In the meeting, NHA officials provided new information on NDHM tenders and consultation papers in the pipeline while responding to questions related to data security and health.
In a consultation meeting held last week on the Unified Health Interface – whose consultation paper was released in July- the NHA revealed important details and clarified several questions about the National Digital Health Mission and its components. The Additional CEO of the National Health Authority also said that after nearly a year of the NDHM pilot in 6 Union Territories, it has been decided that it will be rolled out nationally.
Why it matters? The consultation paper, for which comments are invited until August 23, revealed the facilities that the UHI would provide, data protection rules it would follow, and the specification committee which would design it. However, it still left some questions unanswered – some of which were answered in the meeting along with other important details about NDHM.
What the NHA revealed
During the meeting, NHA Addl. CEO and NDHM mission director Praveen Gedam, Joint Director Vikram Pagaria, Executive Director IT Abhishek Kumar, and NHA’s IT advisor Kiran Anandampillai revealed key details regarding the UHI. They are highlighted below.
1. Single tender to be floated for entire NDHM’s management
- Gedam and Kumar revealed that a single ‘Request for Proposal’ (RFP) will be released for public bids to select an entity that will manage the entire NDHM or a management service provider (MSP).
- Kumar also revealed that this entity would be on-boarded in the next 3 to 4 months.
- Gedam said that there has been an industry consultation on the NDHM; however, the two did not reveal any more specifics about it or the RFP.
2. UHI could be implemented in a year
Kumar said that the UHI could be ready for implementation within a year, after the authority selects an MSP, develops various building blocks, and publishes specifications for them.
3. Sharing health data for commercial purposes
- In response to multiple questions on health data sharing for product improvements and intellectual property rights for the same, Gedam said that a ‘policy on use’ is in the works.
- However, he added that at present they weren’t keen on allowing the use of health data for purposes that wouldn’t serve the public.
“We are waiting for a policy to come out before we decide on this. But idea right now is that we may allow use of anonymized data in the larger public interest- such as public health policies at centre or state, tracking epidemiological data,etc.- but not for purely commercial process like fixing insurance premiums.”
- He also said that after the policy is released, the NHA would have a separate webinar for IPR-related issues.
4. Software built for Medical Councils and ‘their routine processes’
- Gedam revealed that the NHA is creating software to take care of the routine processes of such councils, which can be opted for at their discretion.
- As an example of a use-case, he said that the software will capture the entire journey of a person from when they start their MBBS (or any other degree) till they pass out. He said that “the flow is captured on both the sides – medical council and NDHM, eliminating duplication of efforts.”
5. ‘No need to worry about data security’
- In response to MediaNama’s question on how cybersecurity concerns related to third-party apps of private organisations/NGOs joining the UHI gateway will be allayed, NHA’s Abhishek Kumar said there was no need for concern.
- The Joint Director for Coordination said that the NHA was “taking all possible measures for information security as per internationally accepted standards.”
“..By way of NDHM or UHI gateway we are not making any fundamental changes in the way interactions taking place between area specific stakeholders. At conceptual level record creation storage and sharing will continue to take place under the same conceptual framework as it is happening in (the) pre- UHI OR NDHM era. NDHM architecture is federated in which health records remain at place of origin itself that is with the respective hospitals, clinics their cloud service provider. Any sharing of records can take place by the consent of the individual concerned who is owning the data.”
6. Might consider formation of Health Information Management Professionals
- In response to a query on whether the authority is considering creating ‘Health Information Management Professionals’ for data collection, Gedam said that he may consider it in certain cases. He gave examples of places which feel more comfortable with having people like data entry operators and wards or in-patient departments where typically doctors take rounds, take notes on patients. “There we would probably need someone to digitize the patient data at the end of the day,” he said.
- As for the rest, he said that some data is already being digitised in labs, radiological units, and diagnostic centres. He also noted that in some hospitals, doctors were already using and preferring computers over hand-written notes/prescriptions.
7. More consultation papers en route
During the consultation meeting, the NHA revealed that at least three consultation or policy papers are going to be released in some time. These are-
- Drug Registry: The NDHM strategy paper and Blueprint had mentioned registries on drugs.
- Health Information Sharing and Exchange: This will govern how health data will be shared under the NDHM and layout-related mechanisms in detail.
- Policy on Use: In the meeting, Gedam insinuated that this would govern how health data is shared (or not) with private, public, and non-governmental bodies.
8. Details of the specification committee
The specification committee of the UHI is the committee that will create the open standards protocol that the UHI is slated to be built on. In the consultation paper, it was mentioned that ‘technical experts’ will be a part of it but no further details were given. In response to MediaNama’s question on this, Gedam said that while who and how the members will be selected had not been finalised yet, usually experts from AIIMS, IITs, and well-known names from the ‘industry’ are brought in. This, he said, may also include any retired experts as well.
What is the NDHM? What are its building blocks?
The NDHM seeks to create a digital health architecture using health IDs, unique identifiers for doctors and health facilities, personal health records, and telemedicine and e-pharmacies, among other components.
It has nine building blocks which include four data registries, 2 operations centres to handle privacy issues, APIs to enable third-party integration, and a block to provide aggregated anonymised health analytics for policy-making or research.
These blocks are further arranged in four layers:
- First Layer: Integrations with Aadhaar, Jan Dhan Bank accounts
- Second Layer: Health Data Exchange Layer with the registries
- Third Layer: Health services interface with the UHI
- Fourth Layer: The User Applications made by third parties through API integration
The consultation process so far
So far, the NHA has released consultation papers on the UHI, Health Professionals Registry, Health Facility Registry, NDHM draft implementation strategy, NDHM blueprint, data policy, sandbox framework guidelines, and more.
In July, it held public consultation meetings on the HPR and HFR after releasing papers on it and inviting comments. It had conducted consultations on the draft implementation strategy and Health Data Policy consultation last year as well, and is expected to release multiple other documents for further consultation.
Meanwhile, as is apparent from the consultation meeting, the NHA has been conducting consultation meetings with industry and medical bodies as well.
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