This is the first of a two-part story about what took place at the Open House conducted by the National Health Authority on the Unified Health Interface, Healthcare Professionals Registry, and Health Facilities Registry.
On September 6, multiple participants of the National Digital Health Mission ecosystem joined a zoom call for an Open House on various NDHM layers. Three members of the National Health Authority were already logged in — Addl. CEO Praveen Gedam, Consultant Anand Ravindran and, in a breakaway from other previous events, NHA CEO R.S. Sharma.
During the course of the session, Sharma took a few questions on the proposed building blocks of the NDHM while sharing some thoughts on how the blocks are drawn from the financial sector. He also commented on borrowing from international models to build the health mission. Sharma’s remarks at the event are useful in connecting the dots between the government’s proposed digital health infrastructure and India’s unified payments interface.
Background: The NDHM envisages a layered digital health infrastructure comprising Health IDs, health facilities registry, healthcare professionals registry, teleconsultations, etc. Launched last year by Prime Minister Narendra Modi, an NDHM pilot project is currently underway in 6 Union Territories. Over 11 Crore Health IDs have already been issued under the digital health mission.
On using international examples to build the NDHM
Sharma went on a bit of a rant when one of the participants recommended the NHA take cues from sophisticated financial models across the world. Unfortunately, Sharma probably did not hear the participant say ‘including India’ and began criticising the participant for asking the NHA to refer to international models instead of providing valuable comments of their own.
The following exchange from a transcript of the event has been lightly edited for clarity:
Participant: The point I wish to make is that many of the issues that we are debating here with respect to health data has already been answered and implemented across the world in the financial industry, things like Privacy, things like security, things like distribution, ownership, etc. So my request is for us to look at the financial sector across the world, the most sophisticated ones, including India, and to see how this has been implemented. Vis-a-vis number one, the citizens or the customers and number two, Vis-a-vis the laws that are extent in those countries
Sharma: May I just respond to this particular observation that things have been done and evolved in other countries’ financial sector and therefore one should look at them and they are more sophisticated systems. I think India has done much more- much much more – sophisticated systems in the financial sector.
Participant: No, I did include India-
Sharma: Yeah we are certainly looking into those things what I’m saying is that sometimes countries do have to find their own paths. We should not be just be looking at others only to provide us the guidance
Participant: No,no may I come in here?
Sharma: Let me complete. What I’m saying is that what we are architecting or what we are trying to architect may not really conform to what has been already done in the world, but the only thing which we have to see it is not experience per se, it is actually the conceptual clarity which this paper has and the clarity which we expect you to kind of provide. Now to say that look at others to what they have done and then decide the issue that is not a great help to us.
Other mentions of UPI
Not only then, at multiple points during the Open House, Sharma again referred to the UPI and the Account Aggregator ecosystem.
In response to questions on consent and sharing of health data, Sharma referred to the Electronic Consent artifact developed by MeitY in 2015, also mentioning that it was being used by the Account Aggregator ecosystem.
“Interestingly, this consent artifact is also being used in the financial sector by way of account aggregators, something which was launched on 2 September a couple of days back. There the data owner and again (answering) the question of who owns the data, basically, where does the sort of ownership lies – that data owner can provide consent to a data fiduciary who essentially then can share the data which is required and which the citizen wants to share. So I think there is a very beautiful architecture which has been developed over a period of time, the last 5-6 years,” he said.
Later, making closing comments towards the end of the Open House, Sharma once again referred to the UPI as well as the Aadhaar-based Direct Benefit Transfer (DBT) mechanism.
“We also should be mindful of the fact that our country, you know, where we used to think that what who will do digital it’s a cash economy-Let’s take payment as an example- Our country, we have grown the digital payment systems up before that. We had it NEFT, RTGS. Many, many online digital payment systems had developed by money transfer system and they’re fairly frugal, scalable and all that. But when we develop UPI, for example, which is the first-of-its-kind interoperable system- interoperability is the critical part-We unbundled the payment system from the bank. Earlier they were all if you are an ICICI customer, you have to download the ICICI app or the SBI app or Paytm app,etc. Now UPI changed completely that whole architecture and we created a completely new way of transferring money. And I don’t think there’s any country in the world which transfers money without any payment,” Sharma said on UPI.
On Aadhaar and DBT, Sharma said that despite initial doubts about the project, 57 billion Aadhaar authentications have been conducted so far over the last 7-8 years along with 9 million electronic KYC.
The consultation process so far
So far, the NHA has conducted consultations on the Healthcare Professionals Registry, Health Facility Registry, NDHM draft implementation strategy, NDHM blueprint, data policy, sandbox framework guidelines, and others.
In July, it held public consultation meetings on the Healthcare Professionals Registry and Health Facility Registry. It had conducted consultations on the draft implementation strategy and Health Data Policy consultation last year as well and is expected to release several other papers for further consultation.
- AWS suggests changes to Unified Health Interface and other building blocks of NDHM
- Unified Health Interface: IT For Change warns against oligopolies, raises privacy concerns
- RTI: Over 11 Crore Unique Health ID’s issued through CoWIN says Health Ministry
- At UHI consultation meet, NHA reveals details on NDHM governance, roll-out, and more
- Summary: Consultation paper on UHI shows what NDHM could look like
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