Mind the Gaps in India’s Health Care Digital Push

Context: While the digitisation of health­care data could help, what many Indians face are unaddressed issues in the health sector.

Current Scenario Healthcare data management

• No transmission of data to higher levels: 

• Personal health data are generated by name until the primary health centre -level but not transmitted to higher levels except aggregated numerical data. 

• The decay of information in Hardcopies: 

• Most practitioners, especially without data entry staff, often extract only the relevant notes and return the hard copies.

• Uses of generated data

• Larger health facilities generate and store computerised patient data also for planning treatment, procurement of medicines and consumables.

• Ignoring patients past treatment records:  

• Many tertiary hospitals and medical colleges care little for diagnostic reports from peripheral centres or even the prescriptions of previous doctors.

• Provisions of Portability: 

• The cards provided under the Rashtriya Swasthya Bima Yojana and the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana provided portability without the need for past records.

• Duplication of data: By permitting the reuse of government data sets.

Benefits of NDHM

• Help patients save the burden of carrying medical reports

• Availing Telemedicine support from renowned specialists 

• Easy to claim Insurance

• Will create a homogenised software for all machines in the health sector.

• An IT consulting ?rm has been engaged to build a National Health Stack and a registry of over eight lakh doctors, 10 lakh pharmacists and over 60,000 hospitals is under preparation. 

Concerns related to focus on digitalisation of healthcare

• Possibility of errors in data entry:

• Even entries made for Aadhaar Cards or Voter ID cards have not been error-free.
• Insurance companies would cite the errors to reduce their obligations

• Extensive costs

• It is merely ensuring the customisation of new software and changes in current practices of data maintenance. 
• Thus they have to upgrade their hardware along with customisation and transfer of existing data.
• Public health professionals estimate the cost in thousands of crores for all government and private healthcare industry.

• Dilemma: on the part of public practitioners whether they need to scrap the existing policies or run parallel software provided by the NDHM.

• Presence of existing practises of data collection like the Integrated Disease Surveillance Programme and the Health Management Information System (IDSP-HMIS) 
• Larger hospitals have already gone for robust and sophisticated software systems such as enterprise resource planning
• It should be examined whether digitisation is the immediate problem facing the health sector or the best way to go about addressing data gaps.

• Absence of data-keeping: in small healthcare institutions like an individual based allopathic clinic or the Indian systems of medicine who run small dispensaries in rural areas, makes it non-feasible for them.

• Excessive focus on Data leakage, neglecting real problems: 

• Informed consent is too much of a luxury for the vulnerable and poor defence against data leakage, let alone in a time of health emergency.
• Health practitioners believe that the real problems are 

• Unreliable healthcare facilities in both the government and private sectors,
• Difficulties in getting timely care, 
• Availability of beds and hygienically maintained hospital premises, 
• Availability of doctors physically or online, 
• The continuous neglect of preventive and community health initiatives. 

Conclusion: Health practitioners perhaps need to discover that data is the only cure for all our ills.