Charting a New Course

The National Health Authority (NHA) is the nodal agency which introduced the National Digital Health Mission (NDHM) also known as Ayushman Bharat Digital Mission in India.  The Ayushman Bharat Digital Mission (ABDM) aims to establish a nationwide digital health ecosystem. It seeks to enhance the lives of its residents by connecting hospitals with digital health solutions throughout India and streamlining hospital operations. Additionally, it seeks to build a platform that would enable health data to be interchangeable across the health ecosystem, giving each citizen access to a continuous Electronic Health Record (EHR). The mission’s mandate is to establish a digital health infrastructure for the country that would encompass all citizens (130 crore). Every citizen will now receive a digital health ID as part of this scheme, and their medical records will be protected digitally. It aims to assign each person a unique health ID and build a single, interconnected digital health infrastructure. The Ayushman Bharat Digital Mission aims to maximize the use of digital connectivity and infrastructure for the effective delivery of healthcare services, with a primary focus on patients. 

Access to healthcare facilities is not only a public health concern but a fundamental right of the people residing in the country. Article 21 of the constitution provides a fundamental right to life and personal liberty. A life with dignity is inextricably linked to the right to health. However over 75% of the country’s healthcare infrastructure is in large cities, where only 27% of the population lives thus restricting the access to equitable healthcare infrastructure for many. Overworked public hospitals frequently fail to provide prompt care to chronic diseases like cancer, organ treatments etc. which drives patients to more expensive private hospitals. Indians has one of the world’s highest out-of-pocket medical bill payment rates—63%. 

The lack of sufficient medical facilities in the nation causes hundreds of millions of Indians living in rural areas to face difficulties in accessing healthcare. Rural regions are sometimes served by local healthcare providers who have little to no official education or training. For many rural populations, access to healthcare is impeded by high rates of poverty. Because of its socioeconomic nature, the demand for healthcare services frequently bears both individual and social aspects that need to be taken into consideration while discussing about health rights in a developing country. Since it allows all private and public players to integrate with ABDM, the main goal of the Ayushman Bharat Digital Mission is to provide health services that are accessible, high-quality, and reasonably priced. 

Within the framework of the Ayushman Bharat, ABDM aims to provide over 12 crores impoverished and vulnerable families a medical coverage of ₹5 lakh per family annually for both tertiary and secondary hospitalization. With a focus on efficiency, accessibility, affordability, and timely delivery, ABDM seeks to fulfil the fundamental human right to high-quality healthcare for all residents without imposing financial burdens on them. The ABDM consistently uses technology to expedite processes and enhance healthcare’s accessibility, cost, availability, inclusivity, and safety. Global best practices have been integrated into this mission, and systems have been developed to better fit the Indian healthcare system. 

The three pillars for ABDM are National Health Claims Exchange (NHCX), Unified Health Interface (UHI), and Health Information Exchange and Consent Manager (HIE-CM). NHCX is concerned with insurance claim interoperability, while UHI is focused on health services interoperability. NHCX was developed under the ABDM to address the issues facing the health insurance sector and enhance the timely delivery of healthcare services to patients. UHI attempts to make it convenient for people to receive healthcare services regardless of their location or socioeconomic level, having a positive impact on both healthcare professionals and the public. The unique, digital health ID created under ABDM for every person, is known as the Ayushman Bharat Health Account (ABHA) number. Medical records can be accessed online for admission, treatment, and discharge through this health id. The data that accumulates over time aids doctors in understanding a patient’s past medical conditions and treatments.

The ABDM offers an open, credible, auditable, and functional standard-based communication protocol between payers, providers, and beneficiaries that facilitates the automation of the workflow associated with processing insurance claims. Rapid information sharing and retrieval are made possible by this digital repository. It plays a pivotal role in advancing the government’s efforts to ensure health rights for its citizens. It achieves this by offering accessible and free-of-cost healthcare services, thereby promoting universal health coverage across the nation. Through ABDM, the government can efficiently reach and benefit a broader population, making healthcare more equitable and inclusive for all. 

The implementation of ABDM is not without obstacles, particularly in closing the gap between patient and accessibility to medical care. One of the main challenges is the unequal distribution of digital infrastructure and resources between regions, which leads to unequal access to health services. Furthermore, gaps in digital literacy and awareness undermine the effectiveness of programs especially for rural communities. Limited connectivity and infrastructure constraints in certain regions prevent the seamless integration of digital health solutions. Surviving these challenges requires targeted action to ensure equitable access to and effective use of digital health resources nationwide.

Increasing the use of information and communication technology, especially mobile health, will be one of the most efficient ways to make ABDM more accessible. In addition to sharing trustworthy patient data, mobile healthcare has made it feasible to identify and diagnose medical condition is a timely and efficient manner. Accessibility to quality healthcare and health information is one of the many benefits that is realized by utilizing ICT  for healthcare. Collaboration amongst stakeholders, including governmental organizations, healthcare practitioners, tech specialists, and individuals, is necessary to address this situation. In addition to addressing issues of geographic distance, the service of remote consultation with medical specialists will help to increase the effectiveness and speed of healthcare delivery. 

The Ayushman Bharat Digital Mission is a revolutionary step toward universal healthcare. By facilitating access to quality healthcare, it strengthens the most marginalized groups in society and eventually advances every Indian’s fundamental right to health. It is a major step in ensuring that everyone has access to sustainable healthcare, especially for disadvantaged groups. Assuring that no one is left behind in India’s pursuit of universal healthcare coverage, ABDM paves the path for an economically viable healthcare ecosystem that prioritizes accessibility, affordability, and effectiveness through digital innovation and strategic alliances.

References:

1. https://medlr.in/blog/navigating-the-abdm-ecosystem-a-roadmap-to-digital-health
2. https://www.business-standard.com/finance/personal-finance/national-digital-health-mission-what-it-does-it-for-health-records-124040900463_1.html
3. https://organiser.org/2024/01/13/216116/bharat/transforming-healthcare-exploring-advancement-and-future-prospects-of-ehealth-in-asia/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10064942/#:~:text=It%20will%20facilitate%20the%20access%20of%20citizens,and%20reducing%20the%20administrative%20burden%20on%20healthcare
5. https://accountabilityindia.in/blog/ayushman-bharat-digital-mission-boon-or-bane/#:~:text=The%20primary%20challenge%20is%20that,the%20eHealth%20initiative%20by%20Kerala
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7. https://www.dnaindia.com/jaipur/report-stark-reality-a-tale-of-another-indu-bhushan-2601186