How India will lead the next century when it comes to healthcare digitisation

The world has been looking towards India over the past decade for two reasons - sharing its demographic dividend to power global consumption, and more importantly, providing resources and talent for digitisation.

However, deep down in our hearts, we believe that the world is not able to grasp the true potential of our country. It is a realisation we believed in while working as senior bankers in one of the world's leading investment banks, and we continue to have the same opinion today as promoters of start-up that will define digitization in healthcare in India.

Five years ago, when we started our journey as entrepreneurs, like other startup founders, we had a hypothesis. We felt that the productivity gains and increased market access from digitisation of the saving, investing, and insuring process could really benefit one of the most underdeveloped parts of India - healthcare.

Pretty soon, our hypothesis turned into a mission - to turn each and every health record into digital format.

On September 27, 2021, our mission got a boost from the vision of our Prime Minister with the launch of Ayushman Bharat Digital Mission (ABDM).

What is ABDM?

ABDM aims to improve the quality, accessibility, transparency, and affordability of healthcare in India by bringing together different stakeholders such as patients, doctors, and hospitals under a digital ecosystem and by allowing safe, secure, and seamless flow of health data between them.

The ABDM will facilitate safe and secure flow of health information such as medical bills, prescriptions, and lab reports from one healthcare stakeholder to another irrespective of whether the two are connected to each other and with the consent of the owner of the health data.

For instance, if you want to share your health check-up reports from a path lab with your doctor or medical insurer, then the same can be done with a click after your authorisation.

How does ABDM work?

To integrate and connect the various healthcare stakeholders under a digital umbrella and to simplify access and sharing of digital health records among them, ABDM relies on three main building blocks as given below to interact efficiently with each other:

1. Patient-facing systems such as digital health lockers for viewing, uploading, and updating longitudinal health records, and consent managers for sharing health data between various healthcare entities.

2. Healthcare provider-facing systems for hospitals, clinics, labs, etc., such as clinic management software to deliver digital healthcare to the patient's side.

3. Central systems such as a unique health account number for every citizen, a comprehensive repository of public and private healthcare professionals and facilities, and a Unified Health Interface-an open protocol platform similar to UPI - to allow delivery of healthcare services between multiple healthcare providers and patients.

Why does ABDM matter to you?

The most obvious benefit for patients is that they can do away with the need to carry around medical records in bulky files to doctors and hospitals and the risk of losing them or, in some cases, the need for going for re-tests.

Healthcare providers will have access to a patients’ latest health data as well as their medical history, allowing them to provide more efficient, better quality and more personalised care. This is more relevant in cases where more than one specialist is involved, and it is important that each specialist has a complete picture of the patient’s care.

With the adoption of technology to provide healthcare using websites/mobile, anybody with a connected device can access quality healthcare from anywhere and is no longer limited to locally available resources - extremely important for Tier III and Tier IV towns where access to specialist care is difficult.

More accurate information on health facilities and service providers will empower individuals to make informed decisions and increase accountability of healthcare providers.

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Where will ABDM make its biggest impact?

With the implementation of the ABDM, India can now think of ways to reap the biggest benefit that a truly digital healthcare system can yield - Data!

Currently, many stakeholders in the healthcare ecosystem rely on rarely complete but mostly statistically less relevant data from sources such as surveys, prescriptions, and chemist sale audits for their decision-making that is not only transactional in nature but also relatively expensive to obtain.

Digitisation brought about by the ABDM will not only be more representative of the populace but also will bring in, probably for the first time, the benefits of aggregated longitudinal health data.

Longitudinal health data, which is the data of a patient over a lifetime, can go a long way in solving some of the most complex health issues plaguing the country.

A simple example is when the government wants to know the real side effects of a drug that is being administered today over a longer term, say five years or maybe 10 in different age groups and genders.

Longitudinal data can give an improved understanding of customers’ health and medical history to insurance companies, and they can develop better risk models and pricing of insurance products and innovative product offerings across disease groups.

Availability of comprehensive health data can help in creation of a scientifically developed score similar to CIBIL score that will become an effective method to assess policyholder’s health and thus to price premiums accordingly.

Such a health score will become a superior alternative to current methods of indirectly tracking a patient's health such as wellness programs designed to provide discounts against renewal premiums or other monetary incentives on achievement of health milestones.

Implementation of ABDM will create superior databases of healthcare information for a variety of applications for pharmaceutical companies. Quality data analytics can accelerate clinical trials and research and thereby reduce costs by simplifying steps such as identification of appropriate patients for a trial or by providing the ability to remotely monitor patients, review previous clinical trial events, and even identify potential side effects in time.

Likewise, assessment, monitoring, and prevention of adverse effects with pharmaceutical products will get better.

Analysis of data relating to patient health status and/or the delivery of health care routinely collected from a variety of sources will assist pharmaceutical companies to generate clinical evidence about the usage and potential benefits or risks of a medical product derived and similar other decision-making at all levels.

Over a longer term, as the health data ecosystem develops, new opportunities for Indian phenotype-based drug development will become viable.

Why will the ABDM succeed?

The stated objective of the government in implementing the ABDM is achieving Universal Health Coverage. Work is already underway to develop a unified e-claims platform for faster processing of cashless health insurance claims – this includes both private insurance policies as well as the Pradhan Mantri Jan Arogya Yojana (PMJAY).

This, in turn, will allow for greater adoption of the PMJAY / cashless claims by private hospitals, especially small hospitals (<80 beds) that form the bulk of India’s 70k+ hospitals. Thus, processing claims will become faster and cheaper which can, in turn, significantly bring down the cost of healthcare and penetration of health insurance products.

This, along with an evolved and robust data management policy of ABDM to protect the personal data belonging to participants in the ABDM ecosystem will go a long way in helping India achieve its goal of universal health coverage.

So…what next?

Today, most of the large hospital chains and path labs are in various stages of integration so you will soon start seeing more and more providers linked to ABDM. But no reform can ever be successful without participation of the masses.

The government has already begun initiatives urging citizens to create their unique health account numbers called Ayushman Bharat Health Account Number (or the ABHA Number) and join the mission. What are you waiting for?