Context

Recently, the Prime Minister Shri Narendra Modi has launched the National Digital Health Mission (NDHM) under the Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY).

• In 2017, an interdisciplinary team of academician, government officials and private players and philanthropic sectors published a roadmap for re-imagining India’s health data ecosystem under NITI Aayog’s National Health Stack Bluebook and the health ministry’s National Digital Health Blueprint.

Status of India’s Healthcare Sector

• The general perception behind the inadequate provision and availability of healthcare services is attributed to the country’s developing nation status.
  • India lags behind its BRICS peers on the health and quality index (HAQ index).
• As per the National Health Profile 2018, India’s public health spending is less than 1 per cent of the country’s GDP, which is lower than some of its neighbours, countries such as Bhutan (2.5 per cent), Sri Lanka (1.6 per cent) and Nepal (1.1 per cent).
• According to the World Health Organisation, India finishes second from the bottom amongst the 10 countries of its region for its percentage spending of GDP on public health.
• As per the OECD data available for 2017, India reportedly has only 0.53 beds available per 1,000 people as against 0.87 in Bangladesh, 2.11 in Chile, 1.38 in Mexico, 4.34 in China and 8.05 in Russia.

COVID-19 triggered an introspection of India’s Healthcare System

• Treatment and Viewing of Healthcare System: The headlines of the tragic loss of lives, the exponential increase in cases, economic morass and social disruptions have emerged a deeper subtext on how the healthcare sector is viewed and treated.
• Emergence of Reports on Healthcare’s Problem: The pandemic has raised reports on longstanding problem of healthcare workers protesting the shortage of equipment, patients charging doctors and hospitals for profiteering, policy makers issuing edicts against providers and reported cases of hoarding of essential medicines.
• Increasing lack of interest between stakeholders of the Healthcare System: The growing lack of trust between patients and their doctors and providers and the wider mistrust between policy makers and the industry found fresh ground during the pandemic.

Need of Digital Push for Healthcare Sector

• Easy Availability of Patients’ Report for Doctors and Family members: The ferrying of medical records in polythene bags from doctor to doctor should be avoided and Indians should be able to access their lab reports irrespective of where they were generated and share them with doctors or family members.
  • The portability of clinically-relevant data across private-public divides and states will cut costs and save time and can alter practice andimprove the quality of care.
• Adoption of Standard Language of Operation: All users must be incentivised or mandated to adopt a standard language of communication in order to enable seamless data exchange.
• Digitisation of health infrastructure and delivery: Without the digitisation of health infrastructure and delivery, India cannot accomplish its growth potential, as duly acknowledged by the government.

Concerns associated with Digital Push for Healthcare

• Reducing trained healthcare professionals to data-entry operators: The claims-driven documentation system runs the risk of reducing highly-trained professionals to data-entry operators who must enter billing and legal information that has little relevance for clinical care.
• Over-burdening of healthcare professionals: The patient chart for the placement of a simple stitch for a wound requires, for reimbursement, the documentation of the length, depth and width of the suture.
• Risk in free movement of data: The free movement of health data is not without risks as the concerns with universal IDs is particularly salient when it comes to sensitive personal data like health data.
  • The hospital ethics boards and national data privacy laws are now grappling with difficult questions about third-party use of health data.

Indian Healthcare System based on Empathy

• The society must reframe its outlook and notions about healthcare workers as standard bearers of these professions are not grubby mercantilists, but people wanting to serve with a sense of purpose.
• The faith in the doctor and trust in the hospital/healthcare system is the bedrock of an efficient non-paternalistic, equitable health delivery system.
• The governments need to make laws more effective and watchdogs less virulent and more constructive as regulation by legislation or through watchdogs has not led to an increase in trust in the system.
• The social media needs a dedicated group of health evangelists to fact check, correct and inform the public, especially when fiction is being passed off for facts.

Way Forward

• Use of Artificial Intelligence in digital push for healthcare: The country must harness advances in voice recognition, natural language processing, and machine learning to ignite its health data ecosystem without straining its over-burdened physicians and community health workers.
• Effective Implementation of National Digital Health Mission: The NDHM would provide the scaffolding upon which the market can compete to develop a range of applications that would facilitate data exchange between patients, providers and payers.
• The COVID-19 pandemic has given us great grief and trauma but it also presents an opportunity to reset our outlook, whether in healthcare or climate change.
• The current scope of India’s Digital Health mission must therefore expand beyond mere digitisation of health data, to include various applied aspects of digital health.
• The digitisation of healthcare will make India better-prepared to achieve sustainable development goals in an inclusive manner, and to face black swan events such as the ongoing Covid-19 onslaught.

Source: The Indian Express