Nearly 10 days ago, the Union cabinet chaired by Prime Minister Narendra Modi approved Rs 1,600 crore for the Ayushman Bharat Digital Mission (ABDM), launched as a pilot in 2020. The mission is aimed at creating a digital database of health records of individuals and creating a national repository of hospitals and doctors. Here are the edited excerpts of the interview with R S Sharma, CEO of the National Health Authority, the agency responsible for implementing the project.
ABDM was soft-launched in six Union territories in 2020. How has the mission done so far and what has been the response from the public?
ABDM was launched on pilot mode on August 15, 2020, in six UTs. After a successful implementation in UTs, the prime minister expanded this mission nationwide beginning September 27, 2021. Till the end of February this year, more than 17.25 crore Ayushman Bharat Health Account (ABHA) numbers, earlier known as health IDs, had been created. The reception from the general public has been positive.
ABDM is endeavouring to create a national digital health ecosystem that will support universal health coverage in an efficient, accessible, affordable, timely and safe manner. It will provide a wide range of data, information and infrastructure services. It will leverage open, interoperable and standards-based digital systems, ensuring the security, confidentiality and privacy of health-related personal information.
With Rs 1,600 crore allocated towards the programme for the next five years, how do you think the digital health ecosystem of the country will shape up?
Basically, ABDM sets out the vision to digitise the healthcare ecosystem. The digital public goods created under ABDM are expected to reduce the administrative costs of providing healthcare service by private and public entities. The digitisation of health records is also expected to reduce storage expenses and solve portability issues, making health claims processing more efficient in turn. As a result, healthcare would be made more affordable for individuals.
ABDM aims to bring this about by prescribing common health data standards, developing core modules such as registry of health facilities, healthcare professionals, etc, required for interoperability so that various digital health systems can interact with each other by enabling seamless sharing of data across various healthcare providers who may be using different digital health systems.
ABDM, through its unified health interface (UHI), will enable access to healthcare through teleconsultation using any app. Also, these apps can help individuals in the discovery of appropriate healthcare services, appointment bookings, etc, online, thus making them more accessible. With Rs 1,600 crore approved for the project, we will also provide HR support to states worth Rs 500 crore for implementing ABDM.
There have been some concerns about data privacy and also that digital health cards in some cases are being created without seeking the informed consent of people availing other health services. What do you say about that?
ABDM is being built on the principle of privacy by design and follows a federated architecture, ensuring no health data is centrally stored and only facilitates secure data exchange between the intended stakeholders after the citizen’s consent. This ensures that citizens’ health data is digitally protected and confidentiality is maintained. Registries are being created with the principle of minimalism and with adequate measures for the security of the data. Also, the ABHA number is created for an individual only after collection of their clear and informed consent.
With healthcare services largely inadequate in both public and private sectors in rural areas and tier 2, 3 cities, what purpose do you think a project like ABDM can serve?
With a special focus on inclusivity for all, ABDM has been envisaged to address inequities of access like the one mentioned in your question. ABDM will accelerate the provision of location-agnostic health services through digital technologies like telemedicine. Through ABDM, a patient in a rural area can do a teleconsultation with a doctor anywhere in India and can also share her past records with ease. One of the core building blocks of ABDM is UHI.
Also, we have taken various steps to ensure that the benefits of the mission reach every citizen and inclusion is one of the key principles of ABDM. Wherever needed, the mission has provisions for an assisted mode. Offline mode for creation of health IDs has been enabled wherever internet connectivity might be poor or there would be unavailability of hardware or both.
There are also registries of healthcare providers and facilities being created as part of this mission. Can you help us understand what gaps in the healthcare system these elements will fill and how they will aid common people?
This facility aims to bridge the gaps and establish a single source of truth in terms of information on all health facilities in the country. It eliminates the challenges of the lack of a unique identifier across health programmes, of cumbersome administrative and regulatory procedures, of inadequate channels for communication and coordination.
Similarly, the Healthcare Professionals Registry (HPR) is a comprehensive repository of professionals involved in the delivery of healthcare services across all the systems of medicine, both modern and traditional. These include doctors of all systems of medicines, nurses, paramedics and other healthcare professionals. Verified profiles on the national platform will strengthen the trust of patients. Various digital health solutions shall be integrating with the HPR to have this data available for their users. Till February, nearly 17,000 facilities and over 10,000 doctors have been registered in ABDM. These registries are being created in coordination with the concerned medical councils at both the national and state level.
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