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Employees in protective gear and customers at a men’s salon after the central government eased the nationwide lockdown enforced as a preventive measure against the spread of the novel coronavirus, in Siliguri on Sunday.  (Photo: AFP)
Employees in protective gear and customers at a men’s salon after the central government eased the nationwide lockdown enforced as a preventive measure against the spread of the novel coronavirus, in Siliguri on Sunday. (Photo: AFP)

Health database on the cards: Centre puts proposal in fast lane

With a sharp rise in cases of data breaches, the register has raised concerns about unauthorized access of records

The scale and severity of the coronavirus pandemic has prompted the government to expedite the implementation of the National Digital Health Blueprint that seeks to create a single repository of medical records of all citizens.

The Standing Finance Committee of the government, in a meeting on Wednesday, approved the blueprint, said Preeti Sudan, secretary, union ministry of health. Finance minister Nirmala Sitharaman, while announcing a slew of measures to reform the Indian healthcare sector on 17 May, first indicated that the government will implement a National Digital Health Mission (NDHM), which was mothballed for two years.

The pandemic, which has killed more than 5,000 people in India alone, has pushed to the fore the critical role of healthcare data to identify risk to citizens from diseases, as well as to develop new treatments and save lives.

“The work on the project has already started. We have forwarded a proposal to the finance ministry. We are also working on the sanctioning of posts. This will be a population registry that will have a long-term positive impact on the healthcare ecosystem in India. We are working as per the vision of the finance minister to create a digital health ecosystem," said Sudan.

The National Digital Health Blueprint was prepared by a health ministry panel to create a framework for the national health stack proposed in 2018 by the NITI Aayog, the government think tank.

“It was stuck for more than two years over various issues but due to the covid-19 pandemic, it was expedited and approved within 10 days after the announcement made by the finance minister," a senior government official mentioned above said on condition of anonymity.

With a sharp increase in cases of data breaches and privacy violations, the national register has raised concerns about unauthorized access of health records.

The government said it will ensure that there is no leakage and the data is not misused.

“Unlike Aadhaar, the data will reside at individual hospital servers in a federated architecture. Citizen will own his/ her health data and would require consent to share data. All the basic registries of patients/hospital/medical professionals that enable data sharing will be owned by a government entity. Lastly, data privacy law, which is in the making, will apply and a mechanism for grievance redressal is there in case of breach of privacy," the senior government official mentioned above said.

Meanwhile, several states are already experimenting with digitizing health records to fight the covid-19 pandemic. The Karnataka government this week announced a plan to have a health register of all its residents. Authorities claim that the health registry will help them keep a close watch on the spread of the coronavirus and monitor the most vulnerable population.

Karnataka’s medical education minister K. Sudhakar said in a statement that the project will be first implemented in Chikkaballapur district on an experimental basis.

Similarly, the Rajasthan government has launched Mission Life Saving (LiSa) to combat covid-19. The state government is maintaining a citizen health registry by collecting information about high-risk population from various sources such as Jan Aadhar data base, Mahatma Gandhi Ayushman Bharat Rajasthan Bima Yojana data base (claims), voter list, elderly pension scheme data base and ration card data.

“This strategy is working. Our death rate of around 2.2% is among the lowest in the country and the world for such size of state and geography," said Rohit Kumar Singh, additional chief secretary (medical and health), Rajasthan.

The National Digital Health Blueprint proposes a shared digital healthcare infrastructure by setting up a personal health identifier, health master directories and Aadhaar-based identification of patients.

“All states are at different levels of maturity in their healthcare IT and data gathering in their healthcare systems. While the front runners are Kerala, Goa, Rajasthan and Maharashtra, several other states need to catch up," said Arun Kumbhat, an independent consultant to Access Health Digital, a think tank working with states to devise digital health policies. Kumbhat said that the current “challenge is the lack of interoperability, which creeps in from no standards being followed and since healthcare is state subject."


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