Digital health mission in a click? Not yet

Synopsis: Experts have stated that though ABDM is a step in the right direction, India needs a commensurate push towards establishing a robust infrastructure that’ll be required for its success.

What are some issues with the pilot?

Public health experts are not very confident about the pilot that was run in six Union territories as the benchmark for a national roll-out. The pilot was launched in August 2020 in Chandigarh, Ladakh, Dadra and Nagar Haveli and Daman and Diu, Puducherry, Andaman and Nicobar Islands, and Lakshadweep.

The piloting may not necessarily reveal all the glitches because they have been done in relatively sterile conditions where the central government has direct control over the administration. When this gets rolled out in larger states, its not known how well the system will function or the quality of data that will emerge.

How ABDM aims to achieve security and privacy?

According to sources, the scheme plans to achieve security and privacy ‘by design’ through three building blocks:

– Consent manager: The goal of the consent manager would be to ensure the patient is in complete control of the data.

– Anonymizer: The anonymizer takes the data from health datasets, removes all personally identifiable information to protect the privacy, and provides the anonymized data to the seeker.

– Privacy operations centre

What is the way forward?

i). Govt should test the technology in four to five different sites and socioeconomic groups to get the spatial and demographic dimensions spread over a year. Health is not like a ration card or a bank credit card. There are seasonal, behavioural, cultural, and fiscal dimensions that go into health-seeking behaviour

ii). The data-entry interface has to be user-friendly for doctors to be able to key in patient data. This will specially be required if the plan is to rope in accredited social health activist (or ASHA) workers and cover the rural health care system.

iii). It should be possible for users to opt out of the health ID and ADBM and still receive health care. Also, user-consent for every granular access of the PHR and of the demographic data should ideally be built in.

Source: This post is based on the article “Digital health mission in a click? Not yet” and “Digital health ID concerns” published in Business Standard on 4th Oct 2021.

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