Om Prakash Subbarao

India has made significant strides in its journey towards universal health coverage. This has been made possible through the establishment of over 1.7 lakh Ayushman Arogya Mandirs, extending insurance coverage to 10.74 crore families under the Pradhan Mantri Jan Arogya Yojana, and bolstering public healthcare infrastructure as part of the Pradhan Mantri-Ayushman Bharat Health Infrastructure Mission. While the progress has been commendable, the need for qualified health professionals and infrastructure will continually grow to meet the evolving demands of the system.

Addressing this situation, digital health emerges as a critical solution propelling last-mile healthcare delivery, with Artificial Intelligence (AI) standing out as a powerful tool. AI’s capacity to revolutionise patient care, medical diagnostics, personalise treatments, and healthcare management through advanced algorithms and data-driven insights holds immense promise for shaping healthcare delivery. While AI deployment in healthcare is nascent in India, investments are on the rise, and cross-sector collaborations involving the Government, tech giants, and AI solution providers are gaining momentum.

At this juncture, a question arises – how can we ensure the effective implementation of AI healthcare solutions?

Understanding the key considerations that can guide efforts is crucial. Drawing from current AI implementation in health settings, these parameters include three levers: technology, regulations, and service delivery.

Technology: For quality data, core to all AI initiatives, the following are necessary: anonymized, masked, and representative data for training AI models, and standardisation and interoperable systems to execute AI solutions successfully.

Regulations: Regulations that govern the ethical use of AI are essential to safeguard human rights and ensure the sustainability of AI solutions.

Service Delivery: Capacity building of healthcare providers is essential as they are the primary users of digital healthcare and play a vital role in the long-term adoption of AI solutions.

The Ayushman Bharat Digital Mission (ABDM) – the Government of India’s flagship initiative for building an integrated national digital health ecosystem spearheaded by the National Health Authority – is pivotal in laying the groundwork for these pillars.

Technology and Regulations:

ABDM’s approach to healthcare is anchored in robust technological and regulatory principles. The technology layer employs three critical health registries – Ayushman Bharat Health Account, Healthcare Professional Registry, and Health Facility Registry – alongside federated architecture and interoperability to ensure the authenticity and accessibility of medical data. Regulatory measures like the ABDM’s Consent Manager and Health Data Management Policy further fortify the digital system.

Also Read:- “ABDM will ensure ease of taking care of patients in India”

In a practical scenario, an individual’s medical records are linked to their ABHA and stored where it is generated; i.e., in the information management system of an authorised clinic, hospital, or diagnostic centre. Through ABDM’s federated architecture, these ABHA-linked records are readily accessible to the individual or anyone approved by them. Moreover, interoperability enables easy sharing of records across facilities. Importantly, regulatory measures guarantee that data sharing occurs only with explicit patient consent and is handled sensitively, aligning with the Digital Personal Data Protection Act 2023.

Together, these elements provide fertile ground for developing indigenous AI solutions that enhance healthcare delivery. To illustrate, consider building an AI tool for detecting disease outbreaks in Mumbai. Instead of relying on global open-source repositories or historical data, the AI model will fetch anonymized records from clinics, hospitals, or diagnostic centres in the city. Trained on this large volume of representative, anonymized medical data, the model will generate alerts that are accurate and contextual to the region.

Further, the AI ecosystem can leverage ABDM’s Unified Health Interface (UHI) that enables discoverability and delivery of healthcare services. AI tools like differential diagnosis and treatment regimen assistance, which can be integrated with telemedicine systems, can harness UHI’s capabilities. By integrating these AI tools into UHI-certified applications, they can be utilised by a wider pool of healthcare providers and patients; thereby enhancing their accessibility.

Service Delivery:

For the effective deployment of these AI solutions, healthcare staff must grasp the intricacies of using AI-enabled services. Advancing in this direction, ABDM is equipping healthcare professionals with the knowledge and skills for implementing digital healthcare through localised campaigns and on-field guidance. These concerted efforts are enhancing the healthcare professionals’ readiness to use advanced solutions like AI in healthcare.

ABDM is building an ecosystem that can catalyse AI adoption. The initiative has spurred service delivery reform, enabling digital solutions in over 65,000 facilities. Development in this area needs to happen concurrently through building greater computing infrastructure, data coordination mechanisms, and accounting for human oversight in AI-generated recommendations.

AI’s capability to transform healthcare is evident. ABDM acts as the necessary rails to ensure that AI solutions are deployed effectively to enhance patient outcomes, enable operational efficiency, and drive innovation in healthcare delivery for the country.

Views expressed by Om Prakash Subbarao, Advisor, National Health Authority

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