Covid-19 has given many lessons to the world, including the need to rapidly analyze and use large data. By digitizing health-related details, these data can be collected and analyzed on a large scale, which can help the government in policymaking. The Narendra Modi-led central government has started the National Digital Health Mission (NDHM) with the same objective under which a proposal is to give a different type of health identity card (ID) to every citizen. The Prime Minister can announce it on the occasion of Independence Day on 15 August.
The head of a private hospital who was aware of the deliberations of the National Digital Health Scheme said, 'Suppose NDHM has been implemented. In such a situation, you can imagine how fast policymakers can use those data to assess how patients react to a particular treatment. We will get an idea of how many patients have been given the drug (for example, Remedesvir), how many of them died, how many have improved their health, how old are these patients, how many are men and women. And what is the response to the treatment of people already suffering from any other disease? '
At a time when the epidemic is spreading on a wide scale and patients are getting experimental treatment with consent, this may reduce the need to wait longer for data from clinical trials. The NDHM plan is designed to be a complete digital health system that will include a unique health ID (through voluntary participation), a digital record of individual health, and a registration for doctors, hospitals, diagnostic labs, and chemists. There will be four major Aadhaars such as health-related IDs (which according to government officials would be similar to UPI IDs rather than Aadhaar style numbers), registration for private health records (PHRs), Digi-doctors and health centers. A senior government official said, "Once the legal and regulatory framework of e-pharmacy is finalized, they will also be part of this mechanism. NDHM will not be mandatory but the government believes that the advantage of being part of this mechanism is that everyone can join on one platform because of it. ' But the special feature of this scheme is that to get permission to view a person's health record, that person's consent will be required. The official said, 'If anyone wants to access my data, then any organization or person registered with NDHM has to take my permission. I will get a notification cation and it can be an app notification cation, OTP via SMS, or interactive voice response. ' A person can only give an option to see some of his information or can only allow it to be seen for a particular time. Also, options to access these details can be closed. For the information related to the elderly, children, or unconscious patients, the consent of the people associated with them will also be necessary. Government officials assured that the data would be encrypted and not inserted into any central server. The National Health Authority under the leadership of senior Af Sir Indu Bhushan will implement it.
Bhushan said, 'India is a major center of information technology (IT), so this work should have happened long ago. We are trying to implement NDHM with steps such as keeping big thinking, starting at a small level, and expanding rapidly in scope. We will start with some experimental testing and expand the scope based on his experiences. ' He said that the big challenge would be 'change of management'. Hospitals and doctors have a habit of working in a particular way.
Bhushan clarified that Ayushman Bharat is a separate scheme whereas NDHM is for every Indian. However, he said that under the PMJAY scheme, electronic medical records of 1 crore people have been created and more than 23,000 hospitals are connected to it. These details should also be included in NDHM to help give NDHM initial momentum. Due to keeping the details of the personal health records together, the patients will have the facility that they can visit the health center even without prior documents. Treatment will now become easier for doctors who will also be able to see records. In such a case, a follow-up investigation can also be avoided if not necessary.
The government will have a wide range of data on immunization, infant mortality, childbirth, and chronic diseases associated with diabetes, high blood pressure, and nutritional deficiencies, which will help policymakers to target their initiatives. The hospital and e-pharmacy sectors are also excited about NDHM. Describing it as a 'progressive step', Jai Chakraborty, Chief Operating Officer, PD Hinduja Hospital in Mumbai, said, "Bringing all service providers and beneficiaries on the same platform not only helps in early detection of a disease but especially in treating chronic disease." Will also benefit and it will be won by all. Suppose a patient arrives at the hospital in an emergency without any health record. In such a situation, doctors can easily see their medical details through specific IDs.
Officials said that data related to citizens will be under their complete control. As per the final version of the scheme released by the Ministry of Health and Family Welfare, the major pillars of the scheme include Consent Manager, Anonymizer, Privacy Operations Center (POC), etc. with the help of which the scheme will be implemented. The consent manager will ensure that patients have complete control over the data collected and can decide with whom it can be shared. Anonymizer deletes all information associated with the person's identity by matching it to the health data set, and those viewing it receive anonymous data. If someone looks at private data, the POC will monitor it, review the consent given for the data, provide audit services to follow privacy, as well as the privacy rules to create a digital health mission mechanism. Bhushan said that there are no plans to make it market or office-based services. He said that a lot of precautions will be taken regarding the data and caution will be taken regarding the use of its commercial purpose.
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