Empowering India's healthcare system through digital health mission

The Indian healthcare system is vast and complex, serving 1.4 billion people. The major challenge is providing equal access and quality care to the diverse population.

On 15 August 2020, Prime Minister Narendra Modi inaugurated the National Digital Health Mission (NDHM), now renamed Ayushman Bharat Digital Mission (ABDM). Its main goal is to build a national digital health system that will improve healthcare access and efficiency in India. The ABDM aims to support universal health coverage while safeguarding the security, privacy, and confidentiality of health-related personal information.

In this blog post, we'll learn more about digital health, the ABDM, and information related to Ayushman Bharat Health Account (ABHA).

1. Digital health

What is digital health?

Digital health combines both technology and healthcare, improving healthcare services. This digital transformation includes software, hardware, and services that benefit both patients and healthcare providers. The broader categories include mobile health (mHealth), telehealth, telemedicine, the internet of medical things (IoMT), and electronic medical records (EMRs).

The WHO's global strategy on digital health aims at promoting healthy lives and well-being for everyone, everywhere, at all ages. By embracing digital health, WHO helps reduce gaps while empowering people to make informed decisions about their health and well-being.

Why is digital health important?

Digital health encompasses the digital transformation in the healthcare field, including software, hardware, and services. Digital health offers improved medical outcomes, enhanced efficiency, and strengthened communication between doctors and patients. The digital health system provides patients with ownership of their information, allowing doctors to understand their patients comprehensively and make more informed decisions about patient care. This also gives insights into a patient's health history, lifestyle, and helps provide a personalized treatment plan.

2. What is ABDM?

The Ayushman Bharat Digital Mission aims to develop a digital healthcare ecosystem that provides universal health coverage in an efficient, accessible, and affordable manner. The ABDM aims to develop the integrated digital health infrastructure in the country. It also helps enhance digital health services through the United Health Interface.

ABDM also focuses on interoperability, which ensures that the health systems can communicate and exchange information seamlessly. It helps enable healthcare providers to access patient information from various sources—such as electronic health records (EHRs), laboratory information systems (LIS), radiology systems, and health information exchanges (HIEs)—to facilitate better coordination of care and informed decision-making.

ABDM helps create a seamless online platform whose main goal is to provide healthcare data safely across India. The healthcare data covers both public and personal health information.

The vision of ABDM

The vision is to create a national digital health ecosystem that supports universal health coverage that is efficient, accessible, and affordable while providing a wide range of health-related information. This information includes various data and infrastructure services along with interoperable, standard-based digital systems. It helps ensure the security, confidentiality, and privacy of health-related personal information. Learn more about ABDM.

The objective of ABDM

1. Build advanced digital health systems to manage and share health data easily.

2. Create comprehensive registries for clinical facilities, ensuring accurate information.

3. Ensure all health stakeholders use common standards for data sharing.

4. Create personal health records based on international standards that are easily accessible with the patient's consent.

5. Focus on achieving the Sustainable Development Goals (SDGs) for health.

6. Adopt cooperative federalism to achieve a unified digital health ecosystem.

7. Promote the use of clinical decision support (CDS) by all healthcare practitioners.

8. Leverage health data analytics and medical research for better management.

9. Enhance the effectiveness of governance at all levels.

Salient features of ABDM

1. Unique Health Identification (UHID): Identifies patients based on past health records and connects with various stakeholders for better treatment and coordination of care. Importantly, patient consent is essential for sharing this information.

2. Digi Doctor: This repository of doctors is updated periodically and mapped accordingly to associated facilities.

3. Health facility registry (HFR): A repository of the healthcare facilities across the country that facilitates standardized data exchange.

4. Healthcare professional registry (HPR): A repository of registered and verified different systems of medicines (modern medicine, dentistry, Ayurveda, Unani, Siddha, Sowa-Rigpa, and homeopathy),  and nurse practitioners delivering healthcare services across India.

5. Personal health records (PHR): An electronic record in which patients can track their health-related information and manage their care.

6. Electronic medical records (EMR): A mobile app that contains the medical and treatment history of a patient. It allows healthcare providers to access important health information about patients at a facility. Learn more about the salient features.

3. What is ABHA?

ABHA, or Ayushman Bharat Health Account, is the key to the digital healthcare journey. The National Health Policy launched this flagship scheme of the Government of India.

ABHA is a 14-digit number that uniquely identifies a person as a participant in India’s digital healthcare ecosystem. The number is also linked to the user's health records in the healthcare industry with the user's informed consent. Let's understand more about ABHA, which consists of four pillars.

