This Article is written by Vaibhav Singh (a 3rd-year law student from USLLS, Guru Gobind Singh Indraprastha University)
INTRODUCTION
Prime Minister Narendra Modi launched the Ayushman Bharat Digital Health Mission on September 27 via video conferencing. Currently, PM-DHM is being implemented in the pilot phase in six Union Territories. The key components of PM-DHM include a health ID for every citizen that will also work as their health account, to which personal health records can be linked and viewed with the help of a mobile application; a Healthcare Professionals Registry (HPR) and Healthcare Facilities Registries (HFR) that will act as a repository of all healthcare providers across both modern and traditional systems of medicine.
The Ayushman Bharat Digital Mission (ABDM) is undoubtedly a promising initiative and very relevant in today’s digital age. The broad objective is to maintain health records of citizens in a digital format so that these can be easily accessed by doctors, whether in an emergency or otherwise. The government plans to allow every citizen a 14-digit health ID, much like Aadhaar and, with the medical documents stored online, health practitioners can check out a patient’s medical history no matter where he or she is. Indeed, centralising and digitising pertinent information does seem a good and convenient way to work and would be especially useful when patients are switching health providers.
- The mission aims to develop the backbone necessary to support the integrated digital health infrastructure of the country.
- It will close the current gap that exists among the various stakeholders of the country’s healthcare ecosystem through digital technologies.
- The mission was launched during the third anniversary of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).
- The National Health Authority (NHA) under the Ministry of Health and Family Welfare is the implementing agency of the mission.
AYUSHMAN BHARAT DIGITAL MISSION VISION
ABDM’s broad vision is universal health coverage. It will create a seamless online platform “through the provision of a wide range of data, information and infrastructure services, duly leveraging open, interoperable, standards-based digital systems” while ensuring the security, confidentiality and privacy of health-related personal information.
AYUSHMAN BHARAT DIGITAL MISSION OBJECTIVES
The idea behind this revolutionary mission is to make healthcare equitable and accessible to all citizens giving a continuum of care with citizens being the owner of their health data. The stated objectives of the Ayushman Bharat Digital Mission are as follows:
- Establishing state-of-the-art digital health systems to manage the core digital health data, and the infrastructure required for its seamless exchange;
- Establishing registries at appropriate levels to generate a single source of truth with respect to clinical establishments, health workers, healthcare professionals, drugs and pharmacies;
- Enforcing the adoption of open standards by all national digital health stakeholders;
- Creating a system of personal health records, based on international standards, easily accessible to individuals and healthcare professionals and services providers, based on individual’s informed consent;
- Promoting the development of enterprise-class health application systems with a special focus on achieving the Sustainable Development Goals for health;
- Adopting the best principles of cooperative federalism while working with the States and UTs for the fulfilment of the scheme’s vision;
- Ensuring that healthcare professionals & institutions in the private sector participate actively with public health authorities in the building of the ABDM, through a combination of prescription and promotion;
- Ensuring national portability in the provision of health services;
- Promoting the use of clinical decision support (CDS) systems by health practitioners and professionals;
- Promoting better management of the health sector leveraging health data analytics and medical research;
- Providing for improving the efficiency and effectiveness of governance at every level;
- Supporting effective steps being taken for assuring quality of healthcare; and
- Strengthening the existing health information systems by ensuring their compliance with the defined standards and integration with the proposed ABDM.
AYUSHMAN BHARAT DIGITAL MISSION FEATURES
The salient features of the mission are as under.
- Under this mission, every citizen will get a unique health ID which would act as a digital repository of all health-related data of an individual. The digital health ID is voluntary and free of cost.
- The ID will enable access and exchange of health records of citizens with their consent.
- The Healthcare Professionals Registry (HPR) and the Healthcare Facilities Registries (HFR) components of the mission will be the repository of all healthcare providers and this includes both traditional and modern health practitioners.
- Health ID can be created using the mobile number or the Aadhaar. In the future, registering through PAN card or driving license would also be made possible.
- An individual has the option of either deactivating his/her ID temporarily or permanently deleting the ID, so an exit option is provided.
AYUSHMAN BHARAT DIGITAL MISSION BENEFITS
The scheme is expected to greatly enhance the efficiency, effectiveness, and transparency of health service delivery.
- Patients will be able to securely store and access their medical records (such as prescriptions, diagnostic reports and discharge summaries), and share them with health care providers to ensure appropriate treatment and follow-up. They will also have access to more accurate information on health facilities and service providers.
- The option of availing remote healthcare services such as teleconsultations and e-pharmacy are also there.
- Through the system, citizens will have the choice of accessing both private and public healthcare providers. It will also ensure transparency in the pricing of health services and also enhance accountability for the services delivered.
- Healthcare professionals will also have better access to the medical records of individuals (with their consent) which will ensure timely delivery of the appropriate services. This is because it is possible that patients forget about their past medical details or deem them irrelevant whereas a complete picture may be necessary for doctors to prescribe the course of treatment.
- Also, it will no longer be necessary for people to carry physical reports everywhere.
- Policy makers and programme managers will have better access to data, enabling more informed decision making by the Government.
- With data on people’s health at hand, the government can nudge people towards healthy lifestyles, thereby preventing diseases and saving costs to the people, which means that people with good lifestyles will have to pay lower health insurance premiums.
- Currently, the use of digital health ID in hospitals is restricted to only one hospital or to a single group, and mostly concentrated in huge private chains. The new initiative will bring the entire ecosystem on a single platform.
- The availability of such aggregated information in one place will also greatly aid researchers.
AYUSHMAN BHARAT DIGITAL MISSION CONCERNS
The concerns about the privacy of the data cannot be wished away. Medical records contain very sensitive and private information and, while the PM has assured us the data would be safe, the exact mechanics of how this would be ensured are unclear. After all, we do not yet have a data protection law in India, the Personal Data Protection Bill is yet to be passed. The law could have been a deterrent with some severe punitive measures. Fears that the records could be leaked, sold or otherwise misused, therefore, are not in the least irrational, given that so many individuals theoretically can access the information.
WHAT WAS THE NEED FOR THIS MISSION?
The mission aims to liberate citizens from the challenges of finding the right doctors, seeking appointments, payment of consultation fees, making several rounds of hospitals for prescription sheets, among several others and will empower people to make an informed decision to avail themselves the best possible healthcare.
WAY FORWARD
The NDHM still does not recognize Health as a justiciable right. There should be a push draft at making health a right, as prescribed in the draft National Health Policy, 2015. In addition, the failure of a similar National Health Service (NHS) in the United Kingdom must be learnt from and the technical and implementation-related deficiencies must be proactively addressed prior to launching the mission on a pan India scale.
The standardisation of NDHM architecture across the country will need to find ways to accommodate state-specific rules. It also needs to be in sync with government schemes like Ayushman Bharat Yojana and other IT-enabled schemes like Reproductive Child Health Care and NIKSHAY etc.
