In Digital Health, Equity First

Context: National Digital Health Mission aims to develop the backbone needed for the integrated digital health infrastructure of India, but for the mission to be successful, policymakers should be mindful of certain considerations to achieve the desired social objectives of digital health infrastructure.

Significance of digitising health care

• Helps in better diagnostics and management of health episodes.
• Helps in broader public health monitoring: including socio-economic studies, epidemiology, research, prioritising resource allocation and policy interventions. 
• Helps in creating an organised, efficient, & effective healthcare.

Road map for digitising healthcare: considerations for design choices and policies to achieve social objectives.

• Develop a theory of pathways to “public good”: E.g.
  • Examine how digitisation may facilitate better diagnosis and management.
  • Understand the data structures required for effective epidemiology.
  • Understand how digitisation and data will alleviate health problems such as malnutrition and child stunting etc.
• Examine potential tensions between public good and individual rights:
  • Check possible exclusion errors
  • Address privacy concerns: incorporate ex-ante privacy protection and determining due diligence by clearly defining the operational standards for privacy management
• Addressing the dilemma around digital identity: Indiscriminate linking of digital identity may break silos and create a digital panopticon, whereas not linking at all will result in not realising the full powers of data analytics.
• Work out the operational requirements of the data infrastructure: This requires identifying the diverse data sources and their complexity.
  • E.g. immunisation records, birth and death records, informal health care workers, dispensaries etc.
• Engender people’s trust in the system: by
  • Following “due process” in lawmaking.
  • Building a transparent process of design through openness and public consultations.
  • Avoid “crony expertism” and reject half-baked and poorly-conceived designs: E.g. “public good” should be a good which is actually required and not a good that can be conveniently delivered.