Launched on September 27, 2021, the Ayushman Bharat Digital Mission (ABDM) aims to establish a robust digital health infrastructure in India, enhancing healthcare accessibility, efficiency, and transparency. The initiative leverages Digital Public Infrastructure (DPI) to enable interoperability in digital health transactions, ultimately revolutionizing the healthcare ecosystem. Its origins trace back to the National Health Policy (2017), which prioritized accessibility, a wellness-centric approach, and the use of digital technologies. This was followed by the National Health Stack (2018), which included key components like unique health identifiers and verified registries, and then the National Digital Health Blueprint (2019), which laid the foundation for implementing ABDM.

Key Features of ABDM

Unique Health Identifier (ABHA ID): ABDM provides every individual with a unique Health ABHA ID, which creates a secure and reliable identity to manage and store health records.

Healthcare Professionals Registry (HPR): This comprehensive repository includes healthcare professionals across both modern and traditional systems of medicine. The registry aims to integrate them into India's digital health ecosystem, facilitating better healthcare delivery.

Health Facility Registries (HFR): The HFR is a detailed database of health facilities nationwide, covering public and private establishments, including hospitals, clinics, diagnostic centers, pharmacies, and more.

Health Information Exchange and Consent Manager (HIE-CM): HIE-CM empowers citizens to securely access and share their health records, ensuring data exchange is managed through informed consent.

Unified Health Interface (UHI): UHI facilitates the discovery and delivery of health services, simplifying healthcare interactions and improving access to medical care.

National Health Claims Exchange (HCX): HCX streamlines and standardizes the insurance claims process, enhancing the efficiency of health insurance transactions.

Data Privacy and Security: ABDM places great emphasis on the confidentiality, security, and privacy of personal health information. In line with the Digital Personal Data Protection Act (DPDP Act) of 2023, ABDM's federated architecture ensures secure data sharing, maintaining confidentiality throughout.

Interoperability: ABDM enables seamless healthcare delivery by facilitating secure data exchange among various healthcare stakeholders. The three gateways—HIE-CM, HCX, and UHI—ensure efficient interoperability within the healthcare system.

Transparency: The mission empowers individuals by allowing them to choose between public and private health services. It ensures transparency in pricing, compliance with guidelines, and accountability for healthcare services rendered.

Key Initiatives of ABDM

Scan and Share: ABDM launched a QR-code-based OPD registration service, allowing patients to scan the facility's QR code and share demographic details instantly. This has minimized long queues at registration counters and reduced waiting times from one hour to just 30 minutes, saving approximately 2.5 crore man-hours, with over 5 crore OPD tokens recorded.

Digital Health Incentive Scheme (DHIS): The DHIS, launched on January 1, 2023, provides financial incentives of up to ₹4 crores to encourage the adoption of digital health practices. This initiative has garnered significant interest from both private and public healthcare players.

Microsites for Private Sector Adoption: To address the challenges faced by private sector providers in adopting ABDM, the Microsite initiative operationalized 106 microsites, surpassing the initial target of 100, thereby accelerating private sector participation.

End-to-End ABDM Adoption Pilot: The pilot project aims to digitize healthcare facilities nationwide by making them model ABDM facilities. As of September 27, 2024, a total of 131 healthcare facilities have been selected for participation.

Achievements of ABDM

ABDM has made significant strides in building a digital healthcare ecosystem. Over 67 crore Ayushman Bharat Health Accounts (ABHA) have been created, providing citizens with unique digital health IDs that enable secure access to health records. Additionally, over 42 crore health records have been linked to ABHA, enhancing healthcare delivery.

ABDM has successfully brought major private and public players into the digital health ecosystem. More than 236 private entities—including labs, pharmacies, and digital solution providers—have integrated with the ABDM ecosystem, achieving interoperability. Institutions like AIIMS Delhi and AIIMS Bhopal have emerged as leaders in generating Scan and Share OPD registrations. Over 1.3 lakh healthcare facilities, including more than 17,000 private facilities, are now ABDM-enabled.

The launch of the National Healthcare Providers Registry (NHPR) has also been a significant achievement, with 3.3 lakh health facilities and 4.7 lakh healthcare professionals registered. The National Health Authority (NHA) has also developed portals like the National Medical Register (NMC) and the National Dental Register (NDR) for healthcare professionals.

Moving Towards Transformation

ABDM has expanded its efforts to revolutionize digital healthcare through several partnerships and collaborations. A partnership with IIT Kanpur has fostered the development of digital public goods for healthcare AI, while an MoU with Maharashtra University of Health Sciences (MUHS) has introduced digital health education into medical curricula.

In its effort to promote digital health literacy, ABDM has been training and sensitizing stakeholders to facilitate the adoption of digital health practices. The National Health Authority has introduced a WhatsApp Chatbot as a user-friendly platform to educate stakeholders involved in ABDM.

Various associations are also advocating for integrating digital health into healthcare systems. For instance, the National Accreditation Board for Hospitals (NABH) has launched the first edition of its Digital Health Standards for HIS/EMR Systems, promoting the adoption of digital health technologies. Furthermore, the eSwasthya Dham portal has been integrated with ABDM, extending its benefits to Char Dham Yatris.

Vision for the Future

ABDM envisions a seamless digital health ecosystem where every Indian has access to their health records through a unique Health ABHA ID, connecting all health-related information across healthcare providers. Citizens can avoid long queues for registration, access healthcare conveniently, and facilitate easy doctor appointments.

ABDM also plans to implement a Clinical Decision Support System (CDSS) for healthcare professionals to improve clinical decision-making, patient outcomes, and streamline healthcare delivery. By creating a single source of truth through the "trinity of registries" (ABHA, HPR, HFR) and "trinity of gateways" (HIE-CM, UHI, HCX), ABDM holds immense potential to transform India's healthcare landscape into a highly efficient digital ecosystem.

(Input from various sources)

(Rehash/Ankur Deka/MSM)