What is the Ayushman Bharat Digital Mission (ABDM)? The Government of India launched the Ayushman Bharat Digital Mission (ABDM) on 27th September 2021. ABDM is a flagship digital health initiative that aims to develop the technological backbone for an integrated digital infrastructure in the Indian health system. The government launched a pilot project of the ABDM in the six Union Territories of the country in 2020. In March 2022, the Government of India has announced a budgetary allocation of INR 1600 Crore (~ USD 210 Mn) toward the implementation of the program.The vision of ABDM is to create a unified online platform for India that will provide easy access to treatment records and enable faster and effective treatment. To build the unified digital platform, ABDM seeks to offer a wide range of data, information, and infrastructure services, based on open, interoperable, standards-based digital systems while ensuring the security, confidentiality, and privacy of health-related personal information.The genesis of the program was in the National Health Policy 2017. The NHP 2017 presented the vision of health and wellbeing for all at all ages, emphasizing the need for a continuum of healthcare. Based on this policy directive, the government developed the National Digital Health Blueprint (NDHB), the guiding document that provides the architectural vision, guiding principles, and data standards to create an integrated digital health infrastructure for India. The ABDM is designed and deployed in alignment with the guiding principles of the Blueprint. What are the components of ABDM? One of the critical components of the ABDM includes the creation of a unique health ID i.e., an Ayushman Bharat Health Account (ABHA) for every citizen. As on February 24, 2022, over 173 million people have created their ABHA accounts and over ten thousand doctors and seventeen thousand health facilities have registered in ABDM. The personal health records from accessing care at different healthcare providers across multiple systems of medicine will get linked to the ID, creating a longitudinal health record for the person, which can be viewed with the help of an application (the PHR). The creation of the health ID is voluntary, and the personal health record will comply with security and privacy principles. ABDM will also provide unique identifiers for all healthcare professionals and create a Healthcare Professionals Registry and a repository of all health facilities, i.e., the Health Facility Registry. What are the implications of ABDM? The Health ID will help citizens do away with cumbersome safekeeping and carrying paper-based medical records while navigating the health system. Through the PHR, an individual can share prescriptions, diagnostics reports, and other medical history documents with healthcare providers, irrespective of where and when they were generated. In addition, as old records will not be lost but saved digitally, the patient can avoid needless duplication of tests and procedures. The Health ID promises to reduce inefficiencies and improve clinical outcomes. The treating health professionals can access the entire digital medical record, better understand past health episodes and conditions, and design more effective treatment protocols. The Health ID will also be the reference for other stakeholders in the health system, such as diagnostic laboratories, insurance companies, and government-sponsored health insurance programs. The Healthcare Professionals Registry will bring all health staff such as doctors, nurses, paramedics of India onto a single platform. The Health Facility Registry will be a real-time updated database of all health facilities, which will bring further ease of doing business for all health system stakeholders. ABDM will ensure interoperability and bring together the digital health solutions across all hospitals onto a single platform. Consolidating a person’s medical record is an opportunity for telemedicine, preventive health and wellness, and other varied healthcare solutions to grow. While the individual will be the sole owner of their health record, anonymized and aggregated population-level data will fuel advanced analytics, the use of biomarkers, and the development of preventive healthcare. The population data will aid geography and demography-based monitoring, improve disease surveillance, and support evidence-based policymaking. The ABDM will also impact the health financing sub-system of healthcare stakeholders, thereby providing timely access to affordable healthcare. In addition, the insurance industry will have valuable data for proper underwriting of policies. ABDM will also digitize the claims process, enable auto adjudication of claims, and reduce the time taken to provide reimbursement. In conclusion, the ABDM is an enabling digital framework for the entire healthcare system. The creation of health ID and repositories is the early stage of a more extensive digital health transformation envisioned in a National Digital Health Ecosystem. Authors: Prashanthi Krishnakumar, Program Manager at ACCESS Health International
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