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Ayushman Bharat Digital Mission: All you need to know about India’s ambitious digital health ecosystem

The main aim of the Ayushman Bharat Digital Mission (ABDM) is to develop the necessary backbone of the digital health infrastructure in India.

On September 27, Prime Minister Narendra Modi launched countrywide Ayushman Bharat Digital Mission (ABDM) to create a seamless online platform to enable interoperability within the digital health ecosystem. Under the new mission, the government aims to provide a digital health ID to every citizen in the country where the health records can be saved securely in digital format. With this mission, the government will be able to provide better health facilities to the remotest villages of the country.

During the launch, PM Modi said that for the last seven years, the government of India has been working on strengthening health facilities, and this project would mark its entry into a new phase. He said, “Today, we are launching a Mission that has the potential of bringing a revolutionary change in India’s health facilities.”

While talking about the benefit of having a digital health platform, PM Modi said that the ArogyaSetu app has helped in controlling the spread of Covid-19 infection. He also lauded the role of the Co-WIN platform in administering over 90 crore vaccine shots across the country. He said, using the e-Sanjeevani platform, 125 crore remote consultations were provided during Covid time that helped citizens living in far-flung regions.

He further added that the ABDM would now connect digital health solutions of hospitals to the whole country. It would simplify the processes of the hospitals and make everyone’s life easier. He also noted that over 80 thousand health centres and wellness centres are already operating across the country. He said, “There is a close association between the Ayushman Bharat Digital Mission and ‘Ease of Living.”

Union Minister for Health and Family Welfare Shri Mansukh Mandaviya said that as ABDM would store old medical records, the chances of losing them would be almost nil in the future. He added that a host of facilities like Digital Consultation, Consent of patients in letting medical practitioners access their records and others make this platform a remarkable milestone in health infrastructure in India.

The main aim of the Ayushman Bharat Digital Mission (ABDM) is to develop the necessary backbone of the digital health infrastructure in India. It would bridge the existing gap amongst several stakeholders across the healthcare sector.

How to become part of ABDM?

The first step for a citizen to become part of ABDM is by creating a health ID. It is a randomly generated 14-digit number that would be used to uniquely identify a person, authenticate the identity and connect health records to it. Users would be able to select a PHR (Personal Health Records) Address to access the Health Information Exchange & Consent Manager (HIE-CM). Whenever the health data is to be shared, consent of the patient would be required. In future, the platform may allow to include multiple consent managers that the patients would be able to choose.

The ABDM platform can be accessed either by mobile app or via the web portal. Citizens can also get the Health ID by requesting its creation at a health facility that might include public/private hospitals, community health centres, health and wellness centres across India.

Sharing Aadhaar information is up to the user while registering. Basic information such as name, date of birth, gender, address, mobile number etc., could be pulled via Aadhaar registration, or the user can fill out the form in case Aadhaar is not available, or the user does not want to share the Aadhaar details. Though registration requires a mobile number at the moment, in later stages, the user can register for a Health ID without a mobile number by providing documents at health facilities.

Though the users have the option to create multiple Health IDs to share different records, it is recommended to create only one ID to reduce any confusion. The multiple Health ID systems will allow users to secure their private health records separately. For example, if a patient does not want to reveal the sexual history, the records can be kept under a separate Health ID. One can add a nominee and can create an ID for the children as well.

Process of creating a Health ID and its benefits

Dr Haryax Pathak from Vadodara, Gujarat, created an info thread on Twitter and shared details about how to create a Health ID while explaining its benefits. We also contacted Dr Pathak to discuss the benefits of the system.

First of all, it is essential to understand who all are the stakeholders in ABDM. Citizens and patients are at the centre of the system. The whole healthcare ecosystem that ABDM would create revolves around them. There are several segments of stakeholders who would get benefitted from being part of this ecosystem.

Starting with the policymakers under which the central government and state governments would be able to bring policies based on the health requirement of the citizens based on regions. It will make it easier for the governments to form policies that would benefit patients who are unable to get healthcare in remote areas.

