The boundaries are blurring between a social protection program for the poor and a voluntary project that cuts across all classes.
On September 27, Indian Prime Minister Narendra Modi presided over a new name change ceremony for the National Health Digital Mission (NDHM). Now it is called Ayushman Bharat Digital Mission (ABDM).
It is not simply a question of changing nomenclature. There is more than what we see. In February, The Ken reported that the National Health Authority (NHA) mechanism was working to marry the government-run cashless health insurance scheme for the poor – commonly referred to as “Ayushman Bharat” – with the NDHM (or ABDM).
ABDM is sold as a concept that will help any Indian citizen to access their digital health records at their fingertips. But this trip will be long. Many healthcare players such as laboratories, hospitals and clinics will need to come on board and link all their patient records with unique and newly created health identifiers. They will also have to present the patient with a repository of his health data.
In the future, this will pave the way for opening the results of this data to the market, as the National Digital Blueprint suggests. So far, only 12 public and private providers have been integrated into ADBM, including labs like Dr Lal Pathlabs, SRL Diagnostics and an insurance company, Bajaj Finserv Health.
The Ayushman Bharat program, on the other hand, with 22 million beneficiaries, is a treasure trove of data that would be used to speed up the cogs of ABDM. NHA officials have worked fervently behind the scenes over the past seven months to enroll as many beneficiaries as possible in the cashless health insurance scheme. Two officials confirmed The Ken that each beneficiary with an Aadhaar link will be assigned a unique identifier in the background, which will then be used to create a digital health identifier (with consent) under ABDM.
And while the program will have substantial beneficiaries cornered by this route, it also urges citizens who are financially well off and do not fall under the state’s cashless treatment to enroll under the ABDM.
âLike UPI, ultimately the patient / user must consent to all case movements. So the success of the mission will depend on this. Just pushing up the numbers won’t help anyone, âsaid an industry executive involved in the mission. The Ken.
India is considering providing a unique health identifier to every citizen, so that their health records are stored electronically. But to get a unique health identity card, a citizen must be properly counseled. It also requires citizens to give their specific consent for this purpose. But the NHA took advantage of the Covid vaccination wave to randomly issue unique health identifiers to people vaccinated through the CoWIN portal in the past. Don’t be surprised if you take a look at your vaccination certificate and find out that you have already received one.
Source: Author’s vaccination certificate
While Ayushman Bharat is a social protection scheme, which allows the government to impose the use of Aadhaar to access social benefits, under the Aadhaar law of 2016, ABDM is a voluntary mission, which cannot not enforce the use of Aadhaar.
However, ABDM aims to be the digital backbone of all healthcare services in India (public and private). And to that end, increasingly, Aadhaar is being notified as a preferred proof of identity for Covid vaccinations, accumulating social benefits and creating a unique health identifier.
For now, a complicated marriage is brewing. It remains to be seen how to cut corners like surreptitiously swiping unique health identifiers while patients seek other health services like vaccinations or cashless health insurance, remains to be seen.