NATIONAL DIGITAL HEALTH MISSION (NDHM)

WHY IN NEWS:

• Prime Minister on 15^th August 2020 announced the launch of the National Digital Health Mission under which every Indian will get a health ID that will store the individual's medical records.

BACKGROUND:

• National Health Policy (NHP) 2017 had envisaged creation of a digital health technology eco-system aiming at developing an integrated health information system that serves the needs of all stakeholders and improves efficiency, transparency and citizens’ experience with linkage across public and private healthcare.
• NHP proposed a Digital Health ID to “greatly reduce the risk of preventable medical errors and significantly increase quality of care”.
• In the context of this, the central government’s think-tank NITI Aayog, in June 2018, floated a consultation of a digital backbone for India’s health system — National Health Stack (NHS).
• NHS was intended to be a digital infrastructure built with the aim of making the health insurance system more transparent and robust, while factoring in the uniqueness of India’s health sector, and the political realities of federalism.
• National Digital Health Blueprint, released in 2019, recommended the setting up of the National Digital Health Mission (NDHM), a governmental organisation with complete functional autonomy on the lines of UIDAI and GSTN.
• The new scheme will come under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.

FEATURES OF NDHM

• The NDHM is a complete digital health ecosystem
• NDHM is implemented by the National Health Authority (NHA) under the Ministry of Health and Family Welfare
• Key components of the National Digital Health Mission are
• 1.National Health Electronic Registries:
  • To create a single source of truth for and manage master health data of the nation
• 2.A Federated Personal Health Records (PHR) Framework
  • To solve twin challenges of access to their own health data by patients and to healthcare service providers for treatment, and availability of health data for medical research - critical for advancing our understanding of human health; 
• 3.A National Health Analytics Platform
  • To bring a holistic view combining information on multiple health initiatives and feed into smart policy making, for instance, through improved predictive analytics;
• 4.Other Horizontal Components
  • Unique Digital Health ID
    • The national health ID will be a repository of all health-related information of every Indian.
    • Various healthcare providers — such as hospitals, laboratories, insurance companies, online pharmacies, telemedicine firms — will be expected to participate in the health ID system.
    • Every patient who wishes to have their health records available digitally must create a unique Health ID, using their basic details and mobile or Aadhaar number.
    • Each Health ID will be linked to a health data consent manager, which will be used to seek the patient’s consent and allow for seamless flow of health information from the Personal Health Records module.
    • The Health ID will be voluntary and applicable across states, hospitals, diagnostic laboratories and pharmacies.
  • Digidoctor
    • The Digi Doctor option will allow doctors from across the country to enrol and their details, including their contact numbers if they want to provide them, will be available.

• The role of the NDHM will be to provide information and data to different components of the health eco-system to work together and also provide the technological infrastructure for collection and storage of core/ master data through the various registries. 
• The responsibilities of the NDHM will include:  
  • Providing the technology platform for collection of core health data from the providers and patients
  • Provide a platform for interoperability of health care data through a unique identifier for the provider and patient across the health system
  • Improving the quality of health data collection, storage and dissemination for purposes of research and policy decisions
  • Publishing national indicators for health, to measure quality of care and progress against policy initiatives and SDG Goals
  • Capacity building on health informatics, safety and security

POSITIVE OUTCOMES EXPECTED:

• Easy access to electronic health records:
  • All citizens will be able to access their Electronic Health Records in a convenient manner
• Streamlined diagnosis:
  • Citizens need to undergo any diagnostic test once only, during the course of an episode, despite taking treatment from different health service providers
• Integrated health services at a single point
  • Citizens will get integrated health services at a single point, though multiple agencies/ departments/ services providers are involved
• Assure continuum of care to the citizens
  • NDHM shall assure continuum of care to the citizens, across primary, secondary and tertiary care and across public and private service providers
• Facilitate national portability
  • NDHM shall support national portability for healthcare services
• Protection of privacy:
  • Privacy of personal and health data will be ensured.
  • NDHM's document also states that health records will be accessible and shareable by the patient with appropriate consent and complete control of the records will remain with the patient.
• Help us to achieve SDGs
  • NDHM will help India to achieve SDG’s related to health
• Enable evidence-based interventions
  • NDHM will enable evidence-based interventions in the area of public health
• Ensure data-driven decision making:
  • The analytical capabilities of NDHM will support data-driven decision-making and policy analysis

GLOBAL EXPERIENCES:

• Over the past two decades there have been several Digital Health initiatives that were launched globally to improve the quality of health care and bring down the healthcare costs
• The experiences of NHS Digital in England and the South Korean Model are particularly relevant for India and what we intend to achieve through the proposed NDHM. 

CONCERNS:

• Privacy concerns:
  • With India still lacking a law on data protection, the digital health mission is expected to trigger privacy concerns in the days to come.
• Did not recognize health as a justiciable right:
  • The NDHM still does not recognize ‘Health’ as a justiciable right.
  • There should be a push draft at making health a right, as prescribed in the draft National Health Policy, 2015.
• Health is a state subject:
  • Hence NDHM will need to find ways to accommodate state-specific rules.

CONCLUSION

• NDHM will be shaped as the ‘Technology Arm’ of the Health Sector of India.
• The Mission will leverage open digital systems to provide high-quality healthcare for all.
• It will integrate various digital health services to create an ecosystem which can assimilate existing health information systems.
• However government should ensure that security and privacy of personal information are not threatened and the quality of health care is not deteriorated under the framework

PRACTICE QUESTION:

Q. Explain the key components of National Digital Health Mission. Analyse the challenges associated with digitising health sector in India?