Other stakeholders include healthcare service providers like hospitals, clinics and laboratories. They would get consented access to the health records of the patients whenever required. The same goes for the healthcare professionals like doctors and other practitioners. Dr Pathak, during the conversation, pointed out that the hospitals and doctors need to register on the platform to get access. The system is secure, and it would not give out information to anyone without consent, and both patient and doctor/hospital have to be on the platform to share the health information.

Insurance companies, NGOs, health tech companies, and other stakeholders would also get benefit from the platform. The platform has the potential to make the process of getting health insurance or support from an NGO at a much faster pace.

Creating a Health ID is easy. First of all, one needs to go to https://healthid.ndhm.gov.in.

There are two options, either people can use an Aadhaar card, or they can proceed without sharing Aadhaar information.

In the next step, the user needs to create Personal Health Records Address, which is basically a username, and assign a password. Please note that while logging in, one can either login using the password, or an OTP can be requested in case the password is forgotten, or if someone does not want to enter the password on a public computer.

In the next step, if you have used the Aadhaar login, it will pull information from the database. Else you need to fill out information like name, address, date of birth etc. You need to upload a photo as well. If the photograph pulled out from the Aadhaar database looks old, there is an option to upload the recent photograph.

Once you save the information, your Health ID will be generated. It is as simple as registering for a new email address and require lesser time compared to creating a social media account.

The next step is to set up a digital locker where you can link the health records. There are two options. You can either manually submit the name of the state, city and hospital, or you can pull the information from AB-PMJAY and CoWIN. Once you link the health records, they will show in the app. Notably, your Covid-19 vaccination status will show up in the app once you link your Health ID with your CoWIN information.

To share the information with a hospital, you need to scan the QR code available with the hospital and grant access to your records. Without your consent, the information would not be shared with anyone.

By setting up a digital locker in your profile, you can store scanned copies of old records. There is also an option to add other family members under the same locker.

It is noteworthy that if any doctor or hospital want to access the records of a patient, they have to register themselves on the platform as a service provider. Doctors must be registered with a central or state medical council to get registered on the platform.

While talking to OpIndia, Dr Pathak said, “The platform will not only help the patients to get better access to the healthcare system, it will make it much easier for the healthcare providers to access the old records.” He added that in many cases, old records are not available, and sometimes it makes a lot of difference while choosing the right treatment for the patient. “With ABDM, people living in remote areas would get access to better healthcare. For example, a doctor like me who is sitting in Vadodara will be able to provide consultation to someone sitting in Punjab, and that is going to change the face of the Indian healthcare system completely.”

Why new Health ID and not Aadhaar as Health ID?

It is one of the most asked questions about Health ID. Those who ‘fear’ for their privacy say that Health ID is unnecessary as Aadhaar can be easily used for the purpose. However, in reality, it is not possible.

According to Section 7 of the Aadhaar and Other Laws (Amendment) Act, 2019 [pdf], “Every Aadhaar number holder to establish his identity, may voluntarily use his Aadhaar number in physical or electronic form by way of authentication or offline verification, or in such other form as may be notified, in such manner as may be specified by regulations.” Aadhaar can only be used for availing of Direct Benefits Transfers (DBTs), and it can’t be for any other purpose.

Thus there was a need for an independent and unique identifier to be identified as a Health ID. In the initial stage, a Health ID can be created using an Aadhaar or a mobile phone. Later, there would be an option to use other IDs like PAN cards to create Health IDs at health centres. It is also proposed to make e-KYC mandatory for the creation of Health ID and discontinue Health ID creation via mobile as a move towards creating a trustable and verified ID.

ABDM will not store health information

To ensure privacy, ABDM will not store the health records. They will be stored with healthcare information providers. Once a user provides consent, the records will be shared with the relevant hospital or doctor. The sharing of records is done via encryption mechanisms only.

Opting out of ABDM

There is an option to opt-out from the ABDM ecosystem as per your choice. One can permanently delete or temporarily deactivate the Health ID. If the ID is deactivated, there will be an option to reactivate it as per the user’s choice. However, if a user chooses to delete the records, all information, including demographic details, will be deleted from the system, and the user will not be able to retrieve them in future with the deleted Health ID.

For more information, one can check FAQ section of Health ID.

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B.Sc. Multimedia, a journalist by profession.

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