Dr Sabine Kapasi, Co-Founder and MD, Enira Consulting feels that ABHA has what it takes to make a big difference in Indian healthcare, in spite of several challenges that need to be addressed
As we celebrate the strides in healthcare innovation, let us explore how the Ayushman Bharat Health Account (ABHA) and Unified Health Interface (UHI) emerge as transformative pillars, leveraging digital technologies to enhance access and efficiency in healthcare delivery across India. Its importance can be gauged by how starting April 1, the government has made it compulsory to connect the Central Government Health Scheme (CGHS) beneficiary ID with the Ayushman Bharat Health Account ID.
All of us will remember how the Unified Payment Interface (UPI) had brought about a significant transformation in digital payments across India. Launched by the National Payments Corporation of India (NPCI) in 2016, UPI swiftly became the most widely adopted digital payment system in the country. Its seamless interface has simplified transactions, making swiping and tapping through payments a commonplace experience.
Drawing parallels with UPI’s success, ABHA under the Ayushman Bharat Digital Mission (ABDM) aims to revolutionise the healthcare sector. Managed as a key component of ABDM, ABHA acts as a pivotal tool for Indian citizens, offering a multitude of benefits. These include streamlined processes at medical facilities, enhanced access to treatments, and a robust identity system, effectively transforming the landscape of healthcare services. The ABHA initiative provides citizens with convenient access to medical treatments and healthcare facilities, along with user-friendly options for personal health record applications through the ABDM ABHA app, ensuring a reliable and secure healthcare identity for every individual.
Inclusion is one of the core design principles for all ABDM building blocks. For those who require assistance for the creation of ABHAs, assisted modes have also been rolled out. Further, an offline ABHA generation module has been introduced in rural areas wherein internet connectivity is limited or not available. The most important point to be noted is that health records associated with Health IDs or ABHA numbers can only be accessed with the informed consent of the individual.
The same goes for the UHI, which comprises a set of open protocols designed to facilitate interoperability within health services. It serves as a fundamental component within the ABDM Stack, emphasising the accessibility and delivery of health services. While the existing ABDM components facilitate the exchange of personal health data and maintain registries for doctors, patients, and healthcare facilities, UHI builds upon these elements to offer a seamless, end-to-end user experience. Through applications enabled with UHI, patients can easily discover, schedule, engage in, and pay for services provided by various participating providers, all within their preferred application interface.
The impact of these new initiatives is substantial. Consider the experience of bypassing lengthy queues at the Out Patient Department (OPD) – it significantly improves patient convenience and operational efficiency, akin to a valuable healthcare enhancement. Moreover, the widespread adoption of ABHA and UHI by hospitals nationwide underscores their effectiveness in simplifying processes for both patients and healthcare providers, ultimately enhancing overall healthcare service delivery.
The main objective of ABHA is to reduce the time taken at the OPD registration counter, provide accurate data in the hospital record, and, most importantly, avoid the wait in the long queues. Ever since the launch, the program has witnessed an increase in adoption among various hospitals across India.
As of February 2024, there are around 36 crore ABHA-linked Health Records, indicating a significant digital footprint of health information. Additionally, there are approximately two lakh registered Health Facilities, highlighting the extensive network available for healthcare services. Furthermore, there are roughly three lakh Healthcare Professionals registered, ensuring a robust workforce to cater to patient needs. The Health Records App has been downloaded approximately 67 lakh times, showcasing the growing adoption of digital health solutions among users. Together, these estimates reflect the progress and adoption of digital initiatives in the healthcare sector.
In Uttar Pradesh’s Gautam Budh Nagar, CMS District Hospital achieved a remarkable feat of implementing this scheme and it helped them in the management of the massive footfall.
ABHA and UHI are part of mobile technology-based health solutions, known as MobileHealth (mHealth), which are increasingly revolutionising healthcare delivery, particularly in low and middle-income countries. According to the World Health Organization (WHO), mHealth encompasses electronic health services and information delivered via mobile devices like smartphones and personal digital assistants.
In Ethiopia, mHealth applications have significantly improved maternal and child health indicators. These applications provide accessible and effective tools for monitoring pregnancies, tracking immunisations, and ensuring timely healthcare interventions, thereby reducing maternal and child mortality rates.
Along the Thai-Myanmar border, web-based mobile modules have been instrumental in the treatment and follow-up of malaria cases. These modules facilitate real-time data collection, rapid diagnosis, and targeted treatment strategies, contributing to better disease management and control.
In Senegal’s Saraya region, mHealth solutions are empowering communities to manage malaria cases at the grassroots level. Through mobile-based platforms, community health workers can track outbreaks, conduct awareness campaigns, and coordinate with healthcare facilities for prompt treatment, leading to improved health outcomes and reduced disease burden.
Another noteworthy example is the ReMiND (Reducing Maternal and Newborn Deaths) program in Uttar Pradesh, India. Implemented through Accredited Social Health Activists (ASHA) workers in Kaushambi district, this mobile-based application enhances routine healthcare service delivery. ASHAs can efficiently track pregnancies, provide essential antenatal care, promote institutional deliveries, and offer postnatal support, thereby contributing to a significant reduction in maternal and newborn mortality rates.
Challenges that need to be addressed
However, ABHA faces several challenges that need to be addressed. Firstly, there is a need for more use cases to demonstrate its effectiveness and versatility. Secondly, the literacy rate among the target population poses a challenge, requiring tailored approaches to ensure understanding and usage. Thirdly, technical stability is imperative for the smooth functioning of ABHA and to instill trust among users. Lastly, adoption from the side of doctors is crucial for the widespread implementation and success of ABHA. Addressing these challenges will be essential for the sustainable development and impact of ABHA. Finally, the implementation brings privacy concerns, where the risk of privacy breaches in digital health records can lead to identity theft or discrimination. Cybersecurity risks are also significant, with the increasing digitization of healthcare systems making them vulnerable to attacks like data leaks or ransomware incidents. AI can help prevent these risks and make healthcare systems more resilient against cyber threats.
Despite these roadblocks, ABHA has what it takes to make a big difference in Indian healthcare. Using mobile technology smartly, ABHA is set to change how healthcare is delivered. It will help improve the health of mothers and children, deal with disease outbreaks better, and manage community healthcare effectively. Getting an ABHA number isn’t compulsory, but it does make getting timely medical treatment much easier. It simplifies the transmission of patient information between hospitals, in turn improving medical services. As mobile health (mHealth) grows, ABHA goes beyond its usual role, becoming a key tool in achieving global health goals and making healthcare more engaging and impactful for everyone.