Open digital health ecosystems (ODEs) – Ayushman Bharat scheme
The Indian government, through its implementation of several digital programs, has paved the way for building an effective and comprehensive digital healthcare architecture under the National Digital Health Mission (NDHM). The launch of the NDHM in August 2020, aims to create an ODE. This was one of India’s responses to achieving the sustainable developmental goal 3 - providing universal health coverage along with safe and effective vaccines for all by 2030. Some of the key features of such a system include digital health registries, a unique digital patient ID or Aadhaar, interoperability, and automated processes for claim settlement issues along with cashless transactions.The Ayushman Bharat scheme launched in 2018 by the Ministry of Health and Family welfare incorporates many features of an ODE. The program’s overarching goal is to alleviate poverty by addressing the health care needs of the economically weaker sections of society. Under this scheme, primary health care expenses are incurred by the patient. However, secondary and tertiary health care are expensed to the government.
Despite the scheme’s seeming progress, it is also met with grave challenges such as the scarcity of doctors and trained medical professionals in the country. Additionally, there exist high numbers of infectious diseases among the rural population and a national budget with a relatively low investment in healthcare, including urban and rural heathcare programmes.
COVID-19 – the catalyst for digital transformation
In a country like India, where the access as well as affordability of quality healthcare is still considered a luxury, measures taken by the government to curb the spread of the virus have been relatively ineffective. The pandemic has highlighted the significance of a universal health coverage in conjunction with the need for strong public health systems. A solid primary healthcare system, for instance, facilitates triaging patients, thereby, affording better utilization of tertiary care infrastructure and resources which are scarce. In addition, the disease burden stemming from non-communicable diseases account for a larger share than communicable diseases. This underscores the importance of a health care delivery system that focuses not solely on episodic care, but more, on a comprehensive health care plan that is inclusive of prevention and primary health care as opposed to only secondary and tertiary.Further, the forced lockdown by the Indian government during the pandemic triggered the rise in digital practices among health-related stakeholders, specifically among patients and doctors. Over 50 million Indians used teleconsultation services during the pandemic.