Whether it is AIDS, Malaria or now, COVID-19, infectious outbreaks follow a grim pattern. Diseases hurt certain sections of the community more than the others. Healthcare in India has always been a tale of two cities and averages are hardly representative of the ground realities in rural and semi-urban areas of the country. This asymmetry exists across the entire patient journey, from lack of awareness on preventive care, difficulty to find the right care provider, long commutes for even basic doctor consultation to delayed diagnosis of medical situations, repeated diagnostic tests. and insufficient follow-up care – all these problems are more acute in Tier II and III India.
Since the onset of the COVID-19 pandemic, India has accelerated the use of technology to improve the lives of people. While digitisation has made a greater impact on areas such as finance, education and commerce, it has now opened new possibilities to transform how healthcare is delivered in India and has provided hope for a healthier, brighter future. India is at the cusp of breaking the barriers in the current healthcare ecosystem by using technology as a healthcare enabler.
In August 2020, the Honourable Prime Minister announced the launch of the National Digital Health Mission (or the NDHM), now known as the Ayushman Bharat Digital Mission (or the ABDM). It aims to create an integrated health system that empowers the patient and to provide access to good quality and affordable care. The National Health Authority (NHA) has already made significant progress in this journey. The ABDM will boast a federated architecture that can be leveraged by both public and private sectors to build and provide new, innovative, healthcare solutions. Its key building blocks to begin with, include a unique health account identifier for individuals known as the Ayushman Bharat Health Account (or the ABHA), standardized registries of healthcare professionals and health facilities, federated health records. Next, we will see interoperability and a unified claim settlement engine.
The basic tenet of the ABDM is to facilitate safe and secure movement of health information such as prescriptions and discharge summaries between doctors, patients and other stakeholders in the healthcare ecosystem with the consent of the owner of the health information, i.e. the patient. To allow the flow of digital health records, ABDM has a provision of a unique health account number, known as Ayushman Bharat Health Account number (or ABHA Number), for each citizen who wants to opt-in to ensure that the created medical records are issued to the correct individual or accessed by a health information user that has been granted the consent.
Today, UPI is one of the most sophisticated and more importantly, financially-inclusive payment platforms in the world. That is the potential that ABDM holds to transform the way healthcare is delivered in India, especially for the rural and semi-urban areas of India.
The Indian health system, especially in rural areas, is primarily focused on secondary and tertiary care. As a result, care seeking is delayed due to poor access and affordability. This results in poor health outcomes. The problem is more acute with the spread of lifestyle diseases where early identification plays a big role in the eventual outcome. Increased access due to adoption of technology in various aspects of care such as e-consultation, e-pharmacy, e-diagnostics and e-ICU will especially increase demand for care.
The Government is already working on developing a unified e-claims platform for faster and standardized processing of cashless insurance and PMJAY claims. There will be a stronger shift to adoption of insurance and PMJAY, thus solving for affordability of care for large sections of the society. Again, this will lead to a significant increase in demand for quality healthcare in Tier II and III areas of the country.
Digital “ways of working” will reduce workforce costs and increase productivity. This is important in India where the doctor to population ratio in India is 1:1,511 against the WHO norm of 1:1,000. Aided by remote monitoring and e-consultations will help alleviate the problem of severe shortage of medical personnel in rural areas.
The world has been looking towards India over the past decade for sharing her demographic dividend to power global consumption. The ABDM will solve for both access and affordability, thus bringing good quality healthcare – products and services – to millions of Indians.
Harsh Parikh, Founder and Director, Driefcase
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