Digital Health, a gamechanger for India and world

Digital Health is poised to be a game changer for health systems across the world. Artificial intelligence (AI) models are being used for more accurate chest x-rays, mammography and retinal photographs. Digital therapeutics are helping prevent and treat neurological and mental disorders in many countries while digital interventions have helped thousands manage diseases like hypertension and heart disease.

At the next G20 Health Working Group meet in Goa (April 2023), Ayushman Bharat Digital Mission is likely to receive close attention. This initiative has provided access to a series of health services to both urban and rural Indians. Union Health Minister Mansukh Mandaviya recently announced that more than 10 crore (100 mil-lion) Indians used the free telemedicine service (eSanjeevani). Since it was launched in 2019, 57 per cent of the beneficiaries have been women, one of the vulnerable and neglected groups in the health landscape. Government data suggests around five lakh Indians every day engage with a doctor through eSanjeevani.

India’s COVID-19 experience has demonstrated how Digital Health can fast track a slow and cumbersome delivery system. During the difficult phases of COVID-19 pandemic, digital technol-ogy – apps, telemedicine, social networking sites – helped lakhs of Indians access the vaccination programme, track the virus, consult a doctor online and even get treated in an e-ICU!

Countries like South Korea, Canada and Britain are good samples of Digital Health improving delivery services. Several Canadian companies offer digital therapeutics and AI-based digital devices. In South Korea, at least 50% hospitals follow a paperless system. Britain boasts being home to one of the largest numbers of digital health start-ups in Europe. These start-ups have contributed remarkably in the areas of women health, elderly care, on-demand generalist care and DNA testing for fitness. Digital health has also contributed to making testing for certain diseases more accessible and stigma-free.

GIDH, an action plan for change: India’s proposal as G-20 President, the Global Initiative on Digital Health, or GIDH, endeavours to demonstrate the transformative power of Digital Health based on its recent experiences during COVID-19.

A big reason behind the success of India’s vaccine drive was CoWIN, the digital platform that registered beneficiaries, scheduled vaccinations, generated QR code-based vaccine certificates and captured vaccination history. It tracked the entire vaccine programme across 28 states and 8 union territories. CoWIN made the vaccination drive more equitable and accessible.

The potential of Digital Health has been ac-knowledged in various world fora. Recognising its potential, the WHO established the department for Digital Health and Innovation in 2019 and published a strategy paper for 2020-2025, en-visioning better health for everyone, everywhere.

With the maturing of mobile technologies and cloud systems, today we can imagine the growth of digital immunisation information sys-tems. As citizens we can expect digital receipts, e-certificates of immunisation, and prompt identification of vulnerable areas. Digital systems will provide better capacity to audit a country’s immunisation programme and gauge adverse reactions at greater speed.

Switching from ‘silos to a systems framework’: A 2019 National Digital Health Blueprint (NDHB) report elaborated the advantages of converging data for the benefit of patients and policy makers alike. It worked on the principle that data once captured could be used multiple times, and will help in switching from ‘silos to a systems framework’. The key outcome of such a strategy would be a seamless online platform that facilitates interoperability within health ecosystem. Interoperability is essential for integrated health services – data can be connected to local health facility, state and central hospitals to enhance health outcomes for digital health and e-medicine.

Establishing a digital system poses several challenges of privacy, ownership, and consent. The NDHB proposed the development of Unique Health Identity for every citizen. This would also require the establishment of a consent manager, an anonymizer and a privacy operations centre in order to help the citizen fully realise the potential of digital facilities. Broadly, under this system, health care providers will convert into Health Information Providers (HIPs), and would be required to provide inpatient and outpatient information to the patient as a policy. Surely, this single step will empower patients with a medical history that they can use for better treatment in any state of the country. In most countries, the patient is the owner of health records and the hospital and government agencies preserve the data under trust and seek consent for use. It is the responsibility of the local health facilities to ensure privacy of a patient’s health record is preserved always.

Such a system is better equipped to provide service delivery, facilitated for example by web applications (like the India Health Portal) and mobile apps (such as CoWIN). The use of data-based system will eventually help in reducing costs for patients and enable better monitoring of diseases.
Digital Health envisages a more transparent and people-centric approach to challenges of health. It is the future.

Malvika Kaul, Media academic based in New Delhi