Indigenous people of developing countries have serious shortage of health support including lack of health professionals and technology. It is often difficult for the indigenous people to receive consultation in the hospitals when they face any chronic disease. In Bangladesh, there are 54 groups of indigenous communities with a base of estimated 3 million in number. There are 300 government registered doctors and nurses, and 800 community health workers to provide health services to approximately 3 million people. By the invention of Information Technology, health care services have been modernized and more accessible in recent times. Information Technology has made the health services available at the door of general people. In recent years, there is large number of people in the indigenous community uses internet in their smart phones. As, there is not enough health care organizations and professional doctors in the indigenous community, for this reason, it will be useful and compatible to provide mobile phone-based services to the people. Mobile phone-based health services have great potentiality in reducing ‘digital divide’, and acts as a crucial tool for supporting indigenous community especially chronic disease affected people staying at home. This paper aims to develop, implement and evaluate a mobile based integrated framework for in-home or community care and rural health centers’ patient monitoring and health management.