The National Health Policy 2017, approved by the Union Cabinet a couple of weeks ago, envisages the creation of a health information network, and the setting up of a National Digital Health Authority (NDHA):
1. National Digital Health Authority: the policy suggests the setting up of a National Digital Health Authority (NDHA) will be set up “to regulate, develop and deploy digital health across the continuum of care”, given “the integral role of technology(eHealth, mHealth, Cloud, Internet of things, wearables, etc) in the healthcare delivery.”
2. Aadhaar linked Health Information Network for sharing patient data
By 2020, the government will ensure a “district-level electronic database of information on health system components”, and “Strengthen the health surveillance system and establish registries for diseases of public health importance.” By 2025, it intends to establish a “federated integrated health information architecture, Health Information Exchanges and National Health Information Network”.
The National Health Policy that the health information architecture will “link systems across public and private health providers at State and national levels consistent with Metadata and Data Standards (MDDS) & Electronic Health Record (EHR)“.
“Collaboration with private sector consistent with Meta Data and Data Standards and Electronic Health Records would lead to developing a seamless health information system. The private sector could help in creation of registries of patients and in documenting diseases and health events.”
- Aadhaar: Exploring the use of “Aadhaar” (Unique ID) for identification.
- Patient registries and big data analytics: Creation of registries (i.e. patients, provider, service, diseases, document and event) for enhanced public health/big data analytics
- Health information exchange platforms: creation of health information exchange platform and national health information network
- Smartphones/tablets for capturing realtime data
- Private participation: The objective of the health information system, the policy says, “necessitates private sector participation in developing and linking systems into a common network/grid which can be accessed by both public and private healthcare providers.”
In addition, the policy suggests that “private sector laboratories could be engaged for data pooling and sharing. All clinical establishments would be encouraged to notify diseases and provide information of public health importance.”
The policy also recommends “rapid programme appraisals and periodic disease specific surveys to monitor the impact of public health and disease interventions using digital tools for epidemiological surveys.” “There is also a need to develop information data-bases on a wide variety of areas that researchers can share. This includes ensuring that all unit data of major publicly funded surveys related to health, are available in public domain in a research friendly format.”
3. Regulatory body for medical devices
The policy recommends strengthening regulation of medical devices and “establishing a regulatory body for medical devices to unleash innovation and the entrepreneurial spirit for manufacture of medical device in India. The policy supports harmonization of domestic regulatory standards with international standards.” Apart from this, to prevent poor quality/refurbished devices in healthcare, a “Post market surveillance program” shall be strengthened. Price control “with regard to a list of essential diagnostics and equipment” would also be considered.
4. Teleconsultation: “The policy advocates scaling of various initiatives in the area of teleconsultation which will entail linking tertiary care institutions (medical colleges) to District and Subdistrict hospitals which provide secondary care facilities, for the purpose of specialist consultations. The policy will promote utilization of National Knowledge Network for Tele-education, Tele-CME, Teleconsultations and access to digital library.”
5. Other digital-related initiatives:
- Mental Health: “Leverage digital technology in a context where access to qualified psychiatrists is difficult.”
- Supportive Supervision: “For supportive supervision in more vulnerable districts with inadequate capacity, the policy will support innovative measures such as use of digital tools and HR strategies like using nurse trainers to support field workers.”
- Medical Education: “expanding the number of AIIMS like centers for continuous flow of faculty for medical colleges, biomedical and clinical research. National Knowledge Network shall be used for Tele-education, Tele-CME, Tele-consultations and access to digital library.” It also supports “continuing medical and nursing education and on the job support to providers, especially those working in professional isolation in rural areas using digital tools and other appropriate training resources.”
- Digital Tools for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH): “Digital tools would be used for generation and sharing of information about AYUSH services and AYUSH practitioners, for traditional community level healthcare providers and for household level preventive, promotive and curative practices.”