Govt moots plan to digitise citizen health records by ’22

Aditi Tandon
Tribune News Service
New Delhi, September 20

The government has mooted an ambitious plan to digitise health records of all Indians by 2022.

A new paper by National Institute for Transforming India speaks of creating a national digital health framework usable by the Centre and states across government and private sectors, a framework resting on two pillars -- national health registry and personal health records of citizens.

Entitled, “National Health Stack: Strategy and Approach”, the paper has a message from VK Paul, Member, Health, NITI Aayog, who says, “The National Health Stack (NHS) represents a holistic platform that supports a multitude of health verticals and their disparate branches, and is capable of integrating future IT solutions for a sector poised for rapid, disruptive changes and unforeseen twists. It is now conceivable to aim for digital health records for all citizens by the year 2022.”

The Aayog says the immediate use of NHS is to provide financial protection of Rs 5 lakh annually to 10.74 crore poor families under Prime Minister’s National Health Protection Scheme but adds it will gradually go beyond NHPS to enable healthcare provision and data sharing digitally.

Among key proposed components of NHS are National Health Electronic Registries “to create a single source of health information and manage master health data of the nation” and personal health records to allow “consent based flow of citizens’ health records to stakeholders who require this data to deliver value added services to the user”.

Personal Health Records (PHR) of health users are proposed to be stored.

“Personal Health Record refers to the integrated view of all data related to an individual across various health providers, comprising his medical history, medication and allergies, immunisation status, laboratory test results, radiology images, vital signs, personal statistics such as age and weight, demographics and billing information, and multiple health applications. Because health data is sensitive, the design and implementation must ensure the right level of privacy and security for health data; thus, the PHR is maintained in a secure and private environment, with the individual determining rights of access,” says the paper titled “for consultation”.

Personal data privacy is proposed to be ensured through health data fiduciaries (trustees) that will facilitate consent-driven interaction between entities generating health data and those wanting to consume data for better service delivery.

The document says “NHS design is geared to generate vast amounts of data resulting in some of the largest health databases with secured aggregated data that will put India at the forefront of medical research in the world.”

Earlier, in his message, VK Paul explains how NHS will work, “Various layers of NHS will seamlessly link to support national health electronic registries, a coverage and claims platform, a federated personal health records framework, a national health analytics platform and other horizontal components. The stack will embrace health management systems of public health programs and socio-demographic data systems. The population level base of such an IT system would be individual health record logged through the Health and Wellness Centres in rural areas and corresponding primary health care in urban areas.”

Under NHS, NITI Aayog proposes unique digital health IDs for everyone who registers and also electronic registries of healthcare providers (hospitals, clinics, labs), beneficiaries, doctors, insurers and ASHAs. The paper says “All registries will have open Application Programming Interfaces for publishing and consent-based access by authorised entities.”\

About ‘National Health Stack’ 

Health records of users, their medical history, medication and allergies, immunisation status, lab test reports, radiology images, vital signs, age & weight status, etc to be stored. 

Its benefits 

• Improved services through justified pricing, instant adjudication and on-time payment of claims
• Increased access and availability of service providers through “faster adjudication of claims feature” 
• Potentially place India at forefront of medical research globally as system will generate massive data 
• Reduce healthcare cost via improved fraud detection

Privacy concerns

• Data privacy will be critical part of the design
• All data access would be through API calls to ensure centralised management of the security controls
• Direct access will be prohibited for internal modules while sensitive health data about individuals will be encrypted 
• Several tools to facilitate investigations of breach, if any, will be present

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