On Digital Health ID, proceed with caution

Synopsis: Government must weigh all pros and cons, learn from experiences of other countries to ensure that a good policy does not die due to poor implementation.

What are some potential benefits of ABDM?

– Well-organized data repositories that enable easy access to records can stimulate much-needed research on medical devices and drugs. This storehouse of patient data can be invaluable for clinical and operational research.

– Digital Health ID under ABDM can have a transformative impact in promoting ecosystems that function as paperless facilities. Direct electronic linkages between the patient registration process, doctor, laboratory and pharmacy will help in reducing delays and enhancing efficiencies.

What are the issues with ABDM implementation?

Investments required: While technology helps enhance patient experience, there is a cost attached. Investments have to be made upfront. In the immediate short run, DHID will increase administrative costs by about 20%, due to the capital investment in hardware and software development, technical personnel and data entry servers.

Studies of such reform undertaken in the US in 2009 showed that small and medium hospitals were generally reluctant to adopt EMRs, partly because of the upfront investments that they were required to make. This resulted in the federal government providing subsidies of about $30 billion as an incentive. Hence, any scaling up of this reform would require extensive fiscal subsidies and more importantly providing techno-logistical support to both government and private hospitals.

Lack of infrastructure: A large majority of facilities do not have the required physical infrastructure — electricity, accommodation, trained personnel. Cards getting corrupted, servers being down, computers crashing or hanging, and power outages are common in India. The inability to synchronise biometric data with ID cards has resulted in large-scale exclusions of the poor from welfare projects. Such a scenario in the case of health, will cause immense hardship to the most marginalised sections of our population.

Source: This post is based on the article “On Digital Health ID, proceed with caution” published in The Indian Express on 6th Oct 2021.