- A committee was constituted by the Ministry of Health and Family Welfare to create an implementation framework for the National Health Stack (NHS) proposed by NITI Aayog last year.
- The committee has recommended the setting up of a National Digital Health Mission (NDHM) to manage enormous amounts of health data generated by Ayushman Bharat, the Centre’s flagship health programme as a part of the National Digital Health Blueprint.
- The Ministry of Health and Family Welfare has recently released the National Digital Health Blueprint (NDHB) report in the public domain for inputs from various stakeholder.
- NDHB recognizes the need to establish a specialized organization, called National Digital Health Mission(NDHM) that can drive the implementation of the Blueprint, and promote and facilitate the evolution of NDHE.
Background: National Health Policy 2017
- The National Health Policy 2017 envisages 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.
- Technology deployment and data-driven decision-making in healthcare has been inadequate in India.
- In the absence of holistic, comprehensive and interoperable digital architecture, the use of technology in the health sector continues to grow in an uneven manner and in silos.
- Against this background, the Committee constituted by the Health Ministry to create an implementation framework for the National Health Stack (NHS), has come up with the National Digital Health Blueprint, after surveying the global best practices in adoption of digital technologies
National Health Stack
- The NHS is proposed to be the country’s first futuristic nationally shared digital healthcare infrastructure usable by both the Centre and states across public and private sectors.
- The NHS will facilitate collection of comprehensive healthcare data across the country.
- Subsequent data analysis on NHS will not only allow policy makers to experiment with policies, detect fraud in health insurance, measure outcomes and move towards smart policy making, but also engage market players (NGOs, researchers, watchdog organisations) to innovate and build relevant services and fill the gaps.
- It is now conceivable to aim for digital health records for all citizens by the year 2022.
National Digital Health Blueprint
- The NDHB focuses on providing an efficient and affordable health coverage through a wide-range of data and infrastructure services by leveraging open digital systems that will ensure security and privacy of personal information.
Vision of NDHB
- To create a National Digital Health Eco-system that supports Universal Health Coverage in an efficient, accessible, inclusive, affordable, timely and safe manner, through provision of a wide-range of data, information and infrastructure services, duly leveraging open, interoperable, standards-based digital systems, and ensuring the security, confidentiality and privacy of health-related personal information.
- To establish state-of-the-art digital health systems, for managing the core digital health data, and the infrastructure required for its seamless exchange.
- To establish National and Regional Registries to create Single Source of Truth in respect of Clinical Establishments, Healthcare Professionals, Health Workersand Pharmacies.
- To enforce adoption of open standards by all the actors in the National Digital Health Eco-system.
- To create a system of Personal Health Records, based on international standards, easily accessible to the citizens and to the healthcare professionals and services providers, based on citizen-consent.
- To promote development of enterprise-class health application systems with a special focus on addressing the Sustainable Development Goals related to the health sector
- To adopt the best principles of cooperative federalism while working with the States and Union Territories for the realization of the Vision
- To ensure that the healthcare institutions and professionals in the private sector participate actively in the building of the NDHE, through a combination of prescription and incentivization
- To ensure National Portability in the provision of health services
- To promote the use of Clinical Decision Support (CDS) Systems by health professionals and practitioners
- To promote a better management of the health sector leveraging Health Data Analytics and Medical Research
- To provide for enhancing the efficiency and effectiveness of Governance at all levels through digital tools in the area of Performance Management
- To support effective steps being taken for ensuring Quality of Healthcare
- Leveraging the Information Systems already existing in the health sector
- The National Digital Health Mission (NDHM) would provide technology to manage and analyse data, and create a system of personal health records and health applications.
- 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.
- Central to the “ecosystem” would be a Personal Health Identifier (PHI) to maintain a Personal Health Record (PHR).
- Note: The PHI would contain the names of patients and those of their immediate family, date of birth, gender, mobile number, email address, location, family ID and photograph.
- The committee has suggested to consult Unique Identification Authority of India (UIDAI), which issues Aadhaar, and the Ministry of Electronics and Information Technology (MeitY) in the design of the PHI.
- The committee has also suggested a Command, Control, and Communication Center (CCCC) as a single point of contact in public health emergencies.
- The new Mission to be autonomous like UIDAI and GSTN (Goods and Services Tax Network). It would be partly funded by the government but will also raise a part of its funding through a transaction fee with private players.
- The recommendations from the National Digital Health Blueprint (NDHB) have been opened for public comments, which will be considered before the government takes a final decision on this issue.