Perspectives from ISB

For a massive country like India, the rapid deployment and development of digital health technologies to serve its 1.5 billion people is commendable. Since its inception on July 1, 2015, the government of India’s Digital India initiative has significantly transformed India’s healthcare system and strengthened its health ecosystem.

Ayushman Bharat Digital Mission (ABDM), Co-WIN App, Aarogya Setu, e-Sanjeevani, e-Hospital, and other innovations have expanded healthcare services and facilities throughout India. Through digital highways, these initiatives have closed the distance between different players in the healthcare sector.

The confluence of healthcare and digital innovation has given rise to the disruptive phenomena known as digital health in today’s fast-paced world. This paradigm shift affects how we see, access, and deliver healthcare services; it goes beyond simply integrating technology into the field.

Understanding Digital Health

Digital health refers to a broad range of applications combining technology and healthcare. Worldwide, digital health is changing the face of healthcare through advanced technologies such as eHealth and big data, m-health, AI, IoT, blockchain technology, electronic health records, etc.  Fundamentally, digital health aims to enable better patient care, promote shared decision-making, and empower patients and carers using various digital tools.

The Digital Health Ecosystem

The rise in non-communicable diseases coupled with the population boom has highlighted the need for innovative ways to close the gap between the supply and demand for healthcare. With the ability to deliver healthcare in a personalised and effective manner, digital health technologies have become a ray of hope. Many innovative inventions in the digital health ecosystem strive to improve patient care and management, ranging from wearable monitoring gadgets to telemedicine systems.

India has spearheaded the digital health revolution with its Digital India Campaign (2015) and National Health Policy (2017). The Ayushman Bharat Digital Mission (ABDM) demonstrates the government’s resolve to use technology to provide universal access to healthcare.

Ayushman Bharat Digital Health Mission (ABDHM)

The Ayushman Bharat Digital Mission (ABDM), formerly the National Digital Health Mission (NDHM), aims to establish an integrated digital health infrastructure to strengthen healthcare in India. Its mission is to create a robust digital health ecosystem, enabling secure access and sharing of health records anywhere, anytime. Under this scheme, individuals receive a unique 14-digit ABHA number (health ID), their identity in India’s digital healthcare ecosystem. This identity is recognised and accepted by healthcare providers and payers nationwide. Since its launch on September 27, 2021, the ABHA initiative has achieved remarkable milestones, with 61,62,57,382 accounts created and 38,13,52,948 health records linked. Furthermore, the programme has verified 2,67,497 health facilities and 3,50,188 healthcare professionals.

The ABHA App

ABHA (earlier known as Health ID) is an acronym for Ayushman Bharat Health Account.The ABHA mobile application, often called the ABHA App, is a portal to the Ayushman Bharat Digital Mission (ABDM) ecosystem. The ABHA App allows users to create an address, access health reports (including lab reports, prescriptions, and Co-WIN vaccination records) from their mobile devices, and find health facilities, health professionals, and facilities based on location, specialisation, and rating criteria. Users have complete control over their data and can remove consent as needed.

Aarogya Setu Mobile App

Developed as a mobile application to identify the risks of COVID-19, the Aarogya Setu has evolved into a national health app, offering many digital health services supported by the Ayushman Bharat Digital Mission (ABDM). Aarogya Setu allows users to create an Ayushman Bharat Health Account (i.e. Digital Health ID) and use it to interact with participating healthcare providers and receive digital lab reports, prescriptions, and diagnoses from verified healthcare professionals and health service providers.

Aarogya Setu allows you to make online doctor appointments using the eSanjeevani OPD Application. Also, Aarogya Setu allows users to download immunisation certificates and request changes to them.

