Can a digital ID aid India’s primary health ecosystem?

Can a digital ID aid India’s primary health ecosystem?

Context:

• Recently, the Prime Minister launched the National Digital Health Mission and made an announcement on the creation of a digital health ID for every Indian.

National health ID system:

• The national health ID will be a repository of all health-related information of a person.
• Each Health ID will be linked to a health data consent manager — such as National Digital Health Mission (NDHM) — which will be used to seek the patient’s consent and allow for a seamless flow of health information from the Personal Health Records module.
• The Health ID is created by using a person’s basic details and mobile number or Aadhaar number. This will make it unique to the person, who will have the option to link all of their health records to this ID.
• As envisaged, various healthcare providers — such as hospitals, laboratories, insurance companies, online pharmacies, telemedicine firms — will be expected to participate in the health ID system.
• While the option of digital Health ID will be there, in case a person does not want Health ID, then also treatment should be allowed.

What is needed to ensure that the digital health benefits masses?

• A digital health system can be built only on the basis of a well-functioning health system and integration of data.
• Integrated management of health data must be based on a larger reorganisation and integration of the health system.
• There is a need to regulate the private healthcare sector, strengthen basic data collection from the primary healthcare level in the public health system, and ensure that this data is used in a manner that is respectful of the citizens’ privacy.
• Having something like the Data Protection Act in place is essential.
• In the absence of these preconditions, a digital health ID will be of limited use. And, it definitely cannot substitute for the much wider health system changes required urgently.

Can Digital Health ID achieve universal health coverage?

• At least two or three important elements are needed for building both a robust health system and an effective digital e-health system.
• Certain foundational policies which relate to the larger health system; enabling strategies, which support an integrated information-based system; e-health applications.

What is being done to address the concerns with respect to citizens’ privacy?

• The draft Health Data Management Policy of the National Digital Health Mission (NDHM) states that patients who opt for the health ID will be given complete control and decision-making power over the manner in which their personal data and any sensitive data associated with them is collected and processed.
• They will also be allowed to withdraw their consent at any time.
• Those processing the data, including health information providers and health information users, are expected to formulate and implement a “personal data breach management mechanism”.
• This is to ensure that any instances of violations and non-compliance, including any unauthorised or accidental disclosure, sharing, alteration or use of the personal data, are “promptly” reported to the NHA and other relevant entities.

Global examples of a centralised health record system?

• In 2005, the UK’s National Health Service (NHS) started deployment of an electronic health record system with a goal to have all patients with a centralised electronic health record by 2010.
• While several hospitals acquired electronic patient records systems as part of this process, there was no national healthcare information exchange.
• The program was ultimately dismantled after the cost to the UK taxpayer was more than £12 billion, and is considered one of the most expensive healthcare IT failures.