Healthcare worker groups which have a government-mandated council will be prioritised for enrolment in the Healthcare Professionals Registry (HPR) under the Ayushman Bharat Digital Mission (ABDM), the National Health Authority (NHA) announced on February 10. Those without a council will be enrolled in a phased manner, it added.
Based on stakeholder feedback and internal meetings between top officials, the NHA revealed multiple changes and action points regarding the HPR and Health Facility Registry (HFR).
The proposed databases are two among many components of the ABDM – the Indian government’s multi-tiered, health digitisation project which also envisions a Unified Health Interface, health information exchange, Health IDs, etc. Since some of these components will deal with tele-consultations and processing insurance claims of citizens, it is important to track the changes.
What changes have been made to the HPR?
Healthcare professionals have to self-register: Self-registration by healthcare professionals will be the preferred mode of data entry into the HPR, although data based on transactions can also be used. However, bulk data will be used after careful evaluation of its ‘attributes’ and ‘veracity’, the NHA said. As an action point, the NHA will publish governance/ verification guidelines which will outline onboarding criteria and platform rules.
The NHA further listed three action points, presumably for itself:
- Assess the viability of having e-sign facility for Electronic Health Records.
- Evaluate the possibility of allowing direct sharing of EHRs between doctors and patients i.e. without a technology system like a Health Information Management system for smaller clinics.
- Publish version one of Application Program Interfaces on the ABDM Sandbox. This sandbox is where private and government entities can check their regulatory and technical compliance with the project. APIs essentially allow a platform or service to connect to other platforms and services.
- Develop and approve a HPR product roadmap. The NHA did not elaborate further on the contents of this roadmap.
Notably, the NHA is yet to address whether the HPR will include only professionals who engage with patients or all healthcare workers (for example, a lab technician).
What changes have been made to the HFR?
HFR to only allow for sharing of data: The NHA has said that HFR will not be a ‘licensing portal’ and will only allow for sharing of data with other ecosystem players through APIs. In the consultation paper, it said that enrolled health facilities will be able to apply and receive licenses and certifications from government authorities like the National Accreditation Board for Hospitals.
Verification of health facilities won’t be overseen by the NHA: A layer of Health Facility Verifiers (HFV) will not be created for the HFR and thus, the NHA will not be responsible for verifying facilities. Instead, it will release APIs to allow any entity to take up the role of an HFV, and it will also explore crowdsourcing as a mechanism for verification. Meanwhile, a feature will be added to mark information provided by health facilities as ‘self-declared’. An HFV was defined as an independent, third-party legal entity that is responsible for the verification of data in the HFR, as per the NHA’s consultation paper.
No linking health facilities with workers: “Facilities can be linked to health workers and other facilities to replicate hierarchies in the systems of the programmes,” the consultation paper had said at the time. But now, the NHA has said that it will not go ahead with having such hierarchies; instead, organisations that need it can build it within their own systems.
Mobile health facilities won’t be included in the HFR: The NHA has said that mobile health facilities, like vans that provide healthcare, will be not be included “in the current phase”. The consultation paper had proposed that the following facilities be included in the HFR:
- Diagnostic centres
- Health and wellness centres
- Mobile vans
What were the key submissions that the NHA received?
In the document, the NHA said that it received 62 comments on the HFR and 159 comments on the HPR
On the HFR, most of the comments revolved around:
- Changes in HFR datasets and inclusion of types of health facilities
- Who will be responsible for the selection and onboarding of HFV and how will the liability work?
- Integration of HFR with entities in the wider Indian healthcare ecosystem to enable adoption
On the HPR, most of the comments revolved around:
- Which categories of professionals should be included in the registry?
- How and by whom will data on HPR professionals be managed?
- What features, integrations and incentives will be activated in HPR, and how will these be prioritized?
Where do other components of the ABDM stand?
The ABDM has created over 167 million Unique Health IDs so far. Here’s a status update on the ABDM components besides HPR and HFR.
Unified Health Interface: The UHI, which was opened up for public consultation in July last year, went live in January 2022.
Health Data Retention Policy: A consultation paper was released on the HDRP in November 2021 after which a public consultation meeting was also conducted in December that year. Earlier, in 2019, NITI Aayog had invited public comments on a blueprint document of the ABDM which had largely laid out the framework for the project that we see today.
Strategy document: Public comments were invited on the draft strategy document for the implementation of the ABDM in March 2021.
- NDHM Consultation: NABH recommends changes to the proposed Health Facility Registry
- National Health Authority seeks Aadhaar data to identify health insurance beneficiaries
- India’s flagship health digitisation project will involve Paytm, Jio, and others
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