Instead of having to physically carry around their bulky medical records, Indians will soon be able to use digitally enabled tools to share prescriptions, diagnostics reports, and other medical history documents with healthcare providers, irrespective of where and when they were generated. Late last month, the Government of India launched the Ayushman Bharat Digital Health Mission for the entire country, almost a year after it was implemented on a pilot basis in six Union Territories. 

The flagship digital initiative involves the creation of a unique digital health ID for every citizen, a cadre of digital healthcare professionals, and a centralized facilities registry. The government, through this project, aims to create a “holistic and inclusive” model of healthcare that simplifies processes for hospitals and increases the ease of living of citizens. 

Under the initiative, the government will work towards creating a seamless online platform for easy access to treatment records and to enable faster and effective treatment. The unique digital health ID will involve citizens’ health records being maintained and digitally protected. Under the mission, users can access and link personal records with their unique ID to create a longitudinal health history. According to the Health Ministry, the model stresses preventive healthcare and, in case of disease, tries to ensure easy, affordable and accessible treatment.  

The government seeks to create the online platform through the provision of a wide-range of data and infrastructure services that use open, interoperable, standards-based digital systems to ensure the security, confidentiality,  and privacy of health-related personal information. The mission finds it roots in a 2018 NITI Aayog proposal to create a centralised mechanism to uniquely identify every participating health user, through the National Health Stack.

What is the unique health ID system?

The unique national health ID will be a repository of all health-related information of a person. According to the National Health Authority (NHA), every patient who wants to have their health records available digitally can create this Health ID. The ID will be linked to a health data consent manager which will seek the patient’s consent and allow for seamless flow of health information from the Personal Health Records module. 

The Health ID is created by using a person’s basic details and mobile number or Aadhaar number. This will make it unique to the person, who will have the option to link all of their health records to this ID. The official website states that ABDM will soon roll out features that will support health ID creation with a PAN card or a driving licence. Through the digital health ID, the patient himself and the doctor too can check old records if needed. 

How does one get a unique health ID?

Any person wishing to be part of the ABDM must create a health ID, which is a randomly generated 14-digit number. The ID will be broadly used for: unique identification, authentication, and threading of the beneficiary’s health records across multiple systems and stakeholders. One can get a health ID by self-registration on the portal or by downloading the ABMD Health Records app on one’s mobile. Additionally, one can also request the creation of a health ID at a participating public or private health facility. The beneficiary will also have to set up a Personal Health Records (PHR) address for consent management, and for future sharing of health records. 

Are citizens’ personal health records secure?

The NHA says ABDM does not store any of the beneficiary health records. The records are stored with healthcare information providers as per their retention policies, and are shared over the ABDM network with encryption mechanisms, only after the beneficiary expresses consent.

How exactly will citizens benefit?

The digital health ID, which creates a health account, ensures that a citizen’s old medical records are not lost, as they are stored digitally. This eliminate unnecessary repetition of tests and procedures, and brings about standardisation of care. 

The digital ecosystem will also enable other facilities such as online consultations, diagnosis and delivery of medicines. The digital ecosystem will also cut the unnecessary travel that patients in rural areas and small towns have to undertake to access healthcare.

It will enable individuals to discover hospitals, laboratories and pharmacies across the country through the registries. Currently, many patients rely on recommendations from family and friends for medical consultation, but now the new platform will tell the patient who to reach out to, and who is the nearest. Labs and pharmacies will also be easily identified for better tests using the new platform.

Registration of Healthcare Providers and Institutions:

The initiative also aims at creating a registry of all doctors, nurses, paramedics and of all hospitals, clinics, labs, medicine shops in the country. This means that this digital mission will bring every stakeholder related to health together, on a single platform through a Healthcare Professionals Registry (HPR) and Healthcare Facilities Registries (HFR). These will act as a repository of all healthcare providers across both modern and traditional systems of medicine. This will ensure ease of doing business for doctors and hospitals and healthcare service providers. 

How will it benefit healthcare providers and facilities?

People often do not have their medical records at the time of going to the hospital. In such a situation, the medical consultation, investigation has to be started afresh. Due to the lack of medical history records, it also takes more time and increases the cost and sometimes the treatment becomes contradictory. 

Through the health ID, healthcare service providers will be able to better understand the patient’s health history and past records of illnesses or special conditions. This will help them in reducing inefficiencies and improving clinical outcomes. This will also help hospitals track their patients more closely. For the health insurance industry, the data will help in robust underwriting of policies.

The Mission will connect the digital health solutions of hospitals across the country with each other to bring in interoperability.  At present, the use of digital health ID in hospitals is currently limited to only one hospital or to a single group, and mostly concentrated in large private chains. The new initiative will bring the entire ecosystem on a single platform. Data portability could expedite the treatment of the critically ill, especially those who suffer from more than one ailment.

In Conclusion

As per the ABDM, the initiative aims to develop the backbone necessary to support the integrated digital health infrastructure of the country. It is expected to bridge the existing gap amongst different stakeholders of Healthcare ecosystem through digital highways.

The severity of COVID-19 amongst those with comorbidities highlighted the need for a repository that alerts a doctor to a patient’s medical history at the click of a computer mouse. In the long run, the creation of a health record system could improve public health monitoring and advance evidence-based policymaking. The attainment of these objectives will, however, depend on the manner in which policymakers navigate challenges that arise from the issues that have long affected the Indian healthcare sector. It will also require them to be mindful of the ethical issues pertinent to the use of digital data.

References:

https://www.india.gov.in/spotlight/ayushman-bharat-digital-mission-abdm

https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1758511

https://www.thehindu.com/sci-tech/health/explained-what-are-the-concerns-of-digital-health-mission/article36800075.ece

https://indianexpress.com/article/explained/ayushman-bharat-digital-mission-national-health-id-narendra-modi-7540456/

https://abdm.gov.in/home/ndhm

https://www.moneycontrol.com/news/business/companies/explainer-what-is-ayushman-bharat-digital-mission-what-this-means-to-patients-and-concerns-7519311.html