The country's ambitious national digital health system is going to be started and experimental trials are being started in some parts of the country. Under the National Digital Health Campaign (NDHM), all citizens of the country (through voluntary participation) will be provided a unique health identity card and their health data will be controlled and their digital personal health records will be prepared. Along with the doctors, registration of health facilities will also be done through it.
The center has already offered a draft policy on health data management and has been put up for public review. Its entire emphasis is on measures to maintain data privacy so that the sensitive health information of citizens is kept securely confidential. The data collected in the National Digital Health System (NDHE) will be stored at the Center, State or Union Territory level and the health facility level. Industry experts say that there has been a total emphasis of the government on providing healthcare but never enough steps have been taken towards preparing healthcare data. NDHM has immense potential to change this trend. The aim is to create a database of health information that can be used anywhere between various healthcare providers across the country. Such extensive clinical data can prove extremely useful when managing epidemics or starting biomedical research. For ordinary Indians, it can also play an important role in providing better health outcomes as the data collected will help doctors to match patient needs. Dr. Shuchin Bajaj, founder and director of Ujala Cygnus Healthcare, said, 'We believe that if an anti-diabetic drug has been effective mainly on carnivorous and 6-foot-2-inch white men, then it can eat 5-foot-two-inch rice' Will be equally effective on the person who lives on the east coast of India. This plan will prove to be an important step in the long run, analyzing the data set and creating your own data set.
Experimental testing has been initiated in government hospitals in Ladakh, Chandigarh, Puducherry, Andaman, Lakshadweep, Dadra, and Nagar Haveli where doctors are working on enrollment of both patients and doctors. Public health experts say that these small experimental trials will help to uncover issues that may hinder planning. But one fact is already clear that apart from data security, data entry and data management can play an important role in the success of NDHM and will require additional people.
Dilip Mavalankar, director of the Indian Institute of Public Health, said that it is not practical for doctors and nurses to be aware of patients' data. Says Mavalankar, 'For example, a common problem in the country is that ICU nurses would be expected to do the clerical work associated with data entry of patients daily. However, to make this scheme successful, personnel must be engaged for data entry work. A large number of people will be needed for this work. Like some western countries, India does not have a model where the family doctor's office keeps records of patients and recommends sending patients to a specialist doctor if needed. In Germany, the family doctor is the most important source of information related to any citizen. If such a framework is already in place then it would be easy to implement a broad-scale program of NDHM. Industry insiders say that data management is relatively easy but archiving earlier data will be a big challenge.
Vikram Thaplu, CEO of Apollo Telehealth said, 'Old-date data entry and management is a major challenge. However, this will potentially make things much easier for the telemedicine. The biggest challenge for the telemedicine is to upload health records, especially those living in the village. Thaplu believes that small healthcare providers in remote areas of the country will face the need to upgrade their digital infrastructure. It will be a big challenge to bring all the hospitals on the same technology platform so that they can contact each other. Jay Chakraborty, President (Health Services), Western Region President of the Confederation of Indian Industry (CII) and Chief Operating Officer (COO) of Hinduja Hospital, said, "Training of people is essential, especially for small establishments so that they can access data With understanding, you should also be able to use it when needed. The NDHM includes important pillars such as a specific health identity card (which is based on the UPI ID model), personal health records, DigiDoctor (database of doctors), a health facility registry, e-pharmacy, and telemedicine.
The central agency responsible for the design and implementation of NDHM (one of the prime schemes of Prime Minister Narendra Modi) is the National Health Authority which also manages the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. But the question is whether such a digital campaign will make a difference in society? In an interview to a television channel recently, the most important person associated with the Aadhaar project, Nandan Nilekani, admitted that it is a matter of concern but believes that it is not necessary to have a mobile in everyone's hands at NDHM. Nilekani believes that public access to digital records is necessary. However, experts believe that the government needs to clearly define the objectives of NDHM for a good start.
Dr. Satyanarayana Mysore, Head of Interventional Pulmonology Department of Manipal Hospitals, said, "There should be extensive consultation, planning and consultation before any plan can be implemented." The most important foundation for you is healthcare professionals. You need to reach all these rather than just some famous doctors. ' He also said that if the campaign is to be cleared, then the private sector needs to connect itself with the government. Mysore says electronic medical registers or EMRAs in the US have become a problem for healthcare. Patients often complain that doctors do not directly contact patients face to face nor examine patients. They simply look at a screen and ask them several predetermined questions that have nothing to do with their condition. Dr. Mysore has warned that the care of patients will be further impacted if the government decides to bring comprehensive EMR as a part of the digital health mission.
Another aspect of the discussion is how much freedom or exemption is given to the patients under this scheme. According to experts, some countries like Australia give too much control to patients so that they can decide on their permission related to sharing health information.
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