The Big Picture: National Digital Health Mission & Data Compliance

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The Big Picture: National Digital Health Mission & Data

Compliance

Why in News?

Prime Minister of India, on August 15, 2020 announced plans to give every citizen a unique health ID as a
part of the National Digital Health Mission (NDHM) which will digitise health records as well as
provide a registry of doctors and health facilities

However, unlike Aadhar, the health ID is not mandatory and is only one of the components of the
Mission.
The mission is reckoned by the government to go a long way in providing universal health
coverage to over 1.3 billion people.

Key Points

The aim of the mission is to address issues in the health sector through digital technology.
The NDHM has been rolled out on a pilot mode in six Union Territories: Chandigarh, Ladakh,
Dadra and Nagar Haveli, Daman and Diu, Puducherry, Andaman and Nicobar Islands and
Lakshadweep Island.
It comprises six areas, including:
Health ID
DigiDoctor
Health Facility Registry
Personal Health Records
E-pharmacy and Telemedicines at a later stage.
Clubbing the NDHM with Ayushman Bharat will do a huge advantage for the health sector.

Background

The work on the National Digital Health Mission started with the National Health Policy, 2017.
The policy 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.
A Digital Health ID was proposed to “greatly reduce the risk of preventable medical errors
and significantly increase quality of care”.

National Health Policy 2017

Features:
The policy advocates a progressively incremental assurance-based approach.
It denotes an important change towards a comprehensive primary health care package
which includes care for major NCDs (non-communicable diseases), mental health, geriatric
health care, palliative care and rehabilitative care services.
It envisages providing a larger package of assured comprehensive primary health care
through the ‘Health and Wellness Centres’.
The policy proposes free drugs, free diagnostics and free emergency and essential health
care services in all public hospitals in a bid to provide access and financial protection.
It also envisages a three-dimensional integration of AYUSH systems encompassing
cross referrals, co-location and integrative practices across systems of medicines.
It also seeks an effective grievance redressal mechanism.
Health Expenditure: The policy proposes raising public health expenditure to 2.5% of the GDP by
2025.
Targets:
To increase life expectancy at birth from 67.5 to 70 by 2025 and reduce infant mortality
rate to 28 by 2019.
To reduce mortality of children under-five years of age to 23 by the year 2025.
To allocate a major proportion of resources to primary care and intends to ensure
availability of two beds per 1,000 population distributed in a manner to enable access
within golden hour (the first hour after traumatic injury, when the victim is most likely to
benefit from emergency treatment).
To achieve the global 2020 HIV target under 90-90-90 UNAIDS Target according to
which by 2020,
90% of all people living with HIV will know their HIV status.
90% of all people with diagnosed HIV infection will receive sustained antiretroviral
therapy.
90% of all people receiving antiretroviral therapy will have viral suppression.

Reasons of Including Technology in the Health Sector

The gaps/ loopholes observed in the delivery of healthcare services could be very well addressed
by introducing technology into it.
In order to achieve universal health coverage, these technologies should be tested, standardised
and integrated within the delivery system in a mission mode.
The components of the digital health coverage says that it should be efficient, accessible,
inclusive, affordable, safe and provided timely which is definitely not the condition at
present.

Existing Condition of Health Sector in the Country

Expenditure: The expenditure on the health sector in India is around 1.3% only whereas countries
like Canada and Australia spent 8% and 6.3% of their GDP.
Doctor to patient ratio: The doctor to patient ratio in India is 1: 1456 which means over 1,456
people within the country there is only one doctor available.
Lack of infrastructure: The health sector is also lagging behind in terms of infrastructure and
technology, especially in the rural areas where many small hospitals do not even have computers

Challenges for the Policy

The decision has immense potential to change India’s health infrastructure, while also raising concerns
over privacy and efficient implementation.

There should be one unique ID linked to all the services; AADHAR.


Small hospitals do not have a very updated infrastructure:
So there are chances that wrong medical data of a patient would be uploaded. This is still
skeptical if the patient has the right to update his reports.
Cyber security in terms of digital awareness is not moving as fast as we are moving towards
digitisation in everything.
While the medical health data which is highly critically personal; the challenge is:
How to create awareness among the end users (patients) and
How would the data aggregator (govt) ensure that private hospitals who are
accessing a patient’s personal health information are not misusing it.
As the policy is not mandatory for all it is quite difficult to pursue a large section of the population
to opt for it.

Way Forward

The policy could be a game changer; if taken into account the confidentiality and privacy of
every individual, it could result in India having the most accessible and affordable health care
system.
The policy should rather have a staggered launch and not a full fledged one; firstly the
results of the 6 union territories should be taken into consideration, then probably some other
villages and cities and gradually increasing the coverage areas.
Awareness campaigns that also advertise the benefits of opting for the policy must be organised
in order to encourage a larger section of population to opt for the policy.

Conclusion

The health ID will undoubtedly give a much-needed technological impetus to a sector that has long
been found wanting, more so amid the ongoing Covid-19 pandemic.
The digital technology during the pandemic has been fast tracked and has shown great results.
Helped the front line workers carry out their work more efficiently.
Data is the new gold, hence it should be preserved and secured.

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