To announce a national mission to digitise health records in the middle of a pandemic—when healthcare infrastructure, financial and human resources are all stretched thin—is either visionary or gimmicky. The line between the two begins to blur when one factors in the lack of an actual financial commitment.
The blueprint for digitising India’s patient landscape has been in the works since at least 2018. It was lightyears ahead of earlier efforts to standardise health records, which didn’t go very far. On 15 August, India’s 74th independence day, Prime Minister Narendra Modi launched the National Digital Health Mission (NDHM). Every individual will get a “health ID”, a health account that contains all medical reports—everything from prescriptions to diagnostics.
Overnight, via a 41-page document document NDHM Strategy Overview Read more , the NDHM subsumed the government’s 2018 scheme to provide insurance to 500 million Indians, popularly known as Ayushman Bharat. At least on paper, it became a unified health system for every citizen and the central verifier of all truths in healthcare.
The bureaucracy swung into action. It launched pilots in six Union Territories (UT).
By the end of August, 55,700 individuals were made to register for a health ID. That number has since crossed 100,000. On 26 August, the National Health Authority (NHA), which runs Ayushman Bharat—and will implement NDHM—put out a Draft Health Data Management Policy for public consultation. Despite the importance of this policy policy NDHM National Digital Health Mission: Health Data Management Policy Read more —it will determine NDHM governance—it was open to public feedback for only a week. After a public outcry, the deadline for feedback was extended to 21 September.
But forget the policy for a moment, and focus on its vision and execution.
Based on the tech stack of Aadhaar, India’s unique ID programme, a health stack has been created for NDHM by software think tank iSpirt. Its building blocks include a unique health identifier, DigiDoctor, registry of healthcare facilities, consent manager, electronic and personal health record standards (which allow portability of data), and so on.
In theory, a patient who has a health ID could seamlessly move from one healthcare provider to another. She could fetch her desired health records on a phone or any other device, show it to the doctor, even have it deleted at the doctor’s end within a stipulated period of time. She could also choose to have all her longitudinal health records stored in the Digi-Locker, or a health locker provided by a private company.
