Improving public healthcare systems across India is one of the biggest challenges and it finally seems to be getting its due importance by the incumbent government. NITI Aayog has proposed a new integrated digital healthcare system titled National Health Stack (NHS) which could become the country’s first future-ready healthcare information system available for use by both the Center and states across public and private sectors. They are aiming for digital health record of all citizens by the year 2022. This is an attempt to initiate and implement the healthcare schemes announced by the Modi Government this year. This year in the budget, Arun Jaitley had launched their ambitious National Health Protection Mission named Ayushman Bharat which promised a 5 lakh rupees coverage per family per year for secondary and tertiary care hospitalization. This scheme, also dubbed Modicare, was supposed to cover over 10 crore poor families. The personal health records and service provider records would be available on cloud-based services which will be accessible via open application program interfaces (APIs).
Unique ID to be created
For this, Digital health IDs will be created and registrants will get a unique ID on completing the KYC requirement using national identifiers like Aadhar, Pan Card, Election ID etc. Health records of an individual will comprise all his medical history available across various health providers including, medication and allergies, immunization, laboratory test results, radiology images, vital signs, age and weight, demographics and billing information, and info on multiple health apps. This ID can be then used by a registered beneficiary for scheme related facilities, who will not be asked to provide any other detail by the service provider. A virtual ID too can be created by the user to interact with other stakeholders in the system to preserve privacy. There will be multiple linked layers of the National Health Stack including electronic registries, a coverage and claims platform, a federated personal health records framework, a national health analytics platform as well as other horizontal components.
Privacy of data
The proposal of using open APIs has raised the issue of privacy of sensitive medical data of the Individual registrants and the question about the ownership of such digital data. Breach of medical data not only gives away personal information which could be used to create fake identities but can also put an individual’s reputation at stake. A person suffering from diseases or conditions with stigma attached to them could lead to discriminatory behavior against the individual and it is the individual’s right to keep such information to himself. The NHS paper has covered the issue of privacy stating that the PHR is maintained in a secure and private environment, with the individual determining rights of access. This will be made possible through Health Data Fiduciaries (trustees) that shall facilitate consent-driven interaction between entities that generate the health data and entities that want to consume the PHR for delivering better services to the individual. The health records will use MeitY Electronic Consent Framework which will give users control of their data and protect their data from abuse and compromise.
How will it benefit the stakeholders?
According to Niti Aayog this data set will help in targeted policy making and also help increase transparency, accountability, civil society engagement, and innovations in service delivery. The center can use this to develop portability feature for migrants among other beneficiaries thus fulfilling its promise of healthcare and health protection anywhere in the country. It will improve access and affordability of healthcare, facilitate national health programs, monitor insurance policies and claims, and boost medical research and health analysis. It will also enable on-time payments for service providers while health insurance providers can reap its benefits of reduction in fraud and reduced cost of operations.
Affordable and quality healthcare: A race against time
The government flagship, the Ayushmaan Bharat program is a step forward towards bringing the healthcare sector at par with international standards which will benefit the quality of life. Increasing health expenditure and roping in the services of the public sector by entering into a partnership are some of the initiatives to uplift healthcare. The government intends to provide affordable healthcare to citizens which will also be of high quality. Attaining both requires calculated measures on their part. With regular advancement in medical science and technology, the government needs companies to invest in research and development which will be possible only when the companies themselves get a fair return on investments. The recent price cuts or control on medical devices such as coronary stents can dent the trust of private players in the medical industry. Balancing the interests of citizens and private entities while racing against time to provide high quality medical care is what the government is aiming towards. For achieving this, they need right public policies to support investment, innovation and patient access. – India Today