India is becoming the global leader on digital transformation across sectors.
by Nandan Nilekani
India is becoming the global leader on digital transformation across sectors. In less than a decade, extraordinary initiatives like Aadhaar, UPI, DigiLocker, CoWIN, Account Aggregator etc have established a playbook for transformation that involves creating sector-specific building blocks and establishing them as “digital public goods”. These goods have helped unlock private sector innovation and capital flow while focussing on the end goal – bringing high quality services to everyone.
What’s the Digital Health Mission about?
The national launch of Ayushman Bharat Digital Mission by PM Narendra Modi takes a leaf out of this playbook. It introduces several digital public goods for the healthcare sector. The vision is vast and will redefine how each of us experience healthcare delivery with our doctors and hospitals. Imagine this: Just a QR code scan will register the patient and they can control what information they share from their personal health record (PHR) with the hospital. And post consultation, the PHR gets updated seamlessly. The Mission adopts the Data Empowerment and Protection Architecture (DEPA) which ensures that patients control what they share with whom and for how long, and the purposes the shared data can be used for.
The Unified Health Interface (UHI) proposed by the Mission should help India leapfrog into a new realm of digital health services. Today, you simply use any UPI app to pay anyone without worrying about what app or bank they use. Similarly, the vision is to use any UHI app to connect with any doctor, book an appointment, make a payment, share health records and get the prescription added to health records. Doctors will also have the choice to use the best UHI app that helps them manage their patients’ interactions digitally. Interoperability will accelerate digital adoption. This will be a boon to Bharat as a lot of our healthcare talent is still in the cities.
How is Bharat the real thrust area?
Many elements of the Mission show it is designed for Bharat. It leverages Aadhaar authentication to help people without phones obtain a health ID, collect health records and provide consent for access. It is good to see that patients are being put in control and policies are clear that patients must voluntarily participate. In order to be successful, the Mission will require identifying strong incentives and use cases for all its stakeholders to join hands in this journey.
The emphasis on establishing strong privacy and security standards for health data is in the right direction. The approach of using a federated architecture and not creating any central data store is commendable. Pending India’s Personal Data Protection Bill, the National Health Authority must ensure it plays the role of a strong regulator and protects citizens from misuse or data leaks as the policy on data privacy evolves.
We must apply the principle of data minimalism and add only what would be useful for treatment into the PHR. While the building blocks of this Mission have a host of technical standards and specifications, it is up to the healthtech ecosystem to deal with the complexities and evolve simple solutions that are easy to use for doctors and healthcare providers.
How will it benefit the health insurance ecosystem?
The Mission has announced it will set the digital standards for health claims processing. This is key to India’s journey in achieving universal health coverage. As health insurance moves from covering just in-patient incidents to comprehensive outpatient care, India requires a new health claims exchange that can bring greater transparency and new auto adjudication technology. Only this approach can bring the cost of processing down from the current Rs 600 plus per claim to levels that support an OPD claim that may be just a few hundred rupees.
Everything in the Mission is designed for high-volume, low-cost, small transaction size, and to be universally and easily accessible. It will work for people with smartphones, feature phones and without phones. The ability to either use self-service or assisted service methods ensures it will work for Bharat.
The digital public goods approach requires both time and strong ecosystem adoption for success. UPI was launched in 2016 but it took off in 2019. The Digital Health Mission has ticked off all the right boxes on approach and architecture.
https://cio.economictimes.indiatimes.com/news/strategy-and-management/healthcares-digital-transformation-will-democratise-it/86699694