Fractured Data, Fragmented Care: How Ayushman Bharat Digital Mission Can Offer A Cure For India’s Digital Health Gap

Siloed data is a disease plaguing India's healthcare system. ABDM offers the cure. By embracing collaboration, standardisation, and data security, India can unlock its potential.

By Dr Ritesh Aeron & Dr Sabine Kapasi

India's healthcare system boasts a complex network, weaving together national programs, state initiatives, and private institutions. However, this very complexity masks a critical flaw – fragmented data. Legacy systems operate in isolation, creating isolated pockets of patient information. This fragmentation cripples healthcare delivery.

Imagine a diabetic patient receiving care at a government hospital. Yet, their chronic heart condition remains hidden from the private clinic they visit. This lack of a unified view hinders optimal care, frustrating patients and increasing medical error risks.

Lack of standardisation further complicates matters. National programs like NCD and RCH individually collect valuable data, in incompatible formats that stay in silos.  There is no single source of truth and no primary key to combining data for analysis or identifying patients at risk for multiple conditions.

Fragmented data also restricts patient access to their own records. Consider a pregnant woman receiving RCH care but delivering at a private hospital. Without access to her RCH records, the hospital lacks crucial information, potentially jeopardising the delivery.

This is unacceptable, and siloed data demands immediate action. Both the patient and provider need interoperability for improved access to medical records. A connected healthcare system is essential to deliver quality care and empower patients. And a patient even being the owner of the data doesn’t have any access or claim.

Ayushman Bharat Digital Mission: Connected Healthcare for Digital Transformation

Ayushman Bharat Digital Mission (ABDM) isn't just a framework by the National Health Authority, it's a solution dedicated to bridging these healthcare gaps. They offer a suite of innovative building blocks to empower patients and healthcare professionals:

• ABHA (Ayushman Bharat Health Account): This unique ID grants patients ownership of their electronic medical records (EMRs). The ABHA based Personal Health Record allows patients to know who accesses their data, fostering a sense of control.


• Health Information Providers (HIPs): Encompassing NCD hospitals, RCH clinics, and all institutions generating patient data, through ABDM-complied systems HIPs ensure easy creation and storage of standardised electronic medical records.


• Health Information Users (HIUs): Authorised doctors, nurses, and paramedical staff become HIUs, gaining access to patient information with patient consent, enabling better and holistic care.


• Personal Health Record app and Locker: Patients manage their data on a app and can securely store their information here, controlling access and sharing it with authorised HIUs.


• Health Information Exchange (HIE)- Consent Manager: ABDM-powered HIE-CM facilitates the secure exchange of health information between HIPs and HIUs, ensuring seamless data flow based on patient consent.

ABDM: Building Bridges, Not Walls

ABDM's vision is a connected healthcare ecosystem. The ABDM Registry acts as a central hub, managing user consents and ensuring only authorised parties access information.

Unlocking ABDM's Potential Requires Collaboration

To truly revolutionise healthcare in India, national and state levels need to work together to achieve the following:

• Standardisation & Interoperability: National guidelines for data formats and coding practices are crucial. This allows healthcare professionals to readily identify patient care overlaps and provide holistic treatment.


• Capacity Building: Investing in training equips healthcare professionals with the skills to leverage ABDM effectively.


• Data Security & Privacy: Robust measures are essential to build trust and encourage patient participation in legacy systems as well.

Fostering Alignment For A Thriving ABDM: MoHFW, NHA, States, & NHM

The success of the ABDM hinges on robust alignment between key stakeholders. Here's how to bridge potential gaps and ensure seamless implementation:

Strengthening Communication Channels

Joint Task Forces: Create dedicated task forces with representatives from MoHFW, NHA, states, and NHM at national and State level. These groups can address specific challenges, develop implementation strategies, and monitor progress.

Streamlining Policy and Implementation

NHA Policy Framework & State PIPs: Ensure NHA's policy framework for ABDM aligns with State Program Implementation Plans (PIPs). PIPs should holistically integrate digital health strategies, outlining budgetary requirements for MoHFW and NHA to consider. This avoids duplication and streamlines resource allocation.

Single Nodal Office at State

NHM Mission Director as Nodal Officer: Appointing the NHM Mission Director as the nodal person for ABDM leverages their existing experience and leadership in state health implementation. This ensures smooth integration of ABDM with ongoing NHM initiatives.

Harnessing Technology for Collaboration

Online Collaboration Platforms: Utilise online platforms for knowledge sharing, resource dissemination, and progress tracking. Develop data dashboards and reporting tools at State that provide real-time insights into ABDM adoption and impact across states. This enables data-driven decision-making and facilitates targeted interventions.

Capacity Building and Training

Joint Training Programs: Organise joint training programs for MoHFW officials, NHA representatives, state health department personnel, and NHM staff to enable them with the necessary skills and knowledge to implement ABDM effectively. Provide ongoing technical support to states, addressing challenges and ensuring smooth integration with existing IT infrastructure.

Building Trust and Ownership

Encourage states to take ownership of ABDM implementation. This can be fostered by involving state health departments in program design and decision-making processes. NHA can showcase successful ABDM implementations and learnings in different states to motivate wider adoption that reinforces the value proposition of ABDM.

Siloed data is a disease plaguing India's healthcare system. ABDM offers the cure. By embracing collaboration, standardisation, and data security, India can unlock its potential and deliver a future of connected, patient-centred healthcare for all.

(Dr Aeron is a Parnter at Enira Consulting Pvt Ltd; Dr Kapasi is the Co-Founder and MD of Enira Consulting Pvt Ltd)

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