India is in the midst of what some have dubbed the “world’s biggest healthcare overhaul.” In addition to recently launching one of the world’s largest publicly funded health insurance programs, set to cover some 500 million people living in poverty, the government has also been working diligently to develop a new digital health strategy for the nation.
The work on the strategy began more than five years ago, when the Ministry of Health and Family Welfare and the Ministry of Communication and Technologies developed a new set a metadata and data standards for health – essentially a common set of standards for the collection, creation, and coding of all health data that can be easily transferred across computers and information systems anywhere in the country. The standards were based on global best practices but adapted to better serve the local context. Previous to its work on data standards, the government also developed a system to allow it to issue a National Identification Number to all healthcare facilities in India.
These efforts have now put the government of India in a position to launch a new National Digital Health Blueprint. The blueprint, which is now open for public comments and consultations, validates the six pillar strategy that ACCESS Health has advocated for, namely:
- A governance methodology and framework to help the digital health blueprint bring balance between patient privacy and scale.
- Highlight the value and role of standards-based system design, including meta data and data standards for health, the health data dictionary, and registries.
- A Health Delivery Information System to better manage healthcare provider operations, including software for patients medical records.
- A Health Insurance Information Platform to provide better underwriting support for government schemes and to manage fraud and risks.
- Electronic Health Records and a Health Information Exchange to provide citizens access to their health records and allow policy experts to understand disease burdens patterns.
- Information and communications technology for infrastructure and capacity building to support digital health transformation.
A number of key members now on the ACCESS Health Digital Health team previously worked on the metadata and data standards initiative and on developing the national identification numbers. Their work was carried forward in the national blueprint.
In addition to its impact in India, the work the government has undertaken is likely to become a model for other emerging nations. The blueprint highlights some of the key points that ACCESS Health believes should be a part of any national digital health strategy. These include:
The need for federated governance and technology models to reflect the healthcare system, given that healthcare in India is a state-related subject;
The need to shift focus to more preventive medicine via a focus on strengthening the primary healthcare system and promoting alternative schools of medicine;
The importance of issuing of a personal health identification number that allows consent-based identification and portability of medical records across the continuum of care;
The importance of a mobile-first design approach that recognizes the growing penetration of telecommunication links on the back of low data tariffs;
The need for a data-driven approach to health policymaking that recognizes the role of disease registries for accurate capturing of health burden; and
Recognition that there’s a need for keeping citizens healthy and productive to achieve economic growth as sick citizens become a burden on the system.
Our Digital Health team looks forward to supporting the Government of India in its ongoing efforts to develop and implement this critical new strategy to improve health in the country.