Digital health delivery is gaining popularity, but its expansion in rural India will bank on connectivity
Like most industries and spheres of life, healthcare too is undergoing digitization in India at many levels. Even as the government has led from the front with its landmark National Digital Health Mission (NDHM), now rechristened Ayushman Bharat Digital Mission (ABDM), the private sector is also embracing digitization. At least in metro cities and big towns apart from a few in smaller cities, several private as well as public hospitals providing tertiary care have been engaged in setting up (or upgrading) some form of digital infrastructure and allocating resources and personnel in the recent past. This would also involve the implementation of healthcare IT applications in terms of Hospital Information System, Hospital Management Information System and Electronic Medical Records (EMR), etc., to manage the patient data in electronic format.
Likewise, patients too are evolving into more digital technology-savvy healthcare receivers, using smartphones and other devices to not just store diagnostic reports and doctors’ prescriptions but also to make appointments, consult, use home-based diagnostics and testing facilities and order medicines.
The NDHM was launched as a pilot in six UTs in 2020 when three principal registries such as Health ID, Health Professional Registry (HPR), Health Facility Registry (HFR) and digital infrastructure for data exchange were developed and implemented. Building on this success, the programme was expanded in a country-wide rollout in September 2021, focussing on key components such as Ayushman Bharat Health Account (ABHA), Health Facility Registry, ABHA App, Healthcare Professionals Registry and Unified Health Interface (UHI). Within a year, the programme has registered considerable success.
As of Sep 12, 2022 according to ABDM website, an impressive over 24 crore ABHA numbers have been created with 1,44,371 health facilities and 69,312 health professionals having registered, along with over seven lakh health records App downloads. By July this year, as many as 52 digital health services/applications have integrated with ABDM including 32 private entities. Besides, by July end, there were as many as 919 healthtech innovators in the ABDM Sandbox, a digital space for experiment of integration before a digital app or health product is made live for the actual use.
While the over 24 crore ABHA numbers may already constitute one-sixth of India’s population, the truth remains that a large part of the healthcare value chain remains outside the government-driven ABDM initiative. According to the government’s own data, of nearly 12 lakh healthcare facilities, a mere 1.4 lakh have joined the ABDM platform. Similarly, of the 50 lakh healthcare professionals today, only 69,000 joining the platform is again an insignificant number.
According to the National Health Profile 2019, only 65 per cent of primary health centres in rural India had computers. And the fact that over 65 per cent of rural India still has no internet.
However, it has only been a year since the nation-wide ABDM launch was done. The foundations for a country-wide infrastructure for internet and digital connectivity will ensure a far better internet-penetrated India in the next 25 years. It is likely that initially the healthcare facilities in tier I and II towns will take the digital path.
All the stakeholders in the entire value chain need to reach consensus for ensuring readiness as well as interest of all, including regulators and agencies in states, healthcare service providers, hospitals, healthcare professionals, diagnostic labs, healthcare software vendors, digital consent solution providers, EHR/EMR/ PHR solution providers, hardware makers and insurance companies.
Given that more than 75 per cent of outpatients and 60 per cent of inpatients get treatment in private facilities, it is important to incentivize the private players sufficiently. Accordingly, suitable PPP models need to be worked out. Moreover, the patient record makers and the software providers need to be convinced to design interoperable systems such as free and open source software.
Similarly, hospitals would need to upgrade their systems. Importantly, privacy and confidentiality of data must be ensured through legal framework as well as technological innovations.
Already, India has seen the emergence of an incredible number of healthtech startups. In a world of IoT, the advent of AI, machine learning and robotic process automation (RPA) is not only catalyzing better clinical decision-making and personalization of treatment but also helping authorities in terms of healthcare research, affordable drug discoveries, disease surveillance and even prediction of diseases. So, digitaisation is vastly improving our public health delivery mechanism. The mammoth Covid-19 vaccination exercise carried out successfully through the digital platform in a country-wide operation is illustrative of this improvement even as we continue to work on and refine the ABDM. By 2047, the healthcare network will be far more efficiently digitalised.
(The author is Senior Director, Medical Communication & Corporate sales, Thieme)
