Digital record of health to revolutionise sector
Prime Minister Narendra Modi on Saturday unveiled an ambitious National Digital Health Mission (NDHM) under which every Indian will get a health ID that he said will act “like a healthcare account” and make access to medical services easier.
“From today, the national digital health mission will begin. It will revolutionise Indian healthcare sector. Every Indian will be issued a health ID that will act like a healthcare account, storing details of all the tests done, existing diseases, diagnoses, medicines prescribed,” said Modi in his Independence speech from Red Fort.
It will also ease processes such as booking appointments, making payments, or getting registrations done at hospitals, he said. “Technology will be used to resolve various problems in the health care sector – whether it is getting an appointment, making payment, or queuing up to get the (registration) slip. People will be able to make informed decisions.”
The National Health Authority (NHA), the agency responsible for the implementation of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), has been asked to design, build, roll-out and implement the project. Six Union Territories where the mission was rolled out through a pilot launch are Chandigarh, Ladakh, Dadra and Nagar Haveli and Daman and Diu, Puducherry, Andaman and Nicobar Islands and Lakshadweep, NHA said in a statement.
The programme is a part of the government’s National Digital Health Blueprint aimed at using technology to improve health care delivery. The objectives of the mission are to establish a core digital health database, create a system of electronic health records based on international standards, and establish data ownership pathways so that a patient is the owner his/her health records, among others.
Experts said the move will be beneficial for ensuring continuity of treatment and expediting emergency care.
“A nationwide health ID will ensure three things – continuity, connectivity, and portability of treatment. If a patient goes to a different doctor or someone else fills in for their doctor, all the medical records will be available to them ensuring continuity of their treatment. When a patient has to go to a secondary or tertiary centre, all the basic information will already be there in the record. This is particularly helpful in the emergency department where knowing the blood group or what a person is allergic to can save a lot of time. It will also save cost of repeat tests. The third is portability, which will enable me to have my entire healthcare record when I move from one city to the other without carrying several files,” said K Srinath Reddy, president of the Public Health Foundation of India.
However, the he said there are challenges involving exhaustive electronic record-keeping and issues of privacy.
“Take for example, the US system, which is highly litigious and (where) defensive medicine is practiced; doctors tend to spend a lot of time in detailed record keeping. This can be solved either by simplifying the records to be maintained in a less litigious society or by training physician assistants who are trained to take medical notes and maintain records. However, the privacy needs to be ensured even if anonymised data is provided for research or else there will be telemarketers pushing medicines to people,” said Reddy.
Deepak Agarwal, who headed the initiative to digitise patients’ records at Delhi’s All India Institute of Medical Sciences, said it was a great initiative but impractical at the moment.
“Accessing all medical records of a patient with just one click is a doctor’s dream. However, when we started implementing a similar system at AIIMS we faced several challenges. One is actually digitising the records for which every doctor has to input the records digitally, otherwise it will not work. Second, and more importantly, is finding a unique identifier. If we just enter the patient’s name as Ramu, there will be thousands of records with the same name and many people do not even use second names, making identification of people difficult. The only unique ID that most of the population has is Aadhaar card, but with a Supreme Court judgment no one can legally demand that it be linked. We had tried to do it before the judgment and there was a lot of resistance; now less than 1% patients give the details,” said Agrawal.
Speaking of work done in the health care sector, the PM said that new All India Institutes of Medical Sciences and other medical colleges have been set up in the country, increasing the number of MBBS and MD seats for medical students by 45,000 in the last five years.
He also said over 150,000 wellness centres are being set up across the country. “Around one-third of these are already functional and have helped in the Covid-19 fight,” he said.
(with agency inputs)