaying the task changes to red if task becomes overdue.
	The system generates and displays a preservice list (at ImTeCHO application at mobile end) of services due to be provided during VHND.a	ASHAs mobilize all beneficiaries who are due for services during VHND.
BCC job-aid	Multimedia (short videos, photos) is embedded within home visit. Having multimedia as first screen during home visit reduces formality of interpersonal relationship.a	ASHAs use multimedia and checklist for effective counseling towards BCC during home visits.	Mainly during stabilization and maintenance stage
	Digital form to be completed during home visits contains checklists to assess and address determinants of behavior change of families.
Diagnosis and patient management job-aid	ImTeCHO point-of-care decision support system provides probable diagnosis through in-built algorithms based on information entered.	ASHA interviews and examines beneficiary and enters information in digital form to screen, identify, risk stratify, and manage complicated cases.	Mainly during stabilization and maintenance stage
	Phone as a tool for ASHAs to facilitate referral. There is a feature to call emergency transportation through application.	ASHA use mobile phone to call emergency transportation.
	System sends notification alerts via SMS and schedules home visit for PHC medical officer/ANM once complicated case is identified by ASHA.	PHC medical officer and ANM follow up on complicated cases for timely management.
	The system displays customized patient-management guidelines on mobile phone based on diagnosis.	ASHAs manage complicated cases at home who refuse to get referred to health facility.
	The system generates tasks to remind ASHAs to make follow-up home visits to complicated cases.	ASHAs ensure adherence to suggested treatment.
	System sends notification alerts to the helpline representative's (a qualified health provider) dashboard on web interface once a complicated case is identified by ASHA.a	ASHAs receive guidance from a qualified provider over phone to manage complicated cases who refuse to get referred to health facility.
Supervision and support management job-aid	ASHA performance information module at the ImTeCHO mobile and web end will display objective performance parameters for each ASHA in real time.a	Supervisory staff use ASHA performance information module during supervisory field visits.	Mainly during stabilization and maintenance stage
	A dashboard for medical officer displaying reports regarding coverage of selected key interventions (e.g. immunizations), list of complicated cases, drug stock outs, pending incentive payments, and recent deaths.	Medical officer and PHC staff use reports to supervise ASHAs, replenish drugs, etc., during monthly PHC meeting.
	ASHA incentive management system automatically calculates monthly incentives and records their payment.	PHC staff disburses incentives based on ready-made activity report available through the ImTeCHO web.
	Bulk announcements could be sent to ASHAs to recognize instances of extraordinary effort made for patient care, automated congratulatory messages that appear on mobile if ASHA achieves desired performance standards, etc.	Program management cell regularly uploads announcements. ASHA receives additional performance-based incentives, based on task completion rate from the ImTeCHO program.
	The system displays relevant information to assist PHC staff with timely and accurate data entry into other MNCH registries of health department.a	PHC staff use the ImTeCHO interface to complete data entry into other MNCH registries.
	Selected performance parameters of medical officers made available for their supervisors at block, district, and state levels through web application and monthly emails.	Higher-level health official supervises medical officers and gives relevant instructions.
Training, mentoring, and certification	A separate training application that is used to practice and get hands-on experience	The training team uses training application for training (approximately 7 days) of ASHAs. One to two days’ training of PHC staff for use of the ImTeCHO web interface. Focus on reducing effect of using technology on interpersonal communication.a	Mainly during training stage
	ASHA activity log on web has detailed information about ASHAs’ use of application.	The training team remotely (instead of in the field) mentors ASHAs through series of phone calls based on their activity logs during first few weeks after training.a
Patient management helpline	Helpline dashboard has information about all complicated cases identified by ASHAs.	A team of qualified health providers operate helpline to contact ASHAs and beneficiaries to provide guidance over the phone for patient management.	Mainly during stabilization and maintenance stage
ImTeCHO facilitator (IF)	The web interface shows process indicators report.	IF supervises ASHAs and conveys feedback during monthly performance-review phone call and additional calls in between if indicated based on process indicators.	Mainly during training and stabilization and maintenance stage
	Helpline for technology support	IF provides technology support in case of any technology/mobile phone/ImTeCHO application-related problems reported by users.
		IF attends monthly PHC meeting and makes occasional field visits to those ASHAs whose performance parameters within ImTeCHO is consistently poor.
Program implementation cell atheadquarters	A dashboard to show process indicators, which are tools for monitoring the ImTeCHO intervention Monthly email and SMS to medical officers and higher-level health officials about performance parameters	The cell supervises and supports the ImTeCHO facilitators, program coordinators, and helpline. Coordinates with medical officers and higher level health officials	Throughout the delivery of intervention, including preparatory, training, and maintenance stages
		Intervene in emergency situation
		Develop and improvise software application with help of IT partner

^aComponents that were added or modified based on findings of the pilot.