What does NDHM REALLY Mean for Hospitals and Patients?
The National Digital Health Mission (NDHM) is being hailed as a revolutionary move in the context of healthcare in India. According to a Boston Consulting Group (BCG) report, the digital transformation brought by NDHM can potentially unlock economic value worth $200 billion+ by 2030. This article sheds light on what NDHM really means for hospitals and patients.
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What is NDHM?
Inspired by the success of the UPI (unified payment interface) system, the government of India wanted to bring the same level of data accessibility to healthcare. The overall objective was to efficiently deliver healthcare to the masses of India in a safe and timely manner and to achieve universal health coverage (UHC). The government wanted to leverage Aadhar, Unified Payment Interface, and mobile (JAM trinity) to achieve the above-mentioned goal, and thus National Digital Health Mission (NDHM) was created. The scope of data includes both public health and personal health data.
Problems before NDHM
Lack of Past History for Patients
Patients may recall only bits of information about their condition/advised medication and often forget to bring in their past reports/prescriptions. This is a concern, as past history is particularly relevant for patients suffering from chronic diseases like diabetics, kidney failure, arthritis, etc. Previous prescriptions and reports help in understanding the disease progress, which further enhances the quality of care.
As per one of the studies in the USA, patient care was adversely affected for 7.8% of the patients due to missing clinical information. In Australia, 1.8% of medical errors were due to the unavailability of clinical information. While specific statistics are not available for India, it is evident that a patient’s clinical history becomes an important tool to avoid medical errors and deliver better care.
Lower Adoption of Telemedicine Services
The consultation paper on United Health Interface, which is a part of the NDHM architecture, mentions that out of approximately 6 million outpatient (OP) consultations every day, only 100,000 to 200,000 happened digitally in 2020. This number is significant despite the increased adoption of digital consultations due to COVID-19.
Reports in Fragmented Paper Documents
The consultation paper also highlights that the reports of many patients are in fragmented paper documents that are difficult to share digitally. Some doctors have adopted the practice of writing prescriptions on a pad and sharing pictures of these prescriptions. However, these prescriptions are often lost, creating problems for continuity of care.
NDHM aims to solve these and various other problems affecting Indian healthcare.
The Building Blocks for NDHM
There are 4 building blocks in NDHM
- Health ID
- Healthcare Professional registry (HPR)
- Health Facility Registry(HFR)
- Health records
The health ID is a unique identifier for each enrolled individual in the NDHM system. This ID will help patients access their records from the NDHM system, which the hospitals will push against the Health ID. If the Aadhar card was used during the Covid vaccination, chances are a Health ID has been created for the beneficiaries. You can check your covid vaccine certificate for Health ID. If Health ID is blank, you can create one on https://healthid.ndhm.gov.in/register.
Health Professional Registry (HPR)
HPR is a database of all the healthcare workers in India, which will help in the easy identification of health service providers. HPR will also help weed out bogus or quack doctors from providing services, thus delivering a better quality of care to the masses.
Health Facility Registry (HFR)
HFR is a comprehensive repository of health facilities in the country across different systems of medicine. It includes both public and private health facilities, including hospitals, clinics, diagnostic laboratories, and imaging centers, pharmacies, etc.
Personal Health Records (PHR)
Health records are personal health records of an individual in electronic form in an interoperable format. Individuals can manage, share and control their health records. The most distinguishable feature of PHR from EMR and EHR is that they are under the control of the individual.
Data Interoperability: A Key Highlight of NDHM
The NDHM platform is expected to help in providing comprehensive, interoperable, and accessible data of a patient in a simplified manner. One of the major problems with current systems used across the Indian Healthcare ecosystem is the lack of uniformity of data. The NDHM platform aims to standardize data formats to make data sharing easier across different stakeholders and systems. This standardization will further help clinicians and public health authorities make better decisions and provide timely interventions. With uniform data from across the providers, the patients can see all their health records in one place.
Benefits of NDHM
Let us see how NDMH can benefit various stakeholders in the healthcare system.
Benefits for Patients
The three key benefits of NDHM for patients are listed below.
Ease of Sharing Data with Healthcare Providers
Patients can securely store their medical records, including prescriptions, diagnostics reports, discharge summaries, medical bills, pharmacy records, etc. in a single central repository. They can share the same with healthcare service providers for a better quality of care and follow-up. It can also help them avoid diagnostic tests to a certain extent and thus save costs, considering the easy availability of their recent medical records. The patient can also access more accurate information on service providers with the feedback mechanism offered by NDHM.
Improvement in the Quality of Service
UHI protocols can potentially support a rating/reputation management system that allows ratings of users and service providers. UHI can also potentially includes checks and balances to ensure the ratings are authentic. NDHM is also expected to give a push to the digitization of grievance management for digital health services, such as telemedicine.
Ease of Accessing Digital Healthcare
The interoperability of UHI will make it easier for patients to access digital healthcare services like telemedicine. For example, they can easily contact a doctor of their choice through any UHI-compatible application.
Benefits for Health Service Providers (HSPs)
NDHM offers several key benefits to health service providers.
Improved Access to Patient Health Records
The major benefit for HSPs, such as hospitals will be better access to patient health records, thus enabling them to deliver better and effective care. There will be less reliance on individual memory and more on the systemic record available. It will also reduce regulatory non-compliances like notifying authorities about different diseases and deaths as it will automatically be taken care of.
Faster Insurance Claims Processing
Thanks to interoperable systems, insurance claims processing will become faster due to the faster sharing of patient records with insurance companies/third-party administrators (TPAs).
Participating in UHI will help hospitals become more discoverable. The health professional ID will make it easier for patients to connect with them digitally for services like appointments and teleconsultations using their preferred application.
Flexibility to Choose Software Applications
NDHM gives health service providers the flexibility to deliver health services using any software application of their choice.
Benefits for Government
The government will have access to better data, enabling better decision-making and targeted interventions. It will also enable geography and demography-based monitoring, allowing better program design and delivery of services like nutrition programs in areas with high malnutrition, strengthening of vaccination programs in geographical areas with low vaccination rates, etc.
NDHM will radically transform the way healthcare services are being delivered in India. Along with patients and healthcare providers, NDHM offers a great opportunity to the entire healthcare ecosystem. It will further improve the availability and utilization of available healthcare infrastructure through digitization and empowerment.
The success of this forward-looking initiative will depend on the implementation and participation of all stakeholders. UPI has seen such massive success due to the participation of all the financial institutions and non-financial institutions.
With its open standard approach to implementation, NDHM hopes to achieve the same. Healthtech firms like BestDoc Technology can provide seamless integration with existing HIMS of hospitals and make them NDHM compliant, allowing easy and efficient data transfer between different systems.
- Burnett, S.J., Deelchand, V., Franklin, B.D. et al. Missing Clinical Information in NHS hospital outpatient clinics: prevalence, causes and effects on patient care. BMC Health Serv Res 11, 114 (2011). https://doi.org/10.1186/1472-6963-11-114
- UHI Consultation Paper. (n.d.). Ayushman Bharat Digital Mission (ABDM). https://ndhm.gov.in/assets/uploads/consultation_papersDocs/UHI_Consultation_Paper.pdf