India to get its first public healthcare record system to track the health of all citizens!
This year in the budget, the Union Minister of Finance, Arun Jaitley has launched the ambitious National Health Protection Mission named Ayushman Bharat which promised a 5 lakh rupees coverage per family per year for secondary and tertiary care hospitalization. While improving healthcare in India still remain the biggest challenge, NITI Aayog, as a remedy, has proposed a new integrated digital healthcare system titled National Health Stack (NHS) which could become the country’s first future-ready healthcare information system available for use by both the Centre and states across public and private sectors.
The primary aim of the NHS is to create digital health record of all citizens by the year 2022. The introduction of this new idea is to initiate and implement the healthcare schemes announced by the Central Government this year. According to the reports, the National Health Stack is designed to provide the foundational components that will be required across Ayushman Bharat and other health programs in India. Ayushman Bharat, also labeled as ‘Modicare‘ was supposed to cover around 10 crores of underprivileged families. Once the new venture is implemented, the personal health records will be available via application programme interfaces (APIs).
For creating this record, one would’ve to create a unique Id. The further features of the process would be as follows;
- Digital health IDs will be created and registrants will get a unique ID on completing the KYC requirement using national identifiers like Aadhar, Pan Card, Election ID etc
Health records of an individual will comprise all his medical history available across various health providers including, medication and allergies, immunization, laboratory test results, radiology images, vital signs, age and weight, demographics and billing information, and info on multiple health apps. - This ID can be then used by a registered beneficiary for scheme related facilities, who will not be asked to provide any other detail by the service provider
- A virtual ID too can be created by the user to interact with other stakeholders in the system to preserve privacy.
- There will be multiple linked layers of the National Health Stack including electronic registries, a coverage and claims platform, a federated personal health records framework, a national health analytics platform as well as other horizontal components.
How will it help?
According to the Niti Aayog, the new data will help the government in various ways. For example, this dataset will help in targeted policy making and also help increase transparency, accountability, civil society engagement, and innovations in service delivery. Also, the center can use this to develop portability feature for migrants among other beneficiaries thus fulfilling its promise of health care and health protection anywhere in the country. The NHS will improve access and affordability of healthcare, facilitate national health programmes, monitor insurance policies and claims, and boost medical research and health analysis. It will also enable on-time payments for service providers while health insurance providers can reap its benefits of reduction in fraud and reduced cost of operations.
Amidst considering all the benefits of the new digital healthcare system, the proposal of using open APIs has raised the issue of privacy of sensitive medical data of the Individual registrants and the question about the ownership of such digital data. One of the main issues that need to be concerned about is that the breach of medical data not only gives away personal information which could be used to create fake identities but can also put an individuals reputation at stake. A person suffering from diseases or conditions with the stigma attached to them could lead to discriminatory behavior against the individual and it is the individuals right to keep such information private. The NHS paper has covered the issue of privacy statement that the PHR is maintained in a secure and private environment, with the individual determining rights of access. This will be made possible through Health Data Fiduciaries (trustees) that shall facilitate consent-driven interaction between entities that generate the health data and entities that want to consume the PHR for delivering better services to the individual.
The health records will use MeitY Electronic Consent Framework which will give users control of their data and protect their data from abuse and compromise.