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RSTV: COVID-19: INDIA FIGHTS BACK- NATIONAL DIGITAL HEALTH MISSION (NDHM)

RSTV


Introduction:

National Health Authority (NHA), which is the implementing agency for the Pradhan Mantri Jan Arogya Yojana, has also been working on creating a digital health ecosystem, complete with a personal health ID for every Indian, identifiers for doctors and health facilities and personal health records.

What is the mission about?

  • The mission envisages an integrated platform for the healthcare in the country. The platform will serve as the focal point of a complete digital health ecosystem.
  • It will contain:
    • personal health ID for every Indian
    • digitised health records
    • registry of doctors
    • registry of health facilities across the country
    • registry of e-pharmacy and telemedicine services

Highlights of the National Digital Health Blueprint (NDHB):

  • It lays out the ‘building blocks’ for the implementation of the National Health Stack (NHS), which aims to deploy Artificial Intelligence (AI) in leveraging health records.
  • Keeping true to the government’s larger agenda, of ‘data as a public good’, the blueprint proposes the linking of multiple databases to generate greater and granular data that can be leveraged by the public as well as private sector – including insurance companies, hospitals, apps and researchers.
  • The blueprint proposes a National Digital Health Mission “as a purely government organisation with complete functional autonomy adopting some features of some of the existing National Information Utilities like UIDAI and GSTN.”

 Objectives:

  • To establish national and regional registries to create single source of truthin respect of Clinical Establishments, Healthcare Professionals, Health Workers and Pharmacies.
  • Creating a system of Personal Health Recordsaccessible to the citizens and to the service providers based on citizen-consent.
  • Promoting the adoption of open standards by all the actors in the National Digital Health Ecosystem.
  • Promoting Health Data Analyticsand Medical Research.

 How will it help?

  • It will ensure interoperability of dispersed healthcare data
  • Good quality collection, storage and dissemination of health data
  • Rich resource of health data that can be used for Research & development purposes using Big Data analytics, artificial intelligence etc.
  • Spur in the entrepreneurial activity – mobile applications to facilitate both patients and doctors
  • Easier and effective monitoring of outbreaks like that of Japanese encephalitis, dengue, malaria, novel coronavirus etc.
  • Effective monitoring and assessment of various health schemes
  • Electronic records minimise possibilities of errors, tampering, damage
  • Important for development of the fields of the future – precision medicine, gene-based therapies etc

Concerns:

  • This National Blueprint illustrates yet another example of the Centre moving forward with a major digitisation program involving the data of millions of citizens without a data protection law in place.
  • Data security is a prerequisite for any data movement. Currently, data privacy in health is a gray area.
  • Data researchers and activists have expressed concerns about the development of this policy, which proposes a health data set-up on a foundation of India Stack – a bouquet of privately-owned proprietary software applications.

Scope of NDHM:

  • The NDHB described in the previous chapters indicates, at different places, the contours of the Scope of work to be done if a digital health eco-system is to be established in the country.
  • It is necessary to identify, collate and analyze all these work items to know the precise scope of NDHM. The following requirements culled from the previous chapters help us define the Scope more precisely:
    • Health and Well-being for ALL;
    • Health and Well-being at ALL Ages;
    • Universal Health Coverage;
    • Citizen-centric Services;
    • Quality of Care;
    • Accountability for Performance;
    • Efficiency and Effectiveness in delivery of services;
    • Creation of a holistic and comprehensive health eco-system.
    • The Action Plan must be designed to ensure that the scope as above is well-served.

Expected Outcomes:

  • It is essential that clear outcomes are laid down for a major initiative like the NDHM, so that all the stakeholders can work towards achieving a common set of goals.
  • The outcomes listed here are again culled from the previous chapters and collated for a holistic view. The various artefacts and deliverables of NDHM should be designed and developed in such a manner as to enable us to move in the direction of the outcomes.
  • All citizens should be able to access their Electronic Health Records in a convenient manner, preferably within 5 clicks.
  • Citizens need to undergo any diagnostic test ONCE ONLY, during the course of an episode, despite taking treatment from different health service providers.
  • Citizens should get Integrated Health Services at a single point, though multiple agencies/ departments/ services providers are involved;
  • NDHM shall assure Continuum of Care to the citizens, across primary, secondary and tertiary care and across public and private service providers;
  • A framework for Unified Communication Centre will be prepared to facilitate voice-based services and outreach;
  • NDHM shall support national portability for healthcare services;
  • Privacy of personal and health data, and consent-based access of EHRs will be the inviolable norm that shall be complied by all systems and stakeholders;
  • NDHM will be aligned to the SDG’s related to health;
  • NDHM will enable evidence-based interventions in the area of public health;
  • Above all, the analytical capabilities of NDHM will support data-driven decision-making and policy analysis.