Effective use of technology is critical to this project — this is where the
National Health Stack and its rulebook of sorts, the National Digital Health
Blueprint, drawn up by a committee led by the former UIDAI chairman and
Communications and I-T secretary J Satyanarayana, comes in. The Committee
submitted its final report to Health Minister Harsh Vardhan last week.
So,
what is the National Health Stack (NHS)?
Unveiled by the NITI Aayog last
year, NHS is digital infrastructure built with the aim of making the health
insurance system more transparent and robust, while factoring in the uniqueness
of India’s health sector, and the political realities of federalism. There are
five components of NHS:
*An electronic national health
registry that would serve as a single source of health data for the nation;
* a coverage and claims platform that would serve as the building blocks for
large health protection schemes, allow for the horizontal and vertical
expansion of schemes like Ayushman Bharat by states, and enable a robust system
of fraud detection;
* a federated personal health
records (PHR) framework that would serve the twin purposes of access to their
own health data by patients, and the availability of health data for medical
research, which is critical for advancing the understanding of human health;
* a national health analytics
platform that would provide a holistic view combining information on multiple
health initiatives, and feed into smart policymaking, for instance, through
improved predictive analytics; and
* other horizontal components
including a unique digital health ID, health data dictionaries and supply chain
management for drugs, payment gateways, etc., shared across all health
programmes.
And
what is the National Digital Health Blueprint (NDHB)?
The NDHB is the architectural
document for the implementation of the NHS. Its vision is “to create a national
digital health ecosystem that supports universal health coverage in an
efficient, accessible, inclusive, affordable, timely and safe manner, through
provision of a wide range of data, information, and infrastructure services,
duly leveraging open, interoperable, standards-based digital systems, and
ensuring the security, confidentiality and privacy of health-related personal
information”.
The key features of the blueprint
include a federated architecture, a set of architectural principles, a
five-layered system of architectural building blocks, a unique health ID
(UHID), privacy and consent management, national portability, electronic health
records, applicable standards and regulations, health analytics and, above all,
multiple access channels like call centres, Digital Health India portal, and
the MyHealth app. A total of 23 such building blocks have been identified in
the blueprint for the NHS to become a viable reality.
NDHB recognises the need to
establish a specialised organisation, called the National Digital Health
Mission (NDHM) that can drive the implementation of the blueprint, and promote
and facilitate the evolution of a national digital health ecosystem.
But
why is the NHS necessary?
Currently, apart from Ayushman
Bharat-Pradhan Mantri Jan Arogya Yojana, there are many secondary and tertiary
care schemes running in the states — such as Swasthya Sathi in West Bengal,
Aarogyasri in Telangana, Chief Minister’s Comprehensive Health Insurance Scheme
in Tamil Nadu, Mahatma Jyotiba Phule Jan Arogya Yojana in Maharashtra, etc.
West Bengal has opted out of
Ayushman Bharat, and Telangana and Odisha have never been a part of the scheme.
Also, there is an urgent need for
integration of the two arms of Ayushman Bharat — health and wellness centres
which constitute the primary care arm, and PMJAY, which is the secondary and
tertiary care arm under which the target is to provide 10.74 crore families with
an annual health cover of Rs 5 lakh each. Without integration, the goal of
continuum of care cannot be met — and that would mean PMJAY might end up
becoming a perpetual drain on resources.
Hence, the need for a common
digital language for the operationalisation and inter-operability of various
health schemes, which the NHS seeks to provide.
Is
all the data going to be safe/secure?
One of the biggest concerns
following the high-profile rollout of Ayushman Bharat has been regarding data
security and privacy of patients. The concerns were aggravated after an Assam
minister and a senior official of the National Health Authority posted patient
details on Twitter.
More than a year after the
Justice Srikrishna Committee prepared a draft data privacy law, there has been
little meaningful movement on it. Critics have argued that in the backdrop of
the Supreme Court’s privacy judgment, the data privacy law should ideally have
preceded the implementation of Ayushman Bharat.
The NDHB says: “The consent of
the citizen plays a major role in ensuring that collection of data is done in a
manner consistent with legal rights… It is also important to ensure that… the
data captured is used and disclosed (in an identifiable or anonymised shape) in
a manner appropriate in law and preserving the citizen-directed constraints.”
Source | Indian Express | 5th November 2019
Regards
Mr. Pralhad Jadhav
Research Scholar (IGNOU)
Senior Manager @ Knowledge Repository
Khaitan & Co
Mobile @ 9665911593
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