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WelTel’s concept started in 2005 when clinicians living in Kenya noticed unprecedented loss to follow up during the wide-scale rollout for antiretroviral medications in the treatment of HIV. The need for enhanced engagement in care was evident, especially during long-term management of chronic illness. Mobile phones were ubiquitous and offered the opportunity for a low-touch, efficient way to connect with patients and support treatment adherence. WelTel has worked with numerous patient and provider focus groups, including those most marginalized, to create its core concept. The platform has recently implemented a function to manage contact tracing of patients, allowing both COVID-19+ patients and their close contacts to communicate virtually with health care practitioners during self-quarantine. This strategy has been implemented nationwide in Rwanda. No matter the background of the individual when it came to two-way text messaging in patient care, the best protocol was always “Ask Don’t Tell”, an approach that remains true today. WelTel’s vision is to change the way healthcare is delivered globally while ensuring that those who are hardest to reach are not left behind. IHI Insight 2021 presented by the University of Toronto and University of British Columbia's IHI Open School Chapters IHI UBC: http://www.ihiubc.com/ UTIHI: https://www.utihi.com/