The Union government’s Ayushman Bharat Digital Mission (ABDM) is the attempt to digitise personal health records (PHR) of patients. Thanks to the pandemic, two unrelated things—online healthcare and creating a Unique Health ID (UHID)—propelled the possibility of creating a single digital locker to store health records. This happened when citizens logged on to the CoWIN app for getting vaccine shots. The UHID network will operate like UPI which disconnected the payment system from the banking system.
Leading the ABDM rollout is R.S. Sharma, CEO, National Health Authority, and former chairman of Telecom Regulatory Authority of India (TRAI). Working with a team of developers, system architects and designers, key IT systems have been rolled out under his watch. Recently, the ministry of health unveiled ABDM in six Union Territories (UTs).
What is ABDM all about?
The objective is to leverage technology to deliver health services. Currently, there is a lack of infrastructure and access to doctors in remote areas. ABDM envisages all healthcare-related activities to move online. Most healthcare providers, hospitals, doctors, pharmacists, diagnostic labs, paramedics are encouraged to come on a single platform. Anyone wanting to access a doctor, however distant, can log on to the National Digital Health Mission (NDHM) platform. It will reduce costs, improve access and provide better quality. The idea is to get delivery online with the patient as a decision-maker.
Around 24,000 hospitals are empanelled online with half of them being private hospitals. The UHID can be linked to personal electronic records in a hospital, diagnostic lab, pharmacy, etc. The records can be accessed by the patient across any healthcare provider when needed.
NDHM is expected to fire up an ecosystem of software developers. It is possible to digitize a handwritten prescription using AI. The government expects a whole new software ecosystem to develop around UHID.
On record keeping and data gathering
NDHM will enable patients to share health records electronically. This is to nudge healthcare providers to produce digitally machine-enabled records. The government is not gathering any data. The idea is to use digital means. If you are teleconsulting a doctor, he must have access to your records through your UHID number.
The records will be where they are generated and not in a single repository. For instance, Apollo Hospital will have records of its patients, while Max will keep its records. Since it is virtual, it can be accessed by the patient and shared across healthcare providers. A UHID is required to link health records.
The government nudge
The UHID network will operate like UPI, which disconnected the payment system from the banking system. There will be a protocol for transfer of health-related information transfer, quite like money transfer. Like the virtual payment address in UPI, there will be a virtual health address in UHID.
The security issue
The data will be anonymised, to protect the privacy of people. The government will not have access to data or own the data. It will be guided by data-protection laws.
NDHM does not aim to create a repository of health data. Instead, it will have a directory of Healthcare providers, hospitals, pathology labs, pharmacies, etc. It is a gateway. On top of that will be patient-facing apps and below the gateway will be service providers. It will be guided by patient demand. The patient will choose the doctor, the language, the place of choice and their rate card without it being a silo.
Proof of the pudding
The government conducted a pilot in six UTs. The idea was that UTs are small and directly under the Centre. The government plans to put reference applications like BHIM was for UPI. It will be an open architecture, based on open standards and open source. Already 80,000 out of the 1.5 lakh primary health centres are connected.
Based on the data, using AI and ML, there will be multiple software services on offer. Already machine X-rays are better and extremely rich. Driven by AI, the ministry of health expects lower consultation costs as the doctor has assistance from an expert system, say in reading an X-ray. If the doctor’s care delivery is better, he gains as he becomes more sought-after. India’s healthcare delivery will be driven by data. Already, many decisions are being made based on patient information by state governments. If more people adopt UHID, it will change the face of healthcare in times ahead.