Universal Healthcare (UHC) is a key commitment for India by 2030, as it affects the achievement of all other goals for sustainable development (SDGs). Even though India’s business growth has been slowed down by the pandemic, India is perceived as one of the fastest-growing economies. India needs to introduce and implement initiatives that ensure a healthy workforce, improve the public healthcare framework, and, most importantly, integrate public and private healthcare resources to stimulate growth and development.
The National Digital Health Blueprint (NDHB) was published in the public domain by the Ministry of Health and Family Welfare in July 2019, inviting comments from various stakeholders, including the general public. The purpose of this blueprint is to establish and manage core digital health data and to provide the adequate infrastructure necessary for its continuous exchange.
Understanding the need to introduce the National Digital Health Blueprint
This National Digital Health Blueprint is an extension of the 2017 National Health Policy (NHP 2017), which was formulated to provide all Indian citizens with universal healthcare based on digital technologies to achieve greater efficiency and efficiency.
The National Health Stack (NHS), which is a digital arrangement aimed at developing a clearer and stronger health insurance system, was introduced in 2018 by the NITI Aayog.
In essence, multiple mechanisms are covered by the NHS, including an electronic national health registry that would function as a single health database for the nation. Another mechanism involves a platform for coverage and claims to function as the building blocks for robust health protection schemes, allowing the states to horizontally and vertically expand schemes such as Ayushman Bharat, and further enabling a robust fraud detection system.
Also, the NHS aims to provide a Federated Personal Health Records (PHR) system to provide the citizens with access to their health data, and further facilitating the accessibility of the health data for medical research, which is crucial for evolving the understanding of human health. The NHS also aims to provide citizens with access to their health data through the Federated Personal Health Records (PHR) system and to further facilitate the accessibility of health data for medical research, which is crucial for improving the understanding of human health.
The NHS also requires the implementation of additional horizontal structures with a specific digital health ID, health data language, and supply chain management through health programs, to ensure that different facets of the NHS are completely linked and avoid the accumulation of disconnected silos.
The NDHB is a constructive document that has been introduced for the application of the NHS, keeping in mind the above initiatives. The underlying concept is to make a national digital health ecosystem capable of supporting universal health coverage in a professional, open, comprehensive, fair, timely, and secure manner by offering comprehensive data, information, and infrastructure collection services.
Features of the National Digital Health Blueprint
The NDHB recognizes the need to set up a new agency called the National Digital Health Mission (NDHM) to help and simplify the creation of a national digital health ecosystem that can promote the implementation of the blueprint.
A coherent architecture, a collection of architectural components, a five-layer system of institutional architectural blocks, a Specific Health ID (UHID), control of privacy and consent, national portability, electronic health records, suitable principles and guidelines, and health analytics are the main features of this blueprint.
For its execution, the Blueprint sets out five horizontal and two vertical blocks of construction. Although the document lists National Health Standards as Vertical Layer-1, the implementation of STGs, which will be the basis for incorporating providers’ patient data, is not comprehensive.
Personal Health Records are included in the Horizontal Layer-2, suggesting a federated structure of multiple players operating on an interoperable standard for health data sharing. The Blueprint also recognizes the significance of protection and seamless interoperability requirements for all building blocks and prescribes the use of EHR standards.
The objectives of NDHB include:-
- Establishing and maintaining the core digital health data and the infrastructure needed to share it seamlessly
- Promoting the adoption of open standards by all stakeholders in the National Digital Health Ecosystem to build multiple digital health systems from wellness to disease control across the sector
- Creation of an international standards-based EHR framework that is easily accessible to people and service providers based on citizen consent
- Establishing pathways of data ownership such that the patient is the owner of his/her EHR, and on behalf of the patient, health facilities and government bodies retain the data under trust. The collection and final use of the data shall take place through a process of consent. However, if it properly meets the standards so described, the anonymized data may be used for research purposes. The health facility is responsible for maintaining data protection, security, and confidentiality
- Following the best principles of cooperative federalism while working with the states and union territories for the realization of the vision
- Promoting medical research and health data analytics
- Boosting the efficacy and quality of governance at all levels
- Ensuring quality of healthcare
- Leveraging the already existing knowledge systems in the health sector
- All people should be able to have secure access to their EHRs
- Leveraging existing health record results of citizens, and not repeatedly undertaking medical testing unless warranted
- In a single application (EHR), people should be able to aggregate health data from multiple agencies/departments/service providers where data is generated
- NDHM can provide residents with quality care through primary, secondary, and tertiary care and public and private service providers
- To facilitate the outreach of voice-based services, a framework for Unified Communication Centre will be established
- NDHM will support the national portability of healthcare services
- Privacy of personal and health data and consent-based access to EHRs will be the inviolable quality that all programs and stakeholders will compile.
- NDHM will correspond to health-related SDGs
- NDHM will allow evidence-based interventions in the field of public health
- Most importantly, NDHM’s analytical capabilities will help data-driven decision-making and policy analysis
The government should consider working with the private sector to develop public infrastructure that can be open-sourced and potentially used at scale by both public and private entities to speed up the implementation of NDHB. Many of the NDHB’s core building blocks, such as the consent manager, health portal, etc, can be easily developed by the private sector and deployed as a public good by the government. This strategy would assist the government to move forward with overdrive in the execution of the NDHB vision.
- Final Report On National Digital Health Blueprint (NDHB)
- National Digital Health Mission Report