Ranked 112 among 153 countries in the 2020 global report on health care, it is difficult to believe that plans have been announced to put India in a Digital Health club. Working behind the scenes, unwept, unhonoured and unsung the oft maligned babus have through the National Digital Health Mission (NDHM) kick started several e initiatives. “Starting small, scaling fast but thinking big ” is their motto.
At present utilising services of NDHM is voluntary. Volunteerism has limitations. A carrot and stick policy needs to be adopted. The envisaged digitized interoperable health ecosystem puts patients centre stage. Public or private, urban or rural , large or single every citizen of India, every registered medical practitioner and every health providing establishment can exploit the immense capabilities of this future ready system.
Unique individualised eDigiLockers exclusively for uploading, storing, adding and retrieving all health care related information will be available. Every patient desirous of having digital health records can get a free unique Health ID . Authorised Healthcare providers alone can access the records by searching on the ID, mobile or Aadhaar number.
Every individual will be able to compile, update and store digitally, Personal Health Records in the cloud, accessible only to them or any one else authorised by them. Diagnostic reports, images, discharge summaries, clinical notes, prescriptions and immunization records can be retrieved anywhere in the world by flick of a button. Government cannot access this without patient authorisation every single time.
Future ready, users can even add readings from IoT and wearables. Seamless portability and interoperability ensures that records in any format can be opened with any system, anywhere, anytime. The term ubiquitous is taking a new connotation !! Storing data in the cloud ensures cost effective security, confidentiality and privacy.
Patients needing to see multiple specialists receive more effective treatments as all have access to same information in real time. Individual medical practitioners have unique digital signatures while deploying the DigiDoctor allotted to them. Similarly each clinic, hospital will have its own unique identifying number.
AI will analyse anonymised data generated from a billion EMR’s. Predictive analytics will ensure that we are ready for any epidemics. Digital Health care alone will ensure a radical transformation to achieve long awaited Sustainable Development Goals. EMR’s will decrease paperwork, reduce costs, improve safety, reduce duplication of testing and promote telehealth.
Integrating patient information from multiple sources leads to better clinical decision making. Universal availability of Health records ensures the much needed continuum of care. Healthcare providers enrolled, will have to share a digital copy of all reports with the patient, to enable updating health records. As India moves towards Universal Health Coverage most health costs will be covered by payers. Efficient processing of eHealth claims will become a key requirement.
The National Digital Health ecosystem is designed to support universal health coverage in an efficient, accessible, inclusive, affordable, timely and safe manner providing real-time access to personal health records. Eventually all health care services and health records will be digitised. During the transition period ( several years) physical records will also be required
47 % of countries have an EHR system. 97% of citizens of Taiwan use a Health smart card. The 24/7 universal access to health records has to be seen to be believed. Distance has become meaningless. Geography has become History. Contactless, remote access to health records was available even in the BC ( Before Covid-19) era. The interoperable European Health Insurance Card (EHIC) is issued free to residents of 32 countries.
Fraud, overcharging, duplication of services, investigations and prescriptions is the exception. Insurers in Germany have issued 82 million smart health cards providing real time access to health records. Algeria with 7 million healthcare ID cards has one of the most complete health IT infrastructures. This has expedited the admissions process, decreased costs and medical errors, increased access and expanded options for service delivery. Health administration has been streamlined and simplified.
With no legacy systems to disinherit in eHealth, we can pole vault. We no longer leap frog ( how much can a frog leap ! ) From paper records we have an opportunity to get a unique health id for every sixth human on this planet. Improbable Yes Impossible No ! Man lives on hope and optimism. Who would ever have thought that we would have a billion mobile phones ? 5G and total rural connectivity will eventually be a reality.
We should no longer be following high standards. We should set them. Indian Healthcare should no longer be talking about achieving world class. The world should talk of achieving India class. Made in India is being replaced by make for the world . A journey of a thousand miles begins with the first step. We have already covered many, many miles.
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