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DISHA: A Right Step to Streamline Healthcare Delivery

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Dr Sunil Sharma

DISHA will improve accessibility and will make the patient real owners of his/ her own medical data. It will help in continuum of care and will drastically reduce exposure of patients to repeated diagnostics, writes Dr Sunil Sharma, Head, IT, Jindal Institute of Medical Sciences for Elets News Network (ENN).

Digital Information Security in Healthcare Act (DISHA) is to provide a platform for establishing National and State eHealth Authorities and Health Information Exchanges, to standardise and regulate the processes related to collection, storing, transmission and use of digital health data. It will also ensure reliability, data privacy, confidentiality and security of digital health data.

The Ministry of Health and Family Welfare (MoHFW) plans to set up a nodal body in the form of “National Digital Health Authority” through an Act of the Parliament as a statutory body for promotion/ adoption of e-Health standards, to enforce privacy and security measures for electronic health data, and to regulate storage and exchange of electronic health records.

The purpose of the Act is to provide for electronic health data privacy, confidentiality, security and standardisation and provide for establishment of the National Digital Health Authority and health information exchanges and such other matters related with incidental thereto.

This Act is currently at draft stage for public consultation and soon it will come into effect. For quite a long time, experts were saying that we were not ready for it. How are we going to do this when we don’t have infrastructure and standardisation in healthcare practice? The first step in this direction was formulation of electronic health standards in 2013 and subsequent revision in 2016.

healthcare

It was understood that with adoption of these standards properly, the data capture, storage, view, presentation, and transmission will be standardised to levels that will achieve interoperability of both meaning and data contained in the records.

The focus was to provide a set of international and proven standards with intention towards achieving syntactic and semantic interoperability of health records. The idea that any person in India can go to any health service provider/ practitioner, any diagnostic center or any pharmacy and yet be able to access and have fully integrated and always available health records in an electronic format is not only empowering but also the vision for efficient 21st century healthcare delivery.

DISHA is the step that has taken off late but it will have multifold impact. It will make access to healthcare records seamless for the individual who is the owner of the same. Once the health information exchanges are set up and are functioning, the biggest beneficiary will be the patients.

Additionally, it will have immense impact on the current practices, where frauds in medical practices, overbilling for insurance patients and wrong treatment for a particular disease and hit and trial treatment will come in radar.

The biggest concern for a patient currently is access to his medical data, its integrity and confidentiality. DISHA will improve accessibility and will make the patient real owners of his/ her own medical data. It will help in continuum of care and will drastically reduce exposure of patients to repeated diagnostics.

The second biggest beneficiary will be the insurance companies which have been facing the heat of losses in the wake of fraudulent claims.

Proper information of the patient will reduce such cases and the genuine patients will benefit (The Act provides for consent of the patient in case the data has to be shared with the insurance companies for claim).

Here also, the patient gets benefit as the discharge time will be reduced. Moreover, it will have positive impact on hospitals too which can have faster turnaround time.

It will improve the coordination of care and information among hospitals, laboratories, medical professionals, and other entities through an effective infrastructure for the secure and authorised exchange of digital health data.

Currently, the Government has been found to be on defensive while formulating and implementing health schemes, as the data is forged, exaggerated and does not depict the true ground picture. It is because of this reason that the healthcare policies have failed to bring in desired outcomes.

DISHA will serve as the tool to carry out public health research, review and analysis, and policy formulation and will improve the success rate of healthcare policies and programmes. In addition, it will also improve public health activities and facilitate the early identification and rapid response to public health threats and emergencies including bioterror events and infectious disease outbreaks. This will enhance health and clinical research and healthcare quality to promote early detection, prevention, and management of chronic diseases.

Security of health information data is an important consideration in the light of the current findings and the Act should make stricter norms and regulations. The Government data and websites have continuously come under scanner as multiple instances of hacking and security breaches have been reported.

In such a scenario to instill confidence in patient’s mind the Act should clear the air with strong focus on security measures. The Act also has provisions for penalties and compensations in case of breach of health data and also mentions punishment in case of data theft. Overall, the offensive sections of the Act are loosely drafted and need to be tightened substantially before becoming the law. DISHA will serve as a stepping stone in making the medical health record electronic.

It will also make use of the interoperability standards and will also help to capture the required medical health information in standardised way.

The dream of the patient to access his/ her medical record seamlessly on the go is not far from reality.

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