A Gold For Healthcare
THE Ayushman Bharat Digital Mission (ABDM) is slated to revolutionise the healthcare infrastructure, if only through the digital mode. If our country is to provide equity in healthcare to a population of our size, it would be through such an initiative. But what exactly is ABDM? It is an integrated digital healthcare platform that will bring together all stakeholders by creating a digital registry of the medical history of patients.
Such a digital registry will help patients access quality healthcare. Through health IDs, the ABDM will enable ease of registration and paperless health records will reduce chances of loss of information. The National Digital Health Mission pilot project was launched in six Union territories on 15 August, 2020. The nationwide rollout of the Ayushman Bharat Digital Mission (ABDM) was announced by Prime Minister Narendra Modi on 27 September, 2021.
In her Budget speech this year, Union Finance Minister Nirmala Sitharaman announced that the ABDM will be rolled out during 2022 and highlighted the benefits of the scheme. “Thanking FM @NSitharamanJi for announcingthe rollout of an open platform for the national health ecosystem.
It will consist of digital registries of health providers and health facilities, unique health identity, consent framework and universal access to health facilities,” tweeted Union Health Minister Mansukh Mandaviya. Last year, the Finance Minister had announced that the government would be looking at spending Rs 64,180 crore over six years to improve healthcare services in India. Earlier this year, the Union Cabinet cleared a budget of Rs 1,600 crore for ABDM for use over the next five years. As of 5 April, 2022, 21,18,03,089 ABHA numbers (healthIDs) have been created and 24,390 facilities have been registered.
“The ease with which health institutions (once authorised by the patient) can have access to a patient’s medical data will make all the difference in giving him quality care. It will also reduce the transaction cost of a number of associated services in the ecosystem. For example, insurance companies incur a cost for processing a claim, once this moves to a digital ecosystem, the cost goes down and out-patient insurance can become a reality,” says Pankaj Sahni, CEO, Medanta.
Varun Suri, CEO, Consumer Division, Morepen Laboratories, says it is a step in the right direction. The on ground execution of Ayushman Bharat a few years ago and now the digital mission can make the Indian healthcare system stronger. Ayushman Bharat solved the problem of high healthcare costs for many, and now the digital mission will help everyone access quality care. He believes that it has to be a team effort where the government, the healthcare institutions, and the public play their part to improve the system.
Hurdling
The ABDM is a great initiative, but we cannot turn away from some of the questions that come to mind. Will data privacy be an issue? What are some of the other challenges to the success of this programme? “What we are doing currently is creating all the important tools. The challenge would be using these tools to create the desired impact. At Meddo, we are a part of the core group at the ABDM, trying to figure out these problems and build technology solutions around them,” says Saurabh Kochhar, Founder & CEO, Meddo Health.
Kochhar believes that there must be an incentive for providers to use these systems and contribute to the databases. As a healthcare provider, whether it is a hospital, an out-patient care platform, or a laboratory, anybody who is touching a patient in any way, needs incentives to contribute that information to the central database so that it can create a central deposit.
One of the challenges Sahni points out, was the possible lack of human connection since technology would be involved. He also emphasised that there could be operational challenges in getting all healthcare units online and in digitising their systems.
Of data privacy, Kochhar said, whenever we talk about data we get lost in the privacy issue. “I am not trying to ridicule the importance of it. Globally and nationally there are enough examples of how privacy can be solved. Banking is a fantastic example.” The only other data that is as important as health data for an individual is his financial data. He pointed out that as a country we have secured our financial data successfully, and there is a clear template that we can follow.
He said Europe has actually led the way with its GDPR on enhancing that sphere from purely financial systems to a broader set of personally identifiable data. “I think it is a solved problem. I don’t think that is a problem at all. The larger problem in my opinion, is implementation. While we create all the right kinds of tools, the right kind of mindsets are a must and alongside that incentives become an equally important aspect.”
A Home Run
Whenever anything new is put in place, challenges do come up. It’s par for the course! Let’s look at The United Kingdom’s National HealthService (NHS). It is a nationwide healthcare programme that provides specialised care to citizens free of cost. It offers quality care that is easily accessible and free at the point of use. Residents can make use of critical and noncritical medical care, without having to pay, except for a few specific services, such as long-term care, dental care, and filling up of prescriptions.
For us to get to such a system will take time and will require processes to be put in place. For one, we need to better our doctor-to-patient ratio. We must get to the WHO recommended ratio of 1:1000. Secondly, we need to increase our spending on healthcare much more from 1.2 per cent of the GDP (2021 data).
The United Kingdom spends over nine per cent of its GDP on healthcare. And finally, we must have systems to keep the ABDM up and running. Jitendra Chouksey, Founder & CEO, Fittr, is of the view that over the last few years, digital healthcare has evolved, and contributed greatly to healthcare accessibility and delivery in India. Accelerating the formation of processes for the ABDM is key and should be the focus of the near future.
