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Ayushman Bharat Digital Mission and ownership of personal health records

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Vikalp Sahni, Founder and CEO, Eka Care & Neeraj Koul, Chief Architect, Eka Care talks about Ayushman Bharat Digital Mission and highlights the management of personal health records

The announcement of the Ayushman Bharat Digital Mission (ABDM) by Prime Minister Narendra Modi, has further paved way to the concept of integrated healthcare system. It will give a tremendous boost to various government agencies and players in the field of healthcare which are working towards reconstructing the link between practitioners and patients digitally by giving them access to real-time health records. Fundamentally, this requires adoption of open standards by all the players in the ecosystem of Pradhan Mantri Digital Health Mission.

This is definitely a forward-looking and tech-driven initiative by the Government of India which will surely strengthen India’s Healthcare ecosystem & drive better health outcomes. With ABDM, many technology players will get opportunities to work alongside government to enable connected-care. We at eka care have integrated the APIs and have started to test out changes in the app, through which users can create and store their health-ids”.

Key Components of ABDM

  • National health electronic registries: This will serve as a single view/source of truth and managing master health data of the citizens.
  • A federated Personal Health Records (PHR) framework: To give access of health data to patients/citizens and to the healthcare service providers. This data will also be available for medical research, which is critical for the advancement and understanding of human health as a whole.
  • A National Health Analytics Platform: Considering the fact that health of citizens is the backbone of an economy, this platform will provide a holistic view to the policy makers to take an informed decision through predictive analytics. The system will be robust and capable to combine information from multiple health initiatives and feed to a predefined system.
  • Other horizontal components: Completing & complementing the ecosystem, this involves health directories, unique health IDs, supply chain management for drugs, payment gateways and various other peripheries.

Decrypting the tech Side: Fast Healthcare Interoperability Resources (FHIR) & ABDM Sandbox (NS)

To establish the whole process & system, it is imperative to understand FHIR, pronounced as “fire”. FHIR is a standard describing data formats which includes elements (known as “resources”), and API (application programming Interface) for exchange of electronic health records (EHR). It is a common language in which various digital systems interact with each other, a standardized form of communication. This standard was created by the Health Level Seven International (HL7) health-care standards organization.

The question on how the technologies or products can access or enter the ecosystem is answered by ABDM Sandbox, which was opened to healthcare application developers in August 2020. ABDM Sandbox (NS) is a framework which will allow technologies or products to be tested in the contained environment in compliance with ABDM standards and judge the consumer and market reactions to the same. Focus of NS will be to foster integration of current systems and IT platforms in healthcare with ABDM building blocks.

What’s in for doctors?

Medical practitioners, doctors in this case, understand the importance of health records the most. The focus of ABDM is to empower doctors with complete and correct health information of their patients, assisting them in taking an informed decision. The long-term objective would be to:

  • Provide patient data to serve as precedent for providing better healthcare
  • Minimise paperwork and documentation while transferring or getting patients from another doctor/hospital, saving precious time of the patient
  • Understand patients’ symptoms and earlier diagnosis by accessing their medical history. This should also prevent medical errors and incorrect diagnosis.

At present the ownership of health data is with multiple players, fragmented and unorganised. From diagnosis lab report in patient’s mailbox, to doctor’s prescription stored in a messaging app, there is no single view of the user’s health record. Patients still share their vitals in sheets of paper and doctors store them temporarily on another sheet. It is much more difficult for a developing country to change caregiver and care seeker’s habits than redefining storage of health records.

As the program advances, the AI driven platform should help doctors to access their patient’s health locker (after taking appropriate consent) to review their vitals and health analytics data. A user -friendly platform should enable both doctors and patients to store, update and share health data, diagnosis and details of the treatment. Moreover, the ecosystem would enable doctors to refer their patients to other doctors (specialists or general physicians). This will be instrumental in cases where patients require further/advance treatment(s). With ABDM coming into picture, the data should equally flow between doctors to provide connected care.

Technology/Artificial Intelligence can help extract, redefine and analyse health data like never before. Non-government players joining hands with ABDM will drastically change the healthcare of a country which is evolving and have initiated to create their own system.

 

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