Mind the Gaps in India’s Health Care Digital Push

The Hindu     4th September 2020     Save    

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.