Q. What are your views on the recently approved data management policy under the National Digital Health Mission?
The approval of the National Digital Health Mission is the first step towards building the much-needed digital healthcare infrastructure in India. It will bridge the existing gap amongst different stakeholders across the care continuum for a patient, such as doctors, hospitals, other healthcare providers, pharmacies, and insurance companies of the healthcare ecosystem through digital highways.
NDHM’s underlying vision to create a seamless online platform through the provision of a wide range of data/information would help provide better care to patients through improved clinical research and the right treatment.
Q. Do you think this address the existing safety concern in sharing personal health data?
Personal health data is sensitive, needs consent before sharing and its privacy must be protected. The NDHM framework guarantees a robust system that the medical health records or data will be encrypted and will not be altered with. Ensuring data quality, interoperability, security, and establishing sound data protection policies will achieve the mission’s objectives.
Q. What could be the impact of an opt-out choice in the overall development of the National Digital Health ecosystem?
The opt-out choice would provide the right to an individual to not be a part of the NDHE. However, opting out should not act as a barrier for people to make use of social and health welfare scheme benefits. As far as the overall development of NDHE is concerned, considering the high population of India, even if people opt-out it would not have much impact as the law of large numbers would play a big role in ensuring the results of clinical decision support systems are achieved.
Q. Which aspects need to be prioritized for interoperability of personal health data and how technology will play a crucial role here?
Interoperability of healthcare data is one of the key building blocks of the National Digital Health ecosystem. It would provide the ability for different healthcare stakeholders using multiple data/information sharing systems to access, exchange, integrate, and cooperatively use data in a coordinated manner across regional and national boundaries. It is very important to build a national body that would be responsible for building different types of standards/protocols for data interoperability, privacy, and security.
Earlier, healthcare data exchange partners were primarily patients and hospitals. With the advent of technology, different types of data attributes are generated through the usage of devices, EMR, wearables, diagnostics systems, etc. There would be a need to build a centralized repository to ensure the data is accessible to all stakeholders and the central body has full control over the data, including the ability to authenticate, authorize and record transactions among participants.
Q. What measures do you suggest for furthering implementation of NDHM effectively?
The Government should leverage the learnings from past experiences, like Aadhar or Health Management Information Systems, which got implemented successfully after crossing through multiple hurdles related to data ethical issues, privacy violations, and social stigma. Further, Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is also successfully implemented and provides end-to-end services through an IT platform from the identification of beneficiaries to their admission, treatment, and discharge from hospital and paperless payment to hospitals by using the public digital infrastructure. This experience can also be leveraged to expand the reach of digital health to all residents.