The story so far: The Ayushman Bharat Digital Mission (ABDM), launched on September 27 , aims to give every citizen a unique digital health ID , which involves their health records being digitally protected and making health a “holistic and inclusive model”. Under the mission, users can access and link personal records with their unique ID to create a longitudinal health history. “The model will stress preventive healthcare and, in case of disease, easy, affordable and accessible treatment,” said the Health Ministry. Inaugurating the mission, Prime Minister Narendra Modi said it will not only simplify processes of hospitals but also increase ease of living.
How will it work?
In order to be a part of the ABDM, citizens will have to create a unique health ID – a randomly generated 14-digit identification number. The ID will give the user unique identification, authentication and will be a repository of all health records of a person. The ID can also be made by self-registration on the portal, downloading the ABMD Health Records app on one’s mobile or at a participating health facility. The beneficiary will also set up a Personal Health Records (PHR) address for the issue of consent, and for future sharing of health records. The Ministry said the Digital Ecosystem will enable a host of other facilities like digital consultation, consent of patients in letting medical practitioners access their records, and so forth. It’s also geared up to connect the digital health solutions of hospitals across the country with each other. The nationwide implementation of the digital health ID coincides with the third anniversary of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY).
Where was the pilot project launched?
The pilot project was announced by the Prime Minister during his Independence Day speech last year. So far, over 1 lakh unique health IDs have been created across select Union Territories as part of the pilot project. Now, the mission is looking at rolling out features that will support health ID creation with a PAN card or a driving licence. For those wanting ID creation through mobile or Aadhaar, the beneficiary will be asked to share details of name, year of birth, gender, address, mobile number and Aadhaar. The government has also allowed use of one’s mobile number for registration, if a person doesn’t have an Aadhaar card.
What about privacy issues?
The citizen’s consent is vital for all access. A beneficiary’s consent is vital to ensure that information is released. Records are stored under retention policies and can be accessed only with the consent of users, said the Health Ministry. Besides, users can delete and exit the service any time they want. The account could be reactivated after which the user can share the ID at any health facility or share health records over the ABDM network. However, there are concerns according to experts. Dr. Sudarshan Ballal, chairman, Manipal Hospitals, said: “The introduction of a unique health identification card at the national level would be a game changer in monitoring, providing and managing healthcare for all citizens. But we will have to wait and see the implementation of the project while making sure that the privacy of an individual is maintained at all costs.”
What are some of the challenges?
“India has been unable to standardise the coverage and quality of the existing digital cards like One Nation One Ration card, PM-JAY card, Aadhaar card, etc., for accessibility of services and entitlements. The data migration and inter-State transfer are still faced with multiple errors and shortcomings in addition to concerns of data security. The defence of data security by expressed informed consent doesn’t work in a country that is plagued by the acute shortage of healthcare professionals to inform the client fully. With the minuscule spending of 1.3% of the GDP on the healthcare sector, India will be unable to ensure the quality and uniform access to healthcare that it hoped to bring about,” said K.R. Antony, paediatrician and a public health professional who served UNICEF and the State Health Resource Centre, Chhattisgarh.
He pointed out that personalised data collected at multiple levels are a “sitting gold mine” for insurance companies, international researchers, and pharma companies. “COVID-19 has taught us that the availability of the private sector is not homogeneous and it can’t provide quality service which is charged transparently and is affordable to the common man. India’s public health system has to be strengthened and rejuvenated much more before we bring in the fancy Digital Health Mission,” he added.
Other experts add that lack of access to technology, poverty, and lack of understanding of the language in a vast and diverse country like India are problems that need to be looked into. “Just like we saw people reluctant to take COVID vaccination, here too people will accept the system only if it’s tried and tested and is known to have some benefit,” said another expert.
Meanwhile, for private hospitals wanting to be part of the system, “the National Health Authority certifies and empanels the private hospital. It has to be given access, integrate and test its software and get a nod from the NHA,” according to the Health Ministry. It added that it would want all healthcare providers and allied services, including laboratories, to be part of the mission.