India has, driven by the CoWIN platform, been able to dispense over 197 crore doses of Covid vaccines as on June 28, 2022. The CoWIN platform is a testament to India’s much admired digital push, and work in the digital public infrastructure (DPI) space. Judging by reports, and the assessment of experts, the digital economy could create value in excess of $1 trillion by 2025. BW Businessworld, caught up with Dr. R.S. Sharma, Chief Executive Officer of the National Health Authority (NHA), to pick his mind on unlocking the value of the digital public infrastructure (DPI).
India has made significant progress in the digital public infrastructure (DPI) space. What is the best way to unlock the value of the various platforms?
India has proved to the world that it is second to none in adopting technology and innovating around it. The pandemic highlighted the need for a robust digital public infrastructure (DPI). In particular, the pandemic proved the value of digital systems that were already in use, had basic but flexible functions, and could be applied to the pandemic response effort and other common challenges.
These digital public infrastructure (DPI) systems included digital identification, payments, and data exchanges. None of them were developed with the pandemic in mind, but they became critical enablers of the public health, social protection, and economic responses by the government, businesses, organisations, and individuals.
When we began this journey 12 years back with the creation of Digital Identity for every individual, our aim was to provide individuals a method to authenticate their identity in an efficient manner. At the moment, it is biometric and OTP- based, but we are moving towards facial authentication.
Back then, this project was ahead of its time, and today it has become central to various processes such as banking etc. One way of looking at it is a plug and play model – this authentication can be used across various sectors to ease processes. Similarly, for UPI, we thought about the fact that digital interactions might require transactions. And, hence the UPI, which allows digital transactions remotely and securely.
These DPI goods are horizontal and not built for any particular platforms. Further, these are based on open standards, open API, open source, and are scalable and interoperable. This means that irrespective of the systems used, communication through these Digital Public goods is possible using standard APIs.
Which aspects do you see as challenges to the success of the DPI?
Generally, adoption of digital technologies by all the stakeholders is a challenge for a country. For instance, we have many small clinics across the country which need to be brought on to digital systems. Secondly, for the doctors, we need to provide them a system which is easy to use. We have to find ways and innovate to make systems easy to use.
How can we get the privacy and customer engagement aspects right?
By design we created the digital public goods such that minimal information is collected, and this information is encrypted. Moreover, notice is given wherever the data is used, and consent is taken before use. Then the purpose limitation is factored in, and individuals also have a facility to lock their authentication. These are some of the safety features that were introduced in the creation of the Aadhar (Privacy by Design), and these have been followed for all other digital public goods as well. The federated data structure also provides added security.
To get users engaged with these platforms, methods like advertising on social media could be used. Incentives can be rolled out for people to engage with these programmes. We must focus on better user support for the citizens and fast resolution of queries and grievances. Additionally, development of user friendly and interactive websites and applications is important. Also, let’s not forget that privacy should be kept in mind while developing any programme, with proper frameworks and regulations in place.
Which areas need more focus and a bigger push?
Digital health needs a major focus and push as after the pandemic everybody has come to realise the importance of health. Digital health systems can play a crucial role in connecting patients to doctors online, helping them buy medication, and so on.
Education about these programmes in rural areas is another crucial aspect that requires focus. Internet for all and access to mobile connectivity is very important. Finally, job creation in the IT sector will help solve the resource crunch in the digital sector.
Which are the three key factors to the success of CoWIN?
It was the need for smooth and equitable vaccine coverage that drove the creation of CoWIN. We needed a digital backbone for a country-wide coverage that was also portable and scalable. Moreover, we wanted interoperability so that people could book their vaccines through various applications.
Union Finance Minister, Nirmala Sitharaman, in her 2022-23 Budget speech announced an open platform for the National Digital Health Ecosystem under the Ayushman Bharat Digital Mission. What new innovations have been planned for the ABDM?
The overarching goal of the ABDM is to leverage technology to deliver equitable and affordable health services in an accessible manner. Individuals can maintain longitudinal history for better diagnostics that can be shared with the physician, based on his consent. Federated data structure is being maintained for security of data.
We have also created building blocks such as a consent manager, authenticated registry of doctors, authenticated registry of facilities and so on.
These are the highlights of the ongoing initiatives:
• Consultation to build a ‘Drug Registry’ with credible information about drugs and their substitutes. This is in the development process.
• We are working to create a Health Claims Exchange (HCX) platform for swift processing of insurance claims.
• Repurpose CoWIN to become a platform for universal immunisation.
• Working along with NOTTO [National Organ and Tissue Transplant Organization] to digitalise processes for organ donation. An example would be auto-forwarding the information about a brain death case to applicants desiring the said organ, auto-dissemination of information about a person needing an organ transplant etc.
We are also working to make available anonymised and aggregated health data in the public domain for the benefit of the research community