A pilot project for digitising health records was conducted in Uttarakhand between December 8 to December 16, MediaNama has learned. The project took place in the city of Khatima and saw the enrollment of 1,000 citizens.
The project was conducted along similar lines to the one carried out in Bihar in September, whereby electronic health records and Unique Health IDs were issued to 10,000 people after offering them free medical tests. Both projects were undertaken by Pune-based eHealthSystem. The tech startup has submitted a preliminary report containing observations from the project to the Bihar government, according to Operations Manager Swapnil Chitnis.
The Uttarakhand pilot marks the latest in a growing list of state-level health digitisation projects, such as ones in Odisha, Delhi, and Tamil Nadu. The launch of the Ayushman Bharat Digital Mission (ABDM) last year spurred the push for health digitisation, but it has also led to concerns about insurance coverage, coercion, privacy violations, and more.
How did the Uttarakhand project take place?
Under the project, free testing of 36 to 51 health parameters such as blood sugar, body mass index, etc. was offered to those who signed up. The results of their medical tests were sent to them in a digitised format on their mobile numbers, Chitnis said. Passwords were issued for the patients to log into the eHealthSystem app and view their records. Those without a smartphone were issued a smartwatch so that medical personnel can access the patients’ health data during consults.
The test results are stored on the state government’s MeghRaj cloud server, uploaded through eHealth System’s software. Further, OTP-based authentication was carried out and written consent was taken before issuing the Health IDs, Chitnis added.
What was observed in Bihar?
While the preliminary report is yet to be released by the Bihar government, Chitnis shared a few observations from the project.
Lack of smartphones: According to Chitnis, the level of usage of mobile phones for activities apart from calling is very less in Bihar, specifically in interior parts of the state. Most users have old feature phones instead of smartphones, he said.
Eagerness to adopt technology: Due to poor literacy, exposure, or simply not having a use for technology there has been little smartphone penetration in the state but, Chitnis said, people were willing to learn technology. “That’s what we found out because they were calling us about how should we open our application, download our application, view our medical records…people are trying to change over there,” he said.
Where could such projects take place next? According to Chitnis, talks are currently underway to expand the health digitisation project to Badaun district in Uttar Pradesh as well as districts in Karnataka, Rajasthan, and Odisha.
Ayushman Bharat Digital Mission and the concerns raised
In October, the central government’s ABDM was rolled out nationwide after a year-long pilot and nearly 15 crore Unique Health IDs were issued to citizens. Meanwhile, various state governments have been rolling out similar initiatives, like New Delhi which is planning to link health records with Voter IDs and record geo-coordinates of households, among other things.
However, there are concerns that the rapid digitisation of health can lead to difficulty in accessing health insurance for the people who most need it. Health trackers like wearables and the mapping of family history through initiatives like ABDM can allow insurance companies to raise premiums or deny health insurance coverage to individuals, said researcher Radhika Radhakrishnan in a fieldwork-based policy study. “When individuals become legible to private actors who can access massive amounts of personal data about their lives, it changes how people’s health can have value, and who can benefit from that value,” Radhakrishnan said.
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