New Delhi: It will not be mandatory to get a new Aadhaar-like health ID under the Modi government’s National Digital Health Mission (NDHM), the project’s chief has said.
Under the project, which Prime Minister Narendra Modi announced in his Independence Day speech, the health ID will be a gateway to an individual’s medical records — doctor visits, diseases and drugs consumed among others. The personal health records will be accessible through an app or a website with ownership lying with the individual.
“Participation in NDHM is voluntary, and not mandatory. We hope that the benefits of the scheme will itself create a pull system, strong enough for stakeholders to participate voluntarily,” said Dr Indu Bhushan, chief executive officer (CEO) of the National Health Authority (NHA) and Ayushman Bharat, who also heads the NDHM.
Speaking to ThePrint, Bhushan said that under the programme, a patient can share their records with any health information user such as doctors, hospitals or diagnostic labs.
The NDHM is being rolled out in phases — it has already been launched as a pilot project in the Union Territories of Andaman & Nicobar, Dadra & Nagar Haveli and Daman & Diu, Puducherry, Ladakh and Lakshadweep.
The pilot project includes the enrolment of individuals, doctors and healthcare providers, along with the digitisation of medical records, creating mechanisms for consent-based sharing of information and building systems for securely storing data.
In a freewheeling interview with ThePrint, Dr Bhushan sought to allay privacy concerns surrounding the project, detailed the advantages of the scheme and insisted that it will have a positive impact on the Gross Domestic Product (GDP).
‘Supreme Court privacy rulings will be followed’
Speaking on the privacy concerns, particularly as it involves medical records, CEO Bhushan said the project will adhere to the existing data security and privacy rules and guidelines, in addition to the recent Supreme Court judgments in Information Technology-related cases, the Aadhaar Act and the Personal Data Protection Bill.
“These rules enshrine the right of every citizen to own and control one’s own data, significant among which is health data,” he said.
He reiterated that the “ownership” of the data lies with the individual, which is that only when a person grants access, will a doctor or any other individual be able to see these records, that too for a limited period.
“Only if a patient consents, the health facility can retrieve medical records. It can also be shared for using telemedicine and e-prescriptions services,” he said.
The CEO further said that the pandemic and its fallout have shown that it is not enough to just build health infrastructure and increase supply of healthcare facilities and medical professionals. “We also need to make sure the goods reach the last mile through an integrated digital health ecosystem,” he said.
Benefits of the scheme
According to Dr Bhushan, individuals can use their health IDs whenever they visit a diagnostic lab or a hospital.
“It will greatly ease the process of registering on the National Medical Council and State Medical Councils, and enable them to provide tele-consultations, e-sign reports and give e-prescriptions and e-referrals across the country,” he said.
With more and more doctors registering themselves, the scheme will further help reduce fraud, and enable outpatient insurance in the long-run, the CEO said.
“Having the patient’s health record will free people from the trouble to store and carry their medical reports and old records and avoid unnecessary and expensive repeat tests,” he said. “It will also enable NDHM compliant healthcare providers to use analytics and artificial intelligence to design better care plans, apply remote care plans successfully and help reduce the cost of care.”
Bhushan added that “the scheme will particularly be important for individuals suffering from chronic and non-communicable lifestyle diseases such as diabetes, hypertension and cancer, for whom regular visits to healthcare providers, access to complete past health information, regular tests, and constant monitoring are essential for the maintenance of their health.”
‘Aadhaar card not mandatory’
Aadhaar will not be mandatory for generating the health ID, Bhushan said, adding that other IDs such as PAN card, ration card, electors’ photo identity card along with Aadhaar card will be used for enrolment in the scheme.
According to the CEO, the scheme will be built using the Ayushman Bharat’s network of beneficiaries. The Ayushman Bharat scheme, formally known as Pradhan Mantri Jan Arogya Yojana (PM-JAY), provides an annual health cover of Rs 5 lakh per family to 50 crore beneficiaries.
“Through Ayushman Bharat, the government has significantly stepped up its financial commitment to public healthcare,” Bhushan said. “And while providing financial risk protection on the demand side is critical to change in health-seeking behaviour, it is equally important to build a national digital infrastructure as an integral part of the program design to enable supply-side readiness.”
The Ayushman Bharat provides the right opportunity to help further build infrastructure, he said. “For instance, mapping of 12.5 crore PM-JAY beneficiaries’ e-cards to the health IDs will be a critical integration aspect.”
“Similarly, PM-JAY has provided more than 1.4 crore treatments. These treatments are digitally available with PM-JAY and can be linked with health IDs and become part of the personal health records of individuals,” he said.
‘Project can yield incremental value upwards of Rs 1.5 lakh crore’
According to Bhushan, the implementation of National Digital Health Blueprint, in line with the design, and the adoption of digital public infrastructure by both private and public sector players can potentially yield incremental value upwards of Rs 1.5 lakh crore over the next 10 years.
Bhushan explained that the implementation of NDHM will be value accretive for India’s health ecosystem as well as have a positive impact on GDP.
With robust public digital infrastructure in place, NDHM, he said, “will unleash a new wave of innovation that will enable medical practitioners and service providers to innovate on new care delivery models that are more efficient and value accretive to the overall health ecosystem and GDP”.
‘Beneficial to the country as a whole’
Bhushan claims that the digital infrastructure of NDHM has been proposed based on “a deep understanding of the lived realities of people and the incentive structures prevalent in the Indian healthcare ecosystem, and that makes NDHM unique and set for success”.
With NDHM, the entire Indian health ecosystem stands to gain in two main ways, he explained. “First, reduction of transactional frictions based on trust amongst stakeholders that will promote and make preventive healthcare orientation profitable.”
And second, he added, “the reduction in administrative cost of health insurance will make insurance cheaper and thus enable Universal Health Coverage”.
NDHM will facilitate the on-boarding of all key stakeholders on a digital platform. Once registered and verified by the platform, it will enable their integration with Patient Health Records (PHR), Electronic Medical Records (EMR) and comprehensive collection of anonymised healthcare data across the country.
“The subsequent data analysis will allow policymakers to experiment with policies, detect fraud in health insurance, measure outcomes and strengthen large-scale evidence-based policy making,” he said.
“The scheme will incentivise health care providers to reach out to the common person and reverse the current trend — for the benefit of both the individuals and for the benefit of the nationwide ecosystem,” he added.
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