Prime Minister (PM) Narendra Modi on the 74th anniversary of India’s independence announced the National Digital Health Mission (NDHM) - India's first step towards Universal Health Coverage (UHC).
In order to meet the goals of the National Health Policy (2017), it will give every Indian citizen a unique Health ID consisting digitised health records. It will establish registries of clinical establishments, healthcare professionals, health workers, drugs and pharmacies.
The NDHM has its origin in a Niti Aayog proposal of 2018 to initiate a centralised system in the National Health Stack (NHS). In 2019, a report by the J. Satyanarayana committee was submitted to the Ministry of Health and Family Welfare. It registered the procedure to implement the National Digital Health Blueprint (NDHB). According to the NDHM document, “NDHM systems will be designed to be inclusive - specialised systems will be designed to reach out to the ‘unconnected’, digitally illiterate, remote, hilly and tribal areas.”
Unique Health ID
The National Health Authority (NHA) said that patients who are willing to upload their health records digitally should create a ‘Unique Health ID’ that will have information about medical data, prescriptions and diagnostic reports and summaries of previous discharges from hospitals. This will be available based on the individual’s informed consent. Announcing the mission, PM Modi said, “Every Indian will be given a health ID, which will work as each Indian's health account. It will be like a digitised ‘swasth khata’ (health book) for a patient. This will help to reduce problems in getting treatment with the help of technology.”
The mission will also entail healthcare providers to share a digital copy of any health reports being physically shared with the patient. This has been provisioned to enable the creation of longitudinal health records. This mission aims to promote a better management of the healthcare sector leveraging health related data analytics and medical researches. It is also expected to enhance the efficiency and effectiveness of governance at all levels. The NDHM document reads, “Emerging technologies such as artificial intelligence, the internet of things (IoT), blockchain and cloud computing will provide additional opportunities for facilitating a more holistic digital health ecosystem - that can increase the equitable access to health services, improve health outcomes and reduce costs.”
Importance during pandemic
This mission was officially announced by the PM at a time which the country is dealing with a tough pandemic. The policy is aimed to ensure that healthcare professionals across disciplines have better access to a patient’s medical history for prescribing more appropriate and effective health interventions. It will have the option to access health services through tele-consultation and ensure e-pharmacy for contactless treatment. It will help them to study and evaluate a patient’s medical condition for better results. This policy will simplify the process to treat people with comorbidities in any medical condition. It will also help doctors to suggest preventive healthcare measures for patients in the future.
During the ongoing pandemic, people are opting for a number of health insurances. The NDHM document states that it will help to digitise the claims process and enable faster reimbursement.
The major challenge in this mission is maintaining data security. NDHM will link healthcare details with Aadhaar cards. The possible domain owners for these key health registries include Doctors Registry (National Medical Council/MCI/CCIM), Insurers Registry (IRDAI), Pharmacy Registry (Pharmacy Council of India), Dental Doctors (Dental Council of India) and AYUSH Doctors (relevant bodies within the Ministry of AYUSH). The central government should ensure data security.
The mission clarifies, “NHDM will ensure security and privacy by design. A National Policy on Security of Health Systems and Privacy of Personal Health Records will be developed, in accordance with the Personal Data Protection (PDP) Bill 2019. The government has set up a committee to examine the regulations required for use of non-personal data as well.”