''Doctor to doctor' services through e Sanjeevani Telemedicine System has started functioning Kerala. These services were started with the aim of reducing congestion in health facilities. Currently, a large percentage of service recipients will require follow-up treatment. Large hospitals can be very crowded to see a specialist doctor for follow-up treatment. As a solution to this, Doctor to Doctor service is being implemented. The health department had given permission to implement the scheme in all the districts. Kozhikode district has successfully implemented the Doctor to Doctor service. Activities in other districts are at various stages. With the completion of this, the service will be available across the state. The Doctor to Doctor service is coordinated by setting up a hub in the Kozhikode district. The district's hubs are medical colleges and district hospitals. In addition, specialists will be deployed on a rotation basis in many places. Primary Health Centers, Urban Primary Health Centers, and Family Health Centers act as spokespersons. The services of specialist doctors can also be sought through palliative care nurses who perform field activities and nurses who are mid-level service providers. Patients who do not need an urgent referral are examined by e-Sanjeevani, an expert doctor at the hubs, based on information from health workers from various sources. E Sanjeevani has arranged for a consultation with specialist doctors. Such hubs and spokes should be set up in all districts.