Context: The prime minister announced the launching of National Digital Health Mission (NDHM) amid the ongoing pandemic on the Independence Day 2020.
Background
National Digital Health Mission (NDHM)

• The NDHM envisages digitizing all data relating to all patients available not just with government and private hospitals but also with diagnostic centres, laboratories and individual practitioners of all systems of medicine.
• Capturing data relating to patients and their digitizing could help all stakeholders including the patients, the doctors who attend to them and the healthcare facilities where they seek treatment.
• The NDHM will help revitalize India’s healthcare delivery system by connecting doctors, hospitals and other healthcare providers in an integrated digital health infrastructure.
• The scheme promises an end-to-end, hands-free digital experience.

Advancement on digital health

• Digitising data: capturing data relating to patients and its digitising could help patients, the doctors who attend to them and the health-care facilities where they seek treatment.
• IT network and public health centres: many States have already achieved some advances in these areas with the National Rural Health Mission (NRHM)and afterwards, National Health Mission. For instance, IT network in most public health centres including tribal areas.
• Format of data: Personal health data are generated by name up to primary health centre level. The patients get hard copies of the reports or soft copies on their smartphones.

The outlines of the mission

• An IT consulting firm has been engaged to build a National Health Stack and a registry of over eight lakh doctors, 10 lakh pharmacists and over 60,000 hospitalsis under preparation.
• The Strategy Document has stated that the data would be safe, confidential and stored locally.
• Consent would be required every time before sharing the personal identifiable information.
• It would help patients to avail Telemedicine support from renowned specialists if required.
• It will be easier to get hospital bills settled with insurance cover under government schemes.
• The scheme also aims to replace existing data generation systems with a new homogenised software for all machines in the health sector in the country with a central processor that will extract the relevant data from individual records.

Widespread costs and catches

• Existing practices: In the government sector there are many existing practices and systems for compilation of data as in the Integrated Disease Surveillance Programme and the Health Management Information System (IDSP-HMIS). The staffs are also well versed in using those systems.
• Already existing software systems: Some larger hospitals have already gone for vigorous and refined software systems such as enterprise resource planning and would be in a dilemma as to whether they need to scrap them or run parallel software provided by the NDHM.
• Costly affair: Public health professionals estimate the high costs for all government and private HIPs to upgrade their hardware and connectivity systems, training of present staff, the entry of data afresh.
• Rural areas: In rural areas it is not a feasible option to enter data in computers on their own or engage data entry operators merely to comply with the digitisation protocols.
• Poor defence against data leakage: Lack of adequate cyber security architecture may expose the personal data of patients at risk.

Estimated Measure

National Health stack

• The National Health Stack (NHS) envisages a centralized health record for all citizens of the country in order to streamline the health information and facilitate its effective management.
• It aims to create a unified health identity of citizens.
• The NHS seeks to employ the latest technology including Big Data Analytics and Machine Learning Artificial Intelligence.
• A registry of over eight lakh doctors, 10 lakh pharmacists and over 60,000 hospitals is under preparation. At a later stage, online pharmacies, insurance companies and other stakeholders will be added to the ‘Stack’.
• The scheme intends to replace existing data generation systems with new homogenised software for all machines in the health sector in the country with a central processor that will extract the relevant data from individual records.

National Health Mission

• The National Health Mission through the IT network is connected to most public health centres even in tribal areas. Personal health data are generated by name until the primary health centre level but not transmitted to higher levels except aggregated numerical data.
• Many States have achieved some breakthroughs in the area of digital health within the framework of the National Rural Health Mission (NRHM).

Road Ahead

• Along with digitising health care data, the government should also focus on unreliable health-care facilities in both the government and private sectors, difficulties in getting timely care, availability of beds and hygienically maintained hospital premises, availability of doctors physically and community health initiatives.