India’s Prime Minister marked the 74th Independence Day with the launch of the National Digital Health Mission (NDHM). This strategic move is one among three digital initiatives by the Prime Minister, which included a cyber security policy and optical fibre connectivity for six lakh villages across India.
Key Aspects of NDHM
NDHM represents a comprehensive digital health ecosystem, designed to optimize healthcare service delivery in India. The system has four main features: health ID, personal health records, Digi Doctor, and a health facility registry. Future implementations will include e-pharmacy and telemedicine services. The National Health Authority (NHA), under the Ministry of Health and Family Welfare is responsible for implementing NDHM. NHA also serves as the implementing agency for Ayushman Bharat.
The Digital Platform
NDHM will be made accessible through an app and website. Doctors from across the nation are encouraged to register on the platform by providing their contact details. Registered doctors will receive digital signatures which can be used for writing prescriptions. Participation from hospitals and doctors is voluntary.
Health ID and Personal Health Records
The national health ID will contain all health-related information of every Indian, and is expected to attract participation from various healthcare providers such as hospitals, laboratories, insurance companies, online pharmacies, and telemedicine firms. Users interested in having their health records available digitally must create a unique Health ID. This ID will be linked to a health data consent manager, which will enable the patient to give consent and allow seamless flow of health information from the Personal Health Records module. The Health ID will be valid across states, hospitals, diagnostic labs, and pharmacies.
NDHM in Context
The journey towards a digital health technology ecosystem began in 2017 with the National Health Policy. The central government’s think-tank, NITI Aayog, launched a consultation to build a digital backbone for India’s health system — National Health Stack (NHS) in June 2018. That same year, a committee led by the former chairman of UIDAI released the National Digital Health Blueprint, recognizing the need to establish an organization to facilitate the evolution of the National Digital Health Ecosystem.
National Health Policy 2017
The National Health Policy (NHP) 2017 aimed to provide healthcare in an “assured manner” to all, to address current and emerging challenges arising from socio-economic, technological, and epidemiological contexts. The NHP 2017 proposed several interventions, including a progressive assurance-based approach, a larger package of assured comprehensive primary healthcare services, and raising public health expenditure to 2.5% of GDP by 2025.
Challenges and the Way Forward
Despite NDHM’s potential, it is yet to recognize ‘Health’ as a justiciable right. Data security and privacy concerns are major issues that need to be addressed. Learning from the failure of a similar National Health Service (NHS) in the United Kingdom, it becomes crucial to proactively tackle technical and implementation-related deficiencies. Standardizing the NDHM architecture across states is another challenge, especially since it needs to align with government schemes like Ayushman Bharat Yojana, Reproductive Child Health Care, and NIKSHAY.