National Digital Health Mission

In the year 2020, the world experienced a big shift in the healthcare sector amid the Covid-19 Pandemic. A whole new chapter has begun for those healthcare platforms which have been struggling hard for support from the government. But sadly it took a virus attack for understanding the vital role digital healthcare could play, especially in a country like ours. Under the NDHM program launched by the government every citizen would have a unique health ID, digitized health records and registry of doctors and health facilities.

The pandemic-induced situation and has drawn a five-point conclusion of promoting:

  1. Work from home
  2. Breaking the supply chain from China in India and, hence, pushing for labor reforms, dilute FDI norms and speed up corporatization and privatization etc.
  3. It also came to the conclusion that COVID-19 would see a phenomenal rise in ‘Telemedicine’, a euphemism of the patient-doctor-prescription relation through IT and a mechanism to eventually replace the public health services network.
  4. Increasing contactless delivery like e-commerce, e-Pharmacy, etc.
India in COVID

Some essential points to note under this program:

. Initially the program is supposed to be launched in the six union territories namely Andaman & Nicobar Islands, Puducherry, Dadra-Nagar Haveli & Daman and DIU, Lakshadweep, Chandigarh and Ladakh.

  • There would be modules for digital interface i.e to digitally see, hear and talk to the patient, or anyone related to him/her.
  • Patients would be the focal point under this initiative as under their willingness a unique health ID would be made to keep their health records such as medical condition, prescriptions, diagnosis reports, doctors to consult, etc in digitized format to gain universal access to them. The point to note here is that it’s not a mandatory step but when done, the data would be accessible if authorized.
  • There will be an option of the health ID being linked to Aadhaar, but it will not be mandatory unless the person wants to avail of any government subsidy schemes. 
  • There is no mandate to keep data on Government servers only, further patients also have the option of choosing the time period for which they want to grant consent.
  • The program would provide leverage to e-pharmacies and telemedicine’s services. (Further a study by the Center for Disease Dynamics, Economics & Policy (CDDEP) in the US says that India is facing a shortage of 600,000 doctors with a doctor patient ratio 1:1456 which is way below WHO limit 1:1000.) Under this initiative patients from rural backgrounds will also benefit from experienced doctors and could avail quality low cost generic medicines. Private stakeholders will have an equal opportunity to integrate with these building blocks and create their own products for the market under this.
  • The initiative by using AI and Machine Learning would also help analyze disease patterns, predict onset of ailments and thus suggest seasonal outbreaks. It would thus help effectiveness and transparency in healthcare delivery and preparedness.
  • It would save the cost of travelling to consult a physician and also the burden of diagnostic tests being done multiple times.
  • There would be an Information Security Policy wherein a strict ISO 27001 norms as a standard and NIST as a framework would be followed.
  • The system has the Digi-Doctor option which allows doctors from modern and AYUSH systems of medicine from across the country to register, get authenticated, share data on a web portal, and to write prescriptions with digital signatures.
Rural India

The changes this initiative would bring about:

  1. privatization of healthcare system replacing government healthcare services;
  2. promoting ‘e-Pharmacy’ for online supply of medicines and ‘Telemedicine as mode of online diagnosis to digital prescription for the private sector’s benefit
  3. to keep an individual’s medical history and other details under governmental control, which may well end up being used for commercial purposes by the private sector, including during trials for new formulations by multinational drug companies.

Issues related to the program:

  • who will maintain and manage the centralized repository of citizen’s health data;
  • who will own the data — the individual or the state;
  • whether individuals can transfer the data between service providers (which is an opaque and cumbersome exercise in the offline world today)
  • whether the individual has the right to erase irrelevant healthcare data and maintain ‘his or her right to be forgotten’

As per the National Digital Health Mission blueprint, there will be two separate arms —

  1. one for regulation (Mission Steering Group)
  2. other for implementation and operational management (Empowered Committee).

Details on the usage of the program:

(i) For generating a new health ID card, you need to provide either your Aadhaar card number or mobile phone number. The portal will ask for your basic details such as your name, date of birth, state, and gender once you’ve provided your Aadhaar or mobile phone number.

(ii) Apart from the dedicated portal, public hospitals, community health centers, health and wellness centers across India, and any other healthcare provider who is a part of the National Health Infrastructure Registry will be able to help you create your health ID card.

(iii) In case of new-born and children below 18 years, parents have been provided with the ability to create a health ID card on behalf of their children. Individuals creating digital health IDs have also provided the option to add a nominee to view and help manage their records.

(iv) At present, there is no option for citizens creating their digital health IDs to digitize their old paper records. The government, however, has plans to bring an option to let people upload their paper records under their health IDs.

(v) It will create a personal health record, a national health portal for the mission, a mobile application and dedicated call centers will be established and citizens can get digital referrals, consultations and online appointments.

(vi) Registries and directories will be maintained on diseases, clinical establishments and healthcare professionals. While the doctors will get a unique identifier which would be separate from the license they receive for practicing medicine.

 

A directory of all health facilities (hospitals, diagnostic centers, pharmacies, and clinics), doctors, nurses and paramedical directory and health workers, allied professionals directory will be created.

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