Co-WIN Mobile App

Co-WIN, a web portal for operationalising India’s COVID-19 vaccination programme, was established to strengthen the COVID-19 Vaccine Intelligence Network (CoWIN) system. It is a digitalised platform utilised to roll out and scale up the COVID-19 vaccine Distribution System across the nation. As of November 21, 2023, the overall number of vaccinations administered was over 220.68 crore as of May 17, 2024 in comparison, the total number of registrations was more than 110.93 crore.

eSanjeevani – National Telemedicine Service          

eSanjeevani, the National Telemedicine Service launched in November 2019, exemplifies the advancement of digital health in India, extending free consultations to millions of individuals nationwide. It has emerged as the most extensively documented telemedicine implementation in primary healthcare globally, reaching every corner of the country. Its exponential growth over the past couple of years is evident, from a mere 3000 patients in November 2019 and surging to an impressive ten crore by January 2023. Recently, the platform has achieved a landmark milestone. Based on the latest data, eSanjeevani achieved a significant milestone by providing telemedicine services to over 24 crore patients nationwide. The platform has reached its peak by serving 510,702 patients in a single day, and the platform has been upgraded to support over one million consultations daily. Interestingly, over 57% of Sanjeevani beneficiaries are women, and approximately 12% of the beneficiaries are senior citizens. These statistics emphasise the substantial impact of eSanjeevani, catering to diverse sections of the population.

e-Hospital services

Developed by the National Informatics Centre (NIC), e-Hospital – Hospital Management Information System (HMIS) is a workflow-based ICT solution for hospitals specifically meant for hospitals in the government sector. e-Hospital services have made it easy to make online appointments at government hospitals through the SaaS (Software as a service) model. Launched in July 2015, the e-Hospital application provides government hospitals with e-Hospital, e-BloodBank, and Online Registration System (ORS) applications and an online patient portal for easy appointment booking, lab report access, and blood availability checking. The e-hospital data complies with Ayushman Bharat Digital Mission (ABDM) regulations. Utilised by more than 268 hospitals nationwide, the web-enabled, workflow-based e-Hospital application is housed at NIC’s National Cloud MeghRaj and is based on a decentralised multi-instance architecture.

Challenges and Opportunities in Digital Healthcare

While digital health holds immense promise, its implementation is challenging. From ensuring interoperability and data governance to addressing the digital divide, India faces many hurdles in realising the full potential of digital health. Moreover, the diverse socio-cultural landscape of India necessitates a nuanced approach to digital health adoption, addressing issues of accessibility, literacy, and equity. However, these challenges can be overcome with concerted efforts and strategic partnerships.

Capacity building, robust governance frameworks, and stakeholder collaboration are imperative to overcome these challenges. A specific health data protection law is essential to safeguard personal information. At the same time, concerted efforts are needed to bridge the urban-rural digital divide and enhance digital literacy among the population.

Despite these challenges, digital health promises to transform healthcare delivery in India. The burgeoning digital health startup ecosystem in India exemplifies the nation’s entrepreneurial spirit and innovation in healthcare. Startups are introducing novel technologies and solutions tailored to meet the unique healthcare requirements of the nation’s diverse population.

Transforming Healthcare: India’s Digital Journey Ahead

While the road to digital health may be fraught with many challenges, the opportunities for transformative change are boundless, thanks to digital technologies such as AI. As India embarks on its digital health journey, collaboration, innovation, and inclusivity will be critical drivers of success. Public-private partnerships, multi-disciplinary approaches, and people’s support can further amplify the impact of digital health initiatives, enhancing healthcare outcomes and improving lives.

By embracing innovation, fostering collaboration, and prioritising inclusivity, India can chart a course towards a future where equitable and affordable healthcare is within reach of every individual, irrespective of their socio-economic status or geographical location.

Author’s Bio: Ramesh Kotnana works at the ISB Centre for Business Innovation – Indian School of Business as a Sr. Manager – Competitive Analysis & Strategy. He has a Masters degree in  Library and Information Science from Andhra University and about two decades of work experience in information services and knowledge management domain.

DISCLAIMER : The views expressed in this blog/article are author’s personal.

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