Bihar has decided to take cues from the Indian government’s proposed National Digital Health Mission and digitise the health records of residents at a local level. Starting from September 1, the Bihar government rolled out its health records digitisation pilot to various parts of Nalanda district in partnership with health-tech company eHealthSystems, according to a report by Hindustan Times. The digitised medical records hosted on eHealthSystems’ software will reportedly be made accessible through a login ID and password.
The NDHM – a multi-layered digital health infrastructure – was launched last year by the government, with expectations that it will lead to more teleconsultations and the creation of lifelong, electronic health records for all Indians. The union government has already enrolled over 11 crore people into its digital health mission, but it has also been criticised for not taking informed consent from citizens during the registration process.
Bihar’s pilot project signals yet another form of expansion of the health mission with other Indian states likely to follow suit. The Bihar government has already enrolled nearly 3,000 people into the pilot and targets 7,000 more. In the future, this data could be integrated into the database of the NDHM, according to the state authorities involved.
In detail: How the pilot is being conducted
MediaNama spoke to Swapnil Chitnis, Manager, Operations at eHealthSystems who is in charge of the project, as well as Dr. Ambarish Darak, director of eHealthSystems, to learn more about the initiative.
How people are being enrolled: Free of cost, invasive and non-invasive tests are being offered which include measuring blood sugar, blood pressure, body-mass index, etc. across 36 to 51 parameters. According to Dr. Darak, informed consent is taken from individuals and then their electronic medical records are created. “Everything is done as per the medico-legal standards[…]the entire process has been recorded,” he said.
Where the pilot is taking place: According to Chitnis, the pilot has a camp at a government referral hospital in Kalyan Bigha city in the Nalanda district. It also has a central processing unit in KalyanBigha, where the samples are bought for testing at a laboratory. Additionally, it has conducted two camps each in the cities of Harnaut and Bihar Sharif.
In the future, after meeting the current target for 10,000 individuals, the pilot could expand to the entire district, Chitnis said, and another central processing unit will be added. Before that, the pilot will be expanded to three more camps in the Hilsa, Rajgir, and Chandi areas of Nalanda.
How the data is stored: Chitnis said that the data is recorded and uploaded on the government’s MeghRaj cloud server through eHealthSystem’s software. This is accessible to enrolled individuals through a mobile app of eHealthSystems; however, in case someone doesn’t have a phone, they are given a smartwatch to store this data.
How the data is shared:
According to Chitnis, the pilot is using NDHM’s consent manager sandbox which allows data sharing based on consent. This data sharing framework involves a ‘consent manager’ which can be the NHA or another service provider. They will obtain an individual’s consent for sharing personal or sensitive personal data electronically, generate a “consent artifact”, and then share the data with a Health Information User such as a hospital.
- With hospitals: Once the data is stored, individuals are provided with a health card and a 16-digit login ID and password to access this data through the eHealth Systems mobile app, Chitnis said. An OTP-based mechanism can be used by them to further share this data with hospitals. Individuals will provide their login ID to hospital staff such as the receptionist, nurse, or doctor following which an OTP is generated. This needs to be shared by the patient with the hospital staff in order to give them access to the data for a limited time.
In case patients do not have a smartphone, they can share their data through the smartwatch instead. According to Chitnis, they plan to scale the use of the smartwatch to tracking heart rate, BMI, etc. which can later be accessed by a doctor for consults.
- With government: According to Dr. Darak, anonymised and aggregated data is shared with government authorities through a dashboard.
How the NDHM has progressed so far
The NDHM was launched in August 2020 by Prime Minister Narendra Modi. “The NDHM aims to liberate citizens from the challenges of finding the right doctors, seeking an appointment with them, payment of consultation fee, making several rounds of hospitals for prescription sheets, among several others”, the National Health Authority (NHA) said in a statement soon after the launch.
Since then, NDHM has had over 12 lakh enrolments through its pilot, conducted by the National Health Authority in 6 union territories, while another 11 crore individuals were enrolled through the vaccine-management platform CoWIN. State governments like Odisha (and now Bihar) have also started their own pilots along similar lines. The Tamil Nadu government is planning to establish a population Health Registry and a Unique Health ID (UHID) which will be assigned to residents across the state.
Meanwhile, the NHA has been releasing consultation papers and strategy plans for various parts of the health mission and conducted consultations on them. These building blocks of the NDHM include:
- Unified Health Interface
- NDHM draft implementation strategy,
- NDHM blueprint,
- NDHM data policy,
- Sandbox framework guidelines, and others.
The NHA is also expected to release more information on issues like Health Information Sharing and Exchange, policy on the use of health data, drug registry, and so on.
Update: An earlier version of the story misspelled Kalyan Bigha and eHealthSystems, this has been rectified. The error is regretted.
- Open House on National Digital Health Mission: Stakeholders want no liability for data, fair discovery, and more.
- Unique Health ID to be created for all Tamil Nadu residents: Health Minister Subramaniam
- All you need to know about the National Digital Health Mission
- RTI: Over 11 Crore Unique Health ID’s issued through CoWIN says Health Ministry
Have something to add? Post your comment and gift someone a MediaNama subscription.