The four pillars of ABHA

1. Health and Wellness Centres (HWCs)  

In February 2018, the Government of India announced the creation of 1,50,000 Health and Wellness Centers (HWCs). These centres deliver comprehensive primary health care focusing on both maternal and child health services, as well as non-communicable diseases, including free essential drugs and diagnostic services.The AB-HWC program encompasses a range of reform services such as the provision of medicines, diagnostics, community participation, ownership, and governance. Learn more about HWCs.

2. Pradhan Mantri Jan Arogya Yojana (PM-JAY)  

The second component is the Pradhan Mantri Jan Arogya Yojana, or PM-JAY, under Ayushman Bharat. The scheme was launched in 2018 by the Honorable Prime minister of India, Shri Narendra Modi. This is the largest health assurance scheme in the world that covers 12 crore poor and vulnerable families (approximately 55 crore beneficiaries), providing a health cover of Rs. 5 lakhs per family per year that forms the bottom 40% of the Indian population. Learn more about PM-JAY.

3. Ayushman Bharat Digital Mission (ABDM)  

The Prime Minister launched the ABDM via video conference on 27 September 2021. The aim of the mission is to connect digital health solutions across the country. A budget of Rs. 1,600 crore was allocated for five years to develop the backbone of the program. Its aim is to support an integrated digital health infrastructure and create a secure online platform with interoperable digital standards. Learn more about ABDM.

4. Pradhan Mantri-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM)  

The Prime Minister's Atmanirbhar Swasth Bharath Yojana (PMASBY) which has been renamed as the Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), was announced on 1 February, 2021.

A budget of Rs. 64,180 crore has been allocated for six years to create an IT-enabled disease surveillance system and strengthen healthcare infrastructure across the country. The initiative focuses on enhancing the capacities of health systems and institutions across the continuum of care. The PM-ABHIM is the largest pan-India scheme aimed at strengthening healthcare at all levels, i.e., primary, secondary, and tertiary. Learn more about PM-ABHIM.

Establishing these four pillars has paved the path for an effective approach to achieving the United Nations' Sustainable Development Goal 3 (SDG-3) in our country.

Key benefits of the ABHA health card

The basic benefits of an ABHA card are:

1. Access to the Healthcare Professional Registry (HPR).

2. Easy access to monitoring health records and to all of your medical information, including prescriptions.

3. Seamless registration of personal health records applications like the ABDM/ABHA application for health data sharing.

4. Access AYUSH treatments and services, such as Ayurveda, Unani, and Homeopathy.

5. Securely share medical records with clinics and hospitals using only the ABHA number for access to health data.

4. The challenges of implementing digital transformation in the healthcare system

We are all aware of the significant advancements in the healthcare system in recent times. Healthcare providers have increasingly turned to digitalization to improve monitoring, efficiency, communication, and patient care. However, the process of digitizing medical records can be complex and time-consuming, presenting a set of obstacles that have to be carefully considered.

Patient data security: Healthcare organizations deal with a lot of sensitive data, such as patient information, where privacy is essential. Patient information includes medical history, treatment plans, personal identifiable information (PII), and more. Privacy safeguards are essential to protect patient information from unauthorized access and breaches.

Interoperability: The primary problem in digitizing records is the lack of interoperability. Healthcare systems have a variety of digital platforms and EHRs that may not be compatible with other healthcare systems. This lack of interoperability may hinder the seamless exchange of patient information across different providers and care settings.

Data storage limitations: Data storage can be difficult due to the large amount of information involved in patient care. This includes patient demographics, medical history, X-ray results, lab results, and more. The sheer volume of this patient data requires extensive storage infrastructure, which may be expensive to maintain. Also, as the amount of data grows, medical organizations continually invest in larger storage solutions. Learn more about the challenges of EHR.

Bridging the gap between technology and healthcare

India's healthcare system has significantly improved in empowering India's healthcare system through digital transformation, especially with the implementation of the ABDM and ABHA initiatives. The ABDM aims to create an integrated digital ecosystem, ensuring universal health coverage for all Indian citizens for better access to healthcare. It prioritizes the security, privacy, and confidentiality of health-related personal information regardless of location or socio-economic status.

Other initiatives, like the ABHA, encourage a patient-centric approach promoting transparency, efficiency, and personalized care. By embracing these policies, India can work towards a future where healthcare is equitable, interoperable, and secure for all.