Digital Health ID and you
Source: By Kaunain Sheriff M: The Indian Express
On 27 September 2021, Prime Minister Narendra Modi launched the Ayushman Bharat Digital Mission (ABDM), saying it has the “potential of bringing a revolutionary change in India’s healthcare facilities”. The flagship digital initiative involves the creation of not just a unique health ID for every citizen, but also a digital healthcare professionals and facilities registry.
If a person wants to be part of the ABDM, she must create a health ID, which is a randomly generated 14-digit number. The ID will be broadly used for three purposes: unique identification, authentication, and threading of the beneficiary’s health records, only with their informed consent, across multiple systems and stakeholders.
One can get a health ID by self-registration on the portal or by downloading the ABMD Health Records app on one’s mobile. Additionally, one can also request the creation of a health ID at a participating health facility, which may include government or private hospitals, community health centres, and wellness centres of the government across India.
The beneficiary will also have to set up a Personal Health Records (PHR) address for consent management, and for future sharing of health records.
It is a simple self-declared username, which the beneficiary is required to sign into a Health Information Exchange and Consent Manager (HIE-CM). Each health ID will require linkage to a consent manager to enable sharing of health records data.
An HIE-CM is an application that enables sharing and linking of personal health records for a user. At present, one can use the health ID to sign up on the HIE-CM; the National Health Authority (NHA), however, says multiple consent managers are likely to be available for patients to choose from in the near future.
Currently, ABDM supports health ID creation via mobile or Aadhaar. The official website states that ABDM will soon roll out features that will support health ID creation with a PAN card or a driving licence. For health ID creation through mobile or Aadhaar, the beneficiary will be asked to share details on name, year of birth, gender, address, mobile number/Aadhaar.
Is Aadhaar mandatory: No, it is voluntary. One can use one’s mobile number for registration, without Aadhaar.
If the beneficiary chooses the option of using her Aadhaar number, an OTP will be sent to the mobile number linked to the Aadhaar. However, if she has not linked it to her mobile, the beneficiary has to visit the nearest facility and opt for biometric authentication using Aadhaar number. After successful authentication, she will get her health ID at the participating facility.
The NHA says ABDM does not store any of the beneficiary health records. The records are stored with healthcare information providers as per their “retention policies”, and are “shared” over the ABDM network “with encryption mechanisms” only after the beneficiary expresses consent.
On deletion, the unique health ID will be permanently deleted, along with all demographic details. The beneficiary will not be able to retrieve any information tagged to that health ID in the future, and will never be able to access ABDM applications or any health records over the ABDM network with the deleted ID.
On deactivation, the beneficiary will lose access to all ABDM applications only for the period of deactivation. Until she reactivates her health ID, she will not be able to share the ID at any health facility or share health records over the ABDM network.
You can access your digital health records right from admission through treatment and discharge. Second, you can access and link your personal health records with your health ID to create a longitudinal health history.
Upcoming new features will enable access to verified doctors across the country. The beneficiary can create a health ID for her child, and digital health records right from birth. Third, she can add a nominee to access her health ID and view or help manage the personal health records. Also, there will be much inclusive access, with the health ID available to people who don’t have phones, using assisted methods.
The NHA has launched the NDHM Sandbox: a digital architecture that helps private players to be part of the National Digital Health Ecosystem as health information providers or health information users.
The private player sends a request to NHA to test its system with the Sandbox environment. The NHA then gives the private player a key to access the Sandbox environment and the health ID application programming interface (API). The private player then has to create a Sandbox health ID, integrate its software with the API; and register the software to test link records and process health data consent requests. Once the system is tested, the system will ask for a demo to the NHA to move forward. After a successful demo, the NHA certifies and empanels the private hospital.
Why is this initiative significant?
As the Prime Minister highlighted on 27 September 2021, the initiative has the potential to “increase the ease of living” along with “simplifying the procedures in hospitals”.
At present, the use of digital health ID in hospitals is currently limited to only one hospital or to a single group, and mostly concentrated in large private chains. The new initiative will bring the entire ecosystem on a single platform.
For instance, if a patient is getting treated at AIIMS, Delhi, and wants to move to another hospital in a different city, and if that hospital is also on the centralised ecosystem, the patient does not have to carry physical health records or files of several years of treatment, as the medical history is readily available.
The system also makes it easier to find doctors and specialists nearest to you. Currently, many patients rely on recommendations from family and friends for medical consultation, but now the new platform will tell the patient who to reach out to, and who is the nearest. Also, labs and drug stores will be easily identified for better tests using the new platform.
