Being a nation of 1.35 billion people and the second most populous country in the world has its own challenges, and one of the biggest impacts is felt in the area of public health infrastructure and services. The geographic and climatic diversity of India with such a huge population has led to a great stress on our conventional healthcare system. India loses more than 5 million lives to non-communicable diseases annually. A report titled ‘India Health of the Nation’s States’ released by the Ministry of Health and Family Welfare (MOHFW) highlighted how the NCD situation has worsened in recent decades. They accounted for 30% of ‘disability-adjusted life years’ of all the disease burden in the year 1990 and this percentage has rapidly grown to 55% in 2016. Similarly, the fatalities percentage of these diseases rose from 37% in 1990 to 61% in 2016. The prevalent global pandemic has further exposed the limitation of the existing infrastructure and response abilities. It is in this context that the government has unveiled the National Digital Health Mission (NDHM).
The NDHM is envisaged as a national digital health ecosystem which will make universal health coverage in India more efficient, accessible, inclusive and affordable through a unified platform. This platform will seamlessly integrate various types of data, information and infrastructure service providers. As aresult a highly transparent, inscrutable, interoperable and digitally managed system will bring about a transformation in healthcare delivery in India. There has been ample consideration given to the security, confidentiality and ownership of the healthrelated individual data that the system will generate and accumulate.
Benefits of NDHM
NDHM is being seen as a game-changer in the Indian healthcare ecosystem with its provisions for wide-spread coverage and digital integration of all stakeholders. If implemented effectively, there is no doubt that this will be a landmark in not only Indian context, but, in terms of digitization of health services all over the world. It will boost the efficiency and transparency of the overall health service delivery. The data related to a diagnosis, medication given or the medicines dispensed by the pharmacist, all such information will be stored digitally and patients will have secure access to medical reports such as prescriptions, diagnostic reports, treatment and discharge reports etc. They can seamlessly share the same with any other healthcare provider for follow-up, future references or second opinions. This record maintenance will create greater accountability and will offer people correct information on the options offered by different healthcare providers. The digitization of data allows patients to have access to remote health services such as tele-consultation or ordering medicines online.
As outlined,the NDHM will give people freedom to choose various public and private healthcare providers, home healthcare services and tele-medicine etc. There are guidelines and clearly defined protocols will facilitate stringent compliance, transparency of the pricing and accountability for the quality of care. This digitization of medical records will also benefit the doctors. They will be able to get complete medical history information and current status details of the patient which will enable them to chart a more effective treatment course.
NDHM will also streamline and speed up various third-party processes such as settlement of health insurance claims and facilitate ample and accurate data for healthcare research. There will be more accurate and updated data on various diseases, treatment outcomes, medications, and all other relevant factors which can play a key role in development of new medicines, vaccines and standardized treatment processes. The system would create a strong exchange platform of knowledge, data and opinions among different stakeholders such as patients, healthcare providers, medical researchers and authorities.
Challenges in successful implementation of NDHM
Infrastructure: The majority of state-run facilities suffer from lack of modern equipment such as computers and other paraphernalia required for efficient and accurate digital record-keeping. While the smartphones and mobile data connectivity has spread rapidly all over the country, the institutional broadband access is still very low and almost missing in the semi-urban and rural healthcare facilities. Hence, the authorities will have to undertake major capacity building and expenditure to integrate all such facilities into the digital framework.
Digital literacy: India has a great shortage of doctors, medical workers and diagnostic personnel who are well-versed with digital technology. Hence, the maintenance and operation of the digital assets will pose a number of challenges and it is going to take quite some time to get everyone integrated.
Data security and privacy: Data breaches, hacking and privacy violations are rampant in the digital world and the incidents are only increasing. Hence, NDHM’s successful implementation will greatly rely on enacting strong data protection laws and ensuring cutting-edge data security mechanisms into the framework to eliminate the data theft risks.
A detailed look at the vision of NDHM makes it amply clear that the successful implementation is going to make India a global example of high-quality universal health coverage. There are teething problems that need to be addressed before that dream is realized, but, the authorities are working in tandem with all the conventional and innovative healthcare sector stakeholders such as hospitals, pharmacies, online pharmacies, tele-medicine and home healthcare providers as well as diagnostic service providers to iron out the issues. The day is not far when India will be able to achieve the sustainable development goals pertaining to healthcare facilities in the country!
(The author is Vaibhav Tewari, COO, Portea Medical. Views expressed are a personal opinion.)