Along with empowering Indian industry, the Make in India initiative has also boosted the nation's domestically created, robust, and trustworthy digital infrastructure. On August 15, 2020, India's 74th Independence Day, the Hon'ble Prime Minister of India Shri Narendra Modi unveiled the National Digital Health Mission (NDHM), which aims to build an ecosystem for better healthcare services across the nation.

Aadhaar Unique Identity (UID), JAM trinity (Jan Dhan-Aadhaar-Mobile), and Unified Payments Interface  (UPI) are part of the nation's existing digital infrastructure that links and identifies people while also streamlining their day-to-day lives through digital methods. This solid foundation for digital infrastructure serves as a springboard for NDHM's plans to advance and improve national healthcare through digital management.

The Ministry of Health and Family Welfare (MoHFW), the Ministry of Electronics and Information Technology (MeitY), and the National Health Authority (NHA) are the principal institutions in charge of overseeing and carrying out the purpose.

 

 

National Digital Health Mission(NDHM): Goals, Features and Components

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NDHM seeks to make India Atmanirbhar, or self-sufficient, by offering all of the nation's citizens access to universal health care. In order to build a digital infrastructure for delivering healthcare services across the nation, is consistent with the aims and objectives of the National Health Policy (NHP) 2017 and the National Digital Health Blueprint.

A national digital health ecosystem that supports universal health coverage in India is what NDHM aims to create. It will be: Effective, Accessible, Inclusive, Affordably, Timely, and Safe. While upholding rigorous secrecy and security of the general public's personal information, this digital infrastructure would include substantial volumes of health-related data and many standardized digital services.

 

Mission's Goals

The NDHM envisions the following specific goals in order to support the current health systems in a "citizen-centric" manner and increase the accessibility and equity of health services, including a continuum of care with the citizen as the owner of data:-

• To create cutting-edge systems for managing the essential data for digital health and the infrastructure needed for its seamless exchange;
• Enforce the adoption of open standards by all national digital health stakeholders;
• Establish registries at the appropriate level to produce a single source of truth for clinical facilities, healthcare experts, healthcare workers, pharmaceuticals, and pharmacies;
• To establish a system of personal health records that adheres to international standards and is easily accessible to persons, healthcare professionals, and service providers with the informed agreement of the individual;
• To encourage the creation of enterprise-class health application systems with a particular focus on attaining the health SDGs;
• To implement the best cooperative federalism principles while collaborating with the States and Union Territories to realise the objective;
• To ensure that private healthcare organisations and professionals actively collaborate with public health authorities to create the NDHM through a mix of promotion and prescription;
• To ensure that the delivery of health care is national and portable;
• To encourage the use of clinical decision support (CDS) systems by health practitioners and experts;
• To encourage better management of the healthcare industry by utilizing medical research and health data analytics.

 

Salient Features 

The following digital systems will be implemented by NDHM across the nation:-

1. Health ID: The use of a Unique Health ID (UHID), similar to an Aadhaar ID, to recognize and authenticate a person based on their medical history. The data will also be shared with different stakeholders after receiving the person's informed consent in order to develop a large network of health records.
2. Digi Doctor: A database of medical professionals including personal information like name, affiliation, education, specialization, and years of experience, among other crucial details. The doctor directory will occasionally be updated, along with a map of the hospitals that doctors are connected to.
3. Health Facility Register (HFR): A database of healthcare facilities across the nation. In India, HFR would promote standardized data sharing between private and public health facilities and will be centrally maintained. Periodic profile updates will also be permitted for healthcare facilities.
4. Personal Health Records (PHR): A PHR is an electronic record of a person that would include details about that person's health. The information in PHR may come from several sources and will be handled and controlled by the person who can update and amend the data.
5. Electronic Medical Records (EMR): A patient's medical and treatment history is stored in an app. EMR is envisioned as a web-based system that would include all of the patient's facility-specific health-related information. This would make it easier for doctors to keep tabs on their patient's health and recommend testing and check-ups for preventative purposes.

 

What is the National Digital Health Mission (NDHM) application process?

To apply for the National Digital Health Mission online, simply follow these steps:

Step 1: Go to the official website and select "Create Health ID." The NDHM ID app is also available for download through the Google Play store.

Step 2: After entering your Aadhar Card number and clicking "submit," select "Create Via Aadhar Card."

Step 3: Enter the OTP that was created by an SMS on your phone in the empty field.

Step 4: Subsequently, fill out the form that displays on your screen by entering the necessary information. Afterwards, select "submit."

Step 5: Write down the ID number and print out the page for your records.

