The launch of the National Digital Health Mission (NDHM) comes at a time when the country is reeling under the impact of the COVID-19 pandemic. The mission will go down in history as one of the game-changing policy initiatives launched in 21st-century India. It will revolutionise the efforts of the government in enhancing effective health service delivery and help realise Prime Minister Narendra Modi’s vision of providing health services to every citizen.
Based on the principles of health for all, inclusivity, accessibility, affordability, education, empowerment, wellness, portability, privacy and security by design, the NDHM will build the backbone necessary to create an integrated digital health infrastructure. With its key building blocks or applications, HealthID, DigiDoctor, Health Facility Registry, Personal Health Records, Telemedicine, and e-Pharmacy, the mission will bring together disparate stakeholders and radically strengthen — and, thus change — India’s healthcare delivery landscape.
NDHM is also a purposeful step towards the achievement of the United Nations’ Sustainable Development Goal of Universal Health Coverage — it encompasses key aspects of this goal including financial risk protection, access to quality essential healthcare services, medicines and vaccines for all.
Digital interventions significantly enhance the outcomes of every health service delivery programme. Nowhere is this better demonstrated than the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana scheme, through which 1.2 crore cashless secondary and tertiary care treatments have been provided using an indigenously developed state-of-the-art IT platform. This platform deploys multiple world-class technological applications founded on stringent data privacy and information security policies and protocols. The Arogya Setu mobile app deploys ICT innovations for contract tracing to provide real-time information on COVID cases in the vicinity of the person with the app, and also suggests the course of action based on a patient’s symptoms. These testing times have also propelled a large uptake of telemedicine initiatives, and there is great potential to expand this technology-driven endeavour.
Since the NDHM’s launch, several key stakeholders including doctors, healthcare providers and citizens have demonstrated their support for the project. The NDHM is a product of years of policy research and is informed by the experiences gleaned from implementing the country’s technology-driven social welfare schemes as well as similar digital health programmes across the world. The interest of the citizenis placed at the core of its design.
Some of its principal highlights are as follows.
First, the NDHM is a voluntary scheme — HealthID is entirely voluntary for citizens. While such an ID will make availing healthcare radically simpler and stress-free, its absence will not mean denial of healthcare to a citizen. They can choose to generate their Health Account or ID using their Aadhaar card or digitally authenticable mobile number and by using their basic address-related details and email ID. The use of Aadhaar, therefore, is not mandatory.
Second, providing access to and sharing of personal health records is a prerogative of the HealthID holder. The consent of the health data owner is required to access this information or a part of it. The information can be shared for a period ranging from one hour to unlimited duration. The consent can be withdrawn anytime. The personal health record will enable citizens to store and access their health data, provide them with more comprehensive information and empower them with control over their private health records.
Editorial | For better health
Third, NDHM has been built within a universe of fundamental rights and pieces of legislation such as the Aadhaar Act and the IT Act 2008 as well as the Personal Data Protection Bill 2019. This citizen-centric project is also informed by the entire gamut of Supreme Court judgments and core democratic principles of cooperative federalism. The Mission gets its strategic and technical foundation from the National Digital Health Blueprint, the architectural framework of which keeps the overall vision of NHP 2017 at its core and ensures security and privacy by design. All the building blocks that require handling personal health records will be designed to comply with these laws and policies ab initio.
Fourth, many members of the general public would ask: If this is a digital mission led by technology powered by the internet, how will it reach out to and empower the large number of “unconnected” masses? We have taken this reality into account and are building specialised systems and off-line modules that will be designed to reach out to the “unconnected”, marginalised, digitally illiterate, remote, hilly, and tribal populations. We will leverage the unmatched reach, the physical and social connections and networks of our panchayati raj institutions, millions of ASHAs, and anganwadi workers to enable and empower citizens with digital technologies in the true spirit of Sabka Saath, Sabka Vikaas.
Finally, and equally importantly, the design of NDHM has been built on the principle of partnership with all key stakeholders — doctors, health service providers, technology solution providers and above all citizens. Without their belief, trust, adoption, and stewardship, this mission will not achieve its desired result.
NDHM aims to build a Digital Health Nation on the pragmatic principle of “Think Big, Start Small, Scale Fast”. It is a mission whose time has come because health is the first step towards self-reliance and only a healthy nation can become Atma Nirbhar.
This article first appeared in the print edition on August 29 under the title “The future of health.” The writer is Union Minister for Health & Family Welfare. Views expressed are personal.