Context: Recently, Prime Minister in his Independence Day speech has stated the government’s intention to implement a National Digital Health Mission (NDHM).
Background

• The National Health Policy (NHP) 2017 had laid significant emphasis on leveraging digital technologies for enhancing the efficiency effectiveness of all healthcare delivery services.

Key Points

• Under the National Digital Health Mission, every Indian will be given a digital health ID which will contain information regarding disease, medical reports, medicine prescribed and consultant doctor details of a person.
• The National Health Authority (NHA), which runs the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, would be designing and implementing the NDHM.
• While the core systems of NDHM like Health ID, Digi-Doctor and Health Facility Registry shall be owned, operated and maintained by the Government of India, Private stakeholders will be given an equal opportunity to integrate with the core system and create their own products.
• The NDHM would be a voluntary programme.

Significance
Patient-centric healthcare

• The National Digital Health Mission (NDHM) aims to empower the citizens and make the health care system more patient centric.
• The system will lead to convenience for the patient, given that the patient will not need to store and carry old records. The digital access to patient data can lead to more effective diagnosis.
• The digital data will also help in providing prompt and accurate treatment, especially in emergencies by avoiding repetition of medical history taking and unwarranted tests.

Affordability

• Digital health can help ensure the delivery of health services to a large population at affordable costs.

Improved accessibility

• NDHM will help improve access by providing a big boost to consultation through telemedicine with specialist doctors for patients in smaller towns and remote locations.
• The introduction of telemedicine and e-pharmacy will bring in more inclusivity. NDHM can help provide quality healthcare to rural masses and bridge the divide between urban and rural India.
• It will lead to quality care and better access to healthcare facilities and doctors.

Quality healthcare

• Providing a unique identification to doctors as well as health facilities can lead to streamlining several issues of quality and accountability.

Integrating the stakeholders

• The NDHM will help revitalize India’s healthcare delivery system. The NDHM will help reduce the gap among stakeholders, such as doctors, hospitals and other healthcare providers, by connecting them in an integrated digital health infrastructure.

Data value

• The use of machine learning and artificial intelligence techniques to analyse the data generated from the records will help learn disease patterns, predict the onset of ailments and suggest seasonal outbreaks, bringing efficiencies and effectiveness in healthcare.

Impetus to entrepreneurship

• The NDHM brings a huge opportunity for digital health start-ups to work with providers and insurers to help build the continuum of patient centric care. NDHM provides opportunities for innovation in the healthcare sector.

Challenges

Implementational challenges

• To achieve the proposed shift in the storage and retrieval of medical records in the country, the digital integration of interfaces of various stakeholders in the healthcare sector will have to be achieved.
• Given the large participation of the private sector in the healthcare delivery system in India, the challenge would be to bring the private health care sector under the NDHM and ensure both reliability and quality of the information recorded.
• Currently, 66 percent of treatment of all ailments is met by private hospitals and clinics (as per NSS 75th Round: Key Indicators of Social Consumption in India: Health, Ministry of Statistics and Programme Implementation, Government of India, 2017-18).
• A large share of diagnostic centres and pathology labs are run by the private sector.

No digital penetration:

• The low penetration of digital technology in rural areas will be a challenge in ensuring the potential of inclusivity and accessibility offered by NDHM.

Data privacy

• Data privacy and security issues would be a prime concern in the NDHM.
• Dealing with ethical issues, breach of privacy, and dealing with social stigma are significant challenges for the NDHM.

Public health infrastructure

• The digital health mission must be backed up by high-quality public health infrastructure. The absence of a robust public health infrastructure will rob the NDHM of its potential benefits.
• The biggest hurdle for NDHM is the meagre health budget of India.
• Currently, total health expenditure (both private and public) in India is just 3.6 per cent, while public spending on health is just above 1 per cent of the country’s GDP, which is a low compared to the countries that have some of the best digital health systems in the world.