Digitizing health facilities post Covid

The Covid-19 pandemic highlighted the challenges that were lurking in the dark, challenges that were known but were gradually being dealt with. Transitioning to a digital health infrastructure was on the cards of the policymakers that required a roadmap and an implementation plan to develop an infrastructure for a huge country like India. The National Digital Health Blueprint was released in November 2019, outlining the architecture and the building blocks for establishing a digital ecosystem for India’s healthcare system. And while everyone knew what needs to be done, the pandemic was a call to action, which required speed in operations, management, and service delivery. Everything had to be done fast and it had to be done NOW!

With closure of OPDs in several regions and channelizing of resources to treat Covid-infected patients in hospitals, the IT services in healthcare delivery had to be adopted quickly. In March 2020, the Ministry of Health and Family Welfare launched telemedicine guidelines to facilitate access to online healthcare services. Various doctors started tele-consultation services to support patients in home isolation. The regular patient care model had to be tweaked to a homecare-based model. The Swasth app, driven as part of India Tech Garage, registered over 5000 doctors to provide integrated services for health issues. The eSanjeevani app by the Ministry of Health and Family Welfare successfully catered to the needs of over 14 million patients. The pandemic led to the penetration of digital technology at various levels of the healthcare systems.

State governments too adopted digital tools to help in service delivery. Telangana developed an automated Covid-19 Monitoring System App to identify patients, trace them and monitor their health, enabling real-time surveil­lance and factual data analytics by the health depart­ment. Rajasthan established IT-enabled Janta clinics to provide primary healthcare services, along with referral linkages to secondary and tertiary care health facilities. Kerala started tele-ICU services during the pandemic to address the shortage of intensivists and enable monitoring of critical patients at the designated Covid-19 hospitals.

Given the acceptability of digital tools in healthcare, it is opportune to make primary health services digitally robust. To achieve the goal of National Health Policy 2017 of attainment of highest-possible level of health and well-being for all at all ages, digital services in health and wellness centers (HWCs) should be strengthened. While HWCs are mandated to cover a wide range of services, digital connectivity in primary healthcare setting will enable health facilities to align with the national vision of Ayushman Bharat Digital Mission.

This may require up skilling ASHAs and ANMs, who are the first point of contact in a rural setting. While several training modules exist, for complete adoption of technology, behavioral, and focused hand-holding training modules will be needed. Several civil society organizations and non-profit organizations have been independently working to achieve the same. Governments may consider partnering with them to curate a holistic programmatic intervention.

Then there is the challenge of digital infrastructure, for which procurement and budgetary limitations are often cited as a hurdle. To overcome those, hardware-as-a-service or shared pool of technology infrastructure may be considered by state and district authorities.

Finally, nothing will be accomplished without citizen awareness and information dissemination to the target demographics. The fact that technology tools exist for making access to healthcare easy needs to be carefully crafted in simple public messages via mass communication channels as well as offline modes.

Adopting digital tools at primary levels of healthcare delivery will strengthen health systems, enable real-time disease surveillance, and allow better planning and informed decision-making.

This article is co-authored by Deepjyot Kaur, Associate, NITI Aayog.