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TB F.I.R.S.T — the full Find, Interpret, Refer, Support, Track tuberculosis cascade in one app

Screening · Progressive Web App · Bilingual English and Telugu

The gap between a screening flag and a patient on treatment

Tuberculosis programmes rarely fail at the point of screening. They lose people in the space between screening and treatment initiation. A person is flagged, but the referral is never made. A referral is written, but no one confirms that the patient reached the facility. A confirmatory result comes back, but adherence support and follow-up are never recorded anywhere a supervisor can see. Each of those handoffs is a place where a person who was already found can quietly disappear from the programme before treatment ever begins.

The tools built to close this gap are usually built for one stage at a time — a screening app here, a referral register there, a separate adherence diary somewhere else. That leaves the handoffs between them as the weakest joints in the whole workflow, and the handoffs are exactly where both the paperwork and the patient tend to fall through. Reconciling those stages after the fact becomes a clerical job that nobody has time for, and the cascade view that a district officer actually needs only ever exists as a retrospective reconstruction.

TB F.I.R.S.T exists to close that gap by treating the cascade as one continuous workflow rather than five separate tools. The name is the workflow: Find, Interpret, Refer, Support, Track. A single bilingual progressive web app carries a person from first screening contact through to a tracked outcome, so that the same record that flagged someone for screening is the record that shows whether they were referred, whether they were supported, and whether they were followed up.

What each stage of the cascade does

Find. Front-line and field staff capture screening contacts and presumptive-TB indicators directly on a phone, in the field, without needing a desktop or a separate paper register to reconcile later. The record starts where the person is, not where the office is.

Interpret. Findings are organised into a structured risk view so that programme staff can see at a glance which contacts warrant closer attention and which can wait. This is support for a busy triage decision, never a substitute for clinical judgement or for confirmatory testing.

Refer. A presumptive case is routed to the appropriate facility with a referral record that persists, so the handoff from field to facility is visible rather than assumed. The referral remains attached to the person, not to a loose slip of paper.

Support. Once a person is on treatment, adherence and follow-up support carry forward inside the same record instead of starting a new file at every stage. Nothing has to be re-entered simply because the person moved from one stage to the next.

Track. Programme and district staff can see where every case currently sits in the cascade — screened, referred, started, followed up — closing the loop that paper-based, stage-by-stage systems tend to leave open.

Because all five stages sit inside one application and one bilingual interface, a district tuberculosis officer reviewing cascade status is not reconciling five different data sources. They are looking at one workflow that a field worker, a facility and a supervisor each touch at different points, from different places, on different days.

A prioritisation aid, not a clinical verdict

TB F.I.R.S.T is built around a proprietary fusion TB-risk classifier — a model that combines multiple screening signals into a single risk view to help programme staff decide who to look at first. It is deliberately positioned as a prioritisation and triage support tool. It is not a substitute for confirmatory laboratory testing, for radiology, or for clinical evaluation by a qualified clinician, and it does not by itself establish whether a person has tuberculosis. Its role is to help a stretched screening team decide where to spend the next hour, not to make the call on their behalf.

That framing is a design constraint rather than a disclaimer bolted on at the end. Every flag the classifier produces is meant to be read by a trained person before it becomes an action, and the interface is built so that the underlying findings stay visible next to the risk view instead of being collapsed into a single score. A screening team should always be able to see why a contact was raised in priority, and should always be able to override it.

Built bilingual because the field is bilingual

TB F.I.R.S.T operates in English and Telugu throughout the cascade, not as an add-on translation layer but as a working fact of how it is used. ASHA workers, field screeners and facility staff move between the two languages constantly over the course of a single day, and a screening tool that speaks only one of them adds friction exactly where speed matters most — at the initial contact with a presumptive case. Bilingual operation also matters at the far end of the cascade, where adherence support depends on a person understanding what they are being asked to do for months at a time.

Delivered as a progressive web app

TB F.I.R.S.T is delivered as a progressive web app rather than a native application. A field worker opens it in a phone browser and can add it to the home screen without going through an app store, and a supervisor can open the same workflow on a laptop. For a programme, that means updates reach every user without a distribution cycle, and onboarding a new screener does not begin with a download queue on a shared device.

Who this is for

TB F.I.R.S.T is built for district tuberculosis officers and programme staff who need a single view of cascade status across a district rather than several disconnected registers; for non-governmental screening programmes running active case-finding drives who need a field-usable tool that a screener can operate on a phone; and for community medicine departments running screening camps and outreach as part of teaching and service activity. It is a tool for teams who already run a tuberculosis screening and referral workflow and want the handoffs inside that workflow to stop being invisible.

Where it sits in Clinoble's work

TB F.I.R.S.T is one of several products built by Clinoble Innovations Private Limited around the same idea: that screening only matters if what follows the screen is recorded and followed through. CardioPulmo applies phone-based screening to heart and lung sounds. TeleVaidyam covers teleconsultation and referral for rural primary care. NETHRA is a public-health intelligence platform for early disease-risk reporting and surveillance. Aarogyam365 is a bilingual family preventive-health platform, and the FAP Logbook is a role-based logbook for the MBBS Family Adoption Programme. TB F.I.R.S.T is the screening-to-treatment cascade expressed as a single tuberculosis workflow.

Current status

TB F.I.R.S.T is live as a bilingual progressive web app at tbfirst.com, covering the full Find-Interpret-Refer-Support-Track cascade and built for national screening at scale.

It is developed by Clinoble Innovations Private Limited, a company based in Hyderabad, Telangana, India. The founder and director is Dr. Jaideep Rao M., MBBS, MD Community Medicine, whose background in community medicine shapes how the cascade is structured around real field workflows rather than around a single-stage screening interaction. The company also has two Indian patent applications pending in quantitative clinical imaging, IND 202641088451 and IND 202641090786.