India’s Progress In Digital Healthcare Ecosystem: Evolution Of Policy, Regulations And Future
The Covid-19 pandemic ushered in the need for accelerated digitisation of healthcare across the globe, and India has been in the process of taking several initiatives for its digital healthcare infrastructure, including policy initiatives by the Government of India and advancement of healthcare technology through innovation.
Policies and regulations strengthening the digital healthcare infrastructure
One of the key initiatives for boosting the digital healthcare ecosystem in India was the rapid adoption of telemedicine. The Ministry of Health and Family Welfare of India (MoHFW) introduced the Telemedicine Practice Guidelines in March 2020, paving the way for regulated telemedicine practice in India.
The said guidelines deal with physician-patient relationship, informed consent, continuity of care, referrals for emergency services, medical records, privacy and security of the patient records, issues of liability and negligence, evaluation, health education, and counselling. These guidelines are a welcome addition to the digital healthcare infrastructure in India as they, amongst others, make medical diagnosis, treatment and incidental processes more reliable in the new age of social distancing and virtual consultations.
The Government of India has also routinely allotted a sizable budget for technological advancement and digitisation in the healthcare sector. Digitisation of healthcare records is key for making the benefits of the new technology more scalable, and the Union Budget has made provisions for the same through a planned rollout of the National Digital Health Ecosystem (including the Ayushman Bharat Digital Mission) that will consist of digital registries of health care service providers and health care facilities, unique health identity, consent framework, and aid in universal access to health facilities.
The government also recognises the need for robust laws to protect digital data, especially in view of the promotion and significance of electronic health records. For this, the Digital Information Security in Healthcare Act (DISHA) is proposed for the establishment of a national digital health authority to promote and implement e-health standards, protect patient privacy and security, and regulate the storage and sharing of electronic medical records. The primary goal is to assist India in its digital health journey.
Creation & adoption of a digital healthcare ecosystem
Other than the above initiatives by the Government of India, the ongoing digital health initiatives include: ‘e-Hospital’, which is a cloud-based Hospital Management Information System to help connect patients, hospitals and doctors on a single digital platform; and ‘e-Shushrut’, which is a cloud-based computerised clinical information system for providing accurate electronically stored medical records of patients. The National Health Mission provides support to state governments for services like telemedicine, tele-radiology, tele-oncology and teleophthalmology.1 Other initiatives like the introduction of Aarogya Setu app (for monitoring health status) and the e-Sanjeevani (web-based comprehensive telemedicine solution that facilitates doctor to doctor, and patient to doctor teleconsultations), continue to create a huge impact in the rapidly evolving healthcare infrastructure of India.
Healthcare innovators, including companies and stakeholders are rapidly embracing emerging trends to bring new-age technologically to the forefront while studying the real-life needs of consumers. Several other technologies are at their nascent stage, and they have the potential to overhaul the health care sector of India. These technologies include Internet of Medical Things (IoMT) which could digitise and connect all critical care units of a hospital such as the ICUs, operating rooms, ventilators, navigation systems, etc.; artificial intelligence having advanced diagnostic capabilities including remote diagnosis; 3D printing technology; robot assisted diagnosis and treatment of diseases, including minimally invasive surgeries; wearable healthcare devices, etc.
Digital health as the equaliser and enabler to support development goals
To ensure inclusive welfare and universal access, the need for a sustainable health care infrastructure is inevitable. This will have its own challenges and will create tremendous opportunities for those who can use technology and innovation effectively with a view to ensure that sustainable healthcare is accessible in smaller towns and villages. As a part of its sustainable development goals, India’s aim is to achieve universal health coverage, including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
The Ayushman Bharat Digital Mission is being implemented with the aim to connect healthcare stakeholders via digital pathways on a single platform. It is comprised of digital registries of health providers and hospitals, unique IDs, a consent framework and universal access to health facilities that will unlock creativity and enable solving some of the hardest problems at the last mile, leading to a more plausible future where universal health coverage can be achieved.
The various avenues for improving the current healthcare infrastructure with an aim to achieve universal health coverage include: (i) electronic medical records, aiding faster diagnosis through electronic records of patients available to medical practitioners at the click of a button; (ii) artificial intelligence and surgical robotics, enabling reduction in time and cost for clinical tasks and surgical procedures; (iii) digital and smart health monitors which have already been adopted by a large portion of the population for collecting personalised vital signs and test results in real-time, leading to rapid diagnosis, timely and proper treatment at an early stage, eliminating travel and wait times for diagnosis.
