DPI Concept Proposal for UNDP

Background:
In the rapidly evolving landscape of global digital health, Digital Public
Infrastructure (DPI) has become a pivotal enabler of sustainable development,
particularly in low- and middle-income countries (LMICs). DPI, which refers to the
foundational digital solutions that support public and private service delivery, is
transforming public services and helping countries like India and Bangladesh
achieve national and global development goals.
Bangladesh constantly strives to bolster its Digital Public Infrastructure (DPI).
Bangladesh has been working towards developing digital solutions across key
sectors, setting the stage for ongoing advancements to improve disease surveillance
and patient record management.
However, the COVID-19 pandemic exposed critical gaps in Bangladesh's healthcare
system, with the most deeply rooted challenge being the data silo among different
digital systems. Even the service delivery system and the payment and claim
management systems are not integrated either, which complicates the whole
healthcare ecosystem. It also reflects the need for a Unique Health ID (UHID) and a
Shared Health Records (SHR) system to ensure continuity of care. The absence of SHR
complicates patient management and care continuity, emphasizing the urgent need for
integrated health information systems.
As of now, the disbursement of UHID is ongoing on a limited scale, and the
development of SHR is in the works. Furthermore, Bangladesh is enhancing its
Digital Public Infrastructure (DPI) by integrating Digital Public Goods (DPGs) like
ekShop and NISE, which transition services to digital formats and have shown
international scalability.
By integrating such DPGs into the DPI, particularly in the healthcare sector,
Bangladesh can address several pressing challenges. Bangladesh is effectively
leveraging DPI to standardize and streamline health data across various providers
by deploying systems like the Medical Outdoor Patient Appointment System, EMR, and
the Structural Referral System. This initiative not only supports seamless
interoperability through platforms like the Unique Health ID (UHID) and Shared
Health Records (SHR) but also aligns with the DPI's overarching goals of improving
accessibility and efficiency of public services. Using open-source platforms
ensures that these healthcare systems are both scalable and cost-effective,
mirroring DPI's objectives to provide reliable, inclusive services that narrow the
digital divide. Moreover, incorporating robust security measures through these
systems exemplifies a commitment to data privacy, enhancing public trust in digital
services. This cohesive strategy underscores the transformative impact of DPI,
showcasing a model that could be replicated in other sectors and countries striving
for similar digital advancements.
Objective/Scope:
* To develop comprehensive policy guidelines that ensure the effective
implementation, interoperability, and security of digital health systems within
Bangladesh's Digital Public Infrastructure (DPI), aligning with both national
priorities and international standards.
* To design and implement a Unique Health ID system that provides people with proof
of their legal identity, which is commonly needed to access basic services, rights,
and protections.
* To ensure the interoperability of digital health systems through electronic
medical records/shared health records, enabling seamless information sharing across
healthcare service providers.
* To support efficient and effective governance of Digital Health by establishing a
robust framework for integrated payment and claim management systems.
The Digital Health Blueprint leverages DPI principles to create a future-proof
healthcare ecosystem. Here's a breakdown of the key components:
Core Building Blocks:
* Unique Health ID: A single identifier for each individual to facilitate seamless
record management.
* Healthcare Professionals & Facilities Registry: Comprehensive databases of
healthcare professionals and institutions.
* Unified Health Interface: An open protocol for smooth data exchange between
healthcare systems.
* Personal Health Record (PHR): Empowering individuals to manage their health data.
* Consent Manager: Ensuring user control over data sharing.
* Additional Registries: Drug Registry, Organ Donors Registry, Data Fiduciary
Registry, etc.
Technical Infrastructure:
* Open API-based Microservices: Enabling modular and scalable development of
digital health solutions.
* Audit Log/Observability: Ensuring transparency and accountability through data
logging.
* Interoperability Lab/SI Lab: Fostering collaboration and innovation for seamless
data exchange.
Advanced Features:
* AI-based Early Warning Systems: Utilizing AI for proactive health monitoring and
risk prediction.
* Auditable Access & Data Localization: Ensuring data security and user privacy.
* Decision Support Systems: Providing data-driven insights for improved clinical
decision-making.
* Monitoring and Assessment System: Continuously evaluating the effectiveness of
the digital health ecosystem.
Data Management and Analytics:
* Health Information Standards & Conformance: Establishing clear guidelines for
data collection and storage.
* Data Warehousing & Big Data Analytics: Unlocking valuable insights from
healthcare data.
* Health Dashboard & Reporting: Providing stakeholders with clear and actionable
data visualizations.
* Public Messaging and Grievance System: Facilitating two-way communication between
citizens and healthcare institutions.
* Data Lake for Anonymized Data: Enabling data-driven research and service
development.
Citizen-centric Services:
* Personal Health Records (PHR) Mobile Apps and Web: Empowering individuals to
manage their health information on the go.
* Enable Citizen to Access Records and Services Online: Providing convenient access
to health records and services.
Interoperability and Integration:
* Electronic Immunization System: Streamlining immunization data management.
* Health Claims Processing: Enabling efficient health insurance claim processing.
* Secure Data Transport Services: Guaranteeing secure data exchange between
systems.
Policy Guideline Development:
* Interoperability Standards: Developing standards that facilitate seamless data
exchange across various health systems, ensuring that these systems are
interoperable and can communicate effectively within the broader healthcare
ecosystem.
* Privacy and Data Protection Guidelines: Creating guidelines that protect patient
data in compliance with international regulations such as GDPR, ensuring robust
data protection while also fostering trust in digital health services.
* Standard Operating Procedures (SOPs): Developing SOPs for digital health systems
to ensure consistent and secure management of health information across all
healthcare facilities utilizing resources from the Office of the National
Coordinator for Health Information Technology (ONC). These procedures will be
designed to maintain operational consistency, data integrity, and security
throughout the health system.