 

Required Documents for the National Digital Health Mission

• Aadhaar card
• Health report
• Residence certificate

The National Digital Health Mission is to guarantee simple access to top-notch medical care and general well-being. By taking the steps listed above, you can receive the advantages with the aid of the paperwork and a few clicks.

 

Components 

There are four components:-

a) National Health Electronic Registries

b) Framework for Federated Personal Health Records (PHR) It will combat two issues:-

• Patients' and healthcare providers' access to medical records and data for treatment
• Providing the information for use in medical research

c) A platform for national health analytics

d) Additional Horizontal Components, such as:-

• Health Data Dictionaries and Individual Digital Health IDs
• Payment gateways
• Supply Chain Management for Pharmaceuticals

 

Implementation of the Mission: Governance Structure and Framework

NDHM is a joint project of numerous ministries and departments. The following governance structure is suggested for the implementation of NDHM given the interconnections and comprehensiveness of the Mission:

The mission will maintain two distinct arms, one for regulation and the other for implementation and operational administration, in accordance with the National Digital Health Blueprint. These will operate under a clear governance framework, with the following suggested roles and duties at various NDHM levels:-

 

Mission Steering Group

The mission will be supervised and guided by the Mission Steering Group, which will be established and presided over by the Honorable Minister for Health and Family Welfare. The following individuals will make up it:-

1. Ministers (MeitY, WCD, Social Justice & Empowerment, AYUSH)
2. Principal Scientific Advisor
3. Member Health (NITI Aayog)
4. Secretaries (H&FW, MeitY, Expenditure)
5. CEO (NHA)
6. Additional Secretary (Health)
7. Additional CEO/Mission Director NDHM
8. Other members (as needed, with permission of the Chair)

 

Empowered Committee

The Secretary of Health and Family Welfare will appoint a chairperson for the Empowered Committee. In addition to assisting the Mission with coordination with various stakeholders and engagement with other Ministries & Departments to ensure their involvement in the NDHM, the Committee will make the appropriate policy-level decisions. Additionally, it will oversee the Mission's distribution around the nation and the creation of several directories. The following individuals will make up it:-

1. CEO (NITI Aayog)
2. Secretaries (WCD, MeitY, Social Justice & Empowerment, AYUSH, Expenditure, DHR)
3. CEO, NHA
4. DGHS
5. DG NIC
6. Joint Secretary (eHealth)
7. Additional CEO/Mission Director NDHM
8. Other members (as needed, with permission of Chair)

 

Ministry of Health and Family Welfare

The National Health Authority will receive overall supervision and direction for the implementation of NDHM from the MoHFW. The Ministry will also assist NHA in coordinating with States/UTs, the private sector, and other parties to ensure their involvement in NDHM as well as work toward developing the legal and regulatory framework for NDHM. The Ministry will also publish the required instructions for NDHM adoption by all national health-related activities.

 

Ministry of Electronics and Information Technology

Wherever appropriate and relevant to MeitY, MeitY will collaborate with MoHFW to develop the legislative and regulatory framework for NDHM. MeitY will also play a significant role in offering direction on the suitable technological framework, utilizing digital services in the right way, and harnessing developing technologies globally.

 

National Health Authority

The NHA will be in charge of overseeing NDHM implementation and coordinating with various state governments, the private sector, and civil society organisations. As the mission director of NDHM, an officer with the rank of Additional Secretary or Joint Secretary will be deployed full-time to oversee operations and execution. NHA will have the following key responsibilities:-

• Administrative and technical leadership to the National Digital Health Mission
• Propose policy support as required to the Mission Steering Group, Empowered Committee and MoHFW
• Development of models for self‐financing of the National Digital Health Mission
• Implementation of policies and decisions approved by the Mission Steering Group and Empowered Committee
• Coordination with MoHFW and the States/UTs
• Engagement with all stakeholders including the private sector and civil society organizations, and develop strategic partnerships to achieve the objectives of NDHM
• Resolution of technical and operational issues
• Recruitment of resources from the Government and private sector at competitive market rates
• Management of day-to-day operations of NDHM
• Capacity building of various stakeholders for health informatics

 

Way forward

The NDHM still does not acknowledge "Health" as a legally protected right. As stated in the 2015 draft of the National Health Policy, there should be an effort to make health a right. The privacy and security of patient data are the main issues. The security and confidentiality of the patient's medical records must be guaranteed.

Additionally, prior to beginning the mission on a pan-India scale, technological and implementation-related shortcomings must be aggressively addressed in light of the failure of a similar National Health Service (NHS) in the United Kingdom.

State-specific regulations must be taken into account as the NDHM design is standardised across the nation. Additionally, it must be compatible with other IT-enabled government programmes including Reproductive Child Health Care, NIKSHAY, and Ayushman Bharat Yojana.