The Delhi government’s plan for a digital Health Management System could soon map citizens’ families, collect their facial data, and the geo-coordinates of their houses. Want to refuse enrollment? You would be flagged to the National Capital Territory’s Department of Health and Family Welfare (DoHFW) or the Department of Health Services (DHS).
These details are a part of the Delhi government’s tender for an agency to create and issue health cards under the system. MediaNama had earlier reported that the system involves Voter-ID linked health cards for residents, Unique Health IDs, digital health records, a health information system, etc.
While state governments can process sensitive health data, there is a need to have safeguards in place. The Delhi government’s plan to flag any refusals to enroll may violate the requirement for consensual data collection as laid down in the 2017 Right to Privacy judgement of the Supreme Court.
What are the characteristics of the tender?
The tender asked that the bidder not only build a Health Card Software Solution (HCSS) that will generate and manage such cards but also take care of its issuance. In brief, it lists the following requirements:
- The HCSS needs to be hosted on a Ministry of Electronics and Information Technology empanelled cloud service provider.
- The HCSS has to be available as an IOS and Android app and as a website.
- It should have a dashboard with information on the number of cards issued to the citizen of Delhi, resources, facilities, services, etc.
- It should provide an audit trail on the transactions any registered user has undertaken.
- It should allow the exchange of data with external systems or departmental applications. This, the tender said, would reduce the pressure on the system in case of any external changes.
- It should send a notification to minors to link their voter ID with health cards when they turn 18. Minors’ health cards will be linked to their parents’ voter IDs under the system.
- The HCSS should be connected to the SMS gateway of the centralised helpline that the government plans to establish under the system and the email gateway of the HIMS.
How does the Delhi government plan to enroll people?
Voter IDs will be mandatory to sign up for a health card, according to the tender. Beyond voter IDs, the tender also mentioned a requirement for the citizen to be able to link other optional IDs like Aadhaar, PAN, etc for “ease in de-duplication.”
i) Self-registration on a website or mobile application: A mobile application or a website will be built that is accessible on various browsers and allows people to register themselves for the card.
ii) Counters at Delhi government health facilities: Government healthcare institutions will have counters for people to register for health cards, according to the tender.
iii) Babies could be enrolled at the hospital of birth itself: A mechanism to enroll newborn babies from the hospital of birth has been mentioned in the tender.
iv) Door-to-door survey: A door-to-door survey will have to be conducted by the bid-winning agency, in order to issue health IDs to every citizen, according to the tender. Surveyors have to get people to sign up and collect their details or verify the details of those who have already signed up. In case someone refuses to enroll for health cards, the surveyors have to flag the same in writing.
v) Mandatory for Delhi government employees health scheme: Government employees enrolled in the DGEHS scheme will be enrolled in the system, irrespective of whether they have a Delhi registered Voter ID or not.
What data will the health card contain?
The Delhi government plans on providing every resident with a health card and health ID. This would allow access to vital information even if the HIMS – a system to allow sharing and updating of a citizen’s health records – is down. Apart from location details, the health card will contain:
i) Clinical information: Health card will have “relevant medical/clinical data to be finalized by the panel of Doctor nominated by GNCTD,” the tender said. Some examples listed are “blood group, allergies due to drug, environmental conditions, food, etc., and (information about) medical condition like Diabetes, Recent Surgery, Hypertension, etc.”
ii) Demographic information: Information on demographic and clinical details of a citizen, along with their eligibility for any government schemes.
iii) Proposal for biometric data: A provision to include biometric data to facilitate facial recognition also be included in the health cards. A suggestion to facilitate log-in through facial recognition has also been included.
- Mapped and validated details of all family members for “real-time decision making and disease surveillance”. Initially, a temporary health card is planned to be issued to citizens and, after a door-to-door survey is undertaken, a permanent card will be issued which will include their geo-coordinates.
- QR Code and a picture of the person: The QR code is supposed to be encrypted, holding demographic and clinical information. Scanning this could allow a healthcare provider to update the records, the tender said.
- Unique Health ID provided by the central government will be linked to the card.
Governance of the health card issuing mechanism
The DoHFW will own the project and guide it strategically while the DHS will aid and act on the DoHFW’s behalf. According to the tender, three entities will play a key role in the system which, apart from the DHS and DoHFW, includes the agency/consortium of agencies that wins the bid.
Further, the Delhi government proposes a governance structure comprising:
- A steering committee led by DoHFW’s secretary, and other senior government officials. They would have the final word on the various strategic decisions and moves taken around the system.
- A project management unit will oversee the project in its entirety. According to the tender, the unit will be the “nerve-centre” of the project, enabling coordination between various teams and departments, and having domain experts on it.
- A command and control centre will look after the day-to-day operations. Under these bodies, there will be four teams looking after quality, impact, and delivery.
ABDM and other health digitisation missions
After the start of the Ayushman Bharat Digital Mission in August last year, state governments like Bihar, Tamil Nadu, Orissa, and Delhi announced projects to issue Health IDs and digitise health records for their citizens.
Delhi: In October, the Delhi cabinet gave financial approval to the government’s eHealth card and Health Information Management System (HIMS) project.
Tamil Nadu: In September, the state’s health minister Ma Subramaniam announced that the government would assign Unique Health IDs to each of its citizens.
Bihar: In September, the state began a health digitisation project in its Nalanda district in partnership with health tech startup eHealth Systems.
Odisha: In August, the state started a health digitisation project related to mother and child health in various districts.
- Delhi cabinet approves plan to issue eHealth cards, health IDs to residents
- Bihar launches pilot project to digitise health records in line with NDHM
- Unique Health ID to be created for all Tamil Nadu residents: Health Minister Subramaniam
- Indian government to start implementing NDHM nationwide in coming days
Have something to add? Post your comment and gift someone a MediaNama subscription.