Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

National Health Stack (NHS) and National Digital Health Blueprint (NDHB)

Note4Students

From UPSC perspective, the following things are important :

Prelims level : National Health Stack (NHS) and National Digital Health Blueprint (NDHB)

Mains level : Need for digital health record


  • The challenge of making quality and affordable healthcare accessible to every one of India’s 135 crore citizens has acquired an altogether new dimension.
  • The report charting out the process for implementing the National Digital Health Blueprint (NDHB) has been completed.

What is the National Health Stack (NHS)?

  • Unveiled by the NITI Aayog last year, NHS is digital infrastructure built with the aim of making the health insurance system more transparent and robust.
  • There are five components of NHS:
  1. Electronic national health registry that would serve as a single source of health data for the nation;
  2. Coverage and claims platform that would serve as the building blocks for large health protection schemes, allow for the horizontal and vertical expansion of schemes like Ayushman Bharat by states, and enable a robust system of fraud detection;
  3. Federated personal health records (PHR) framework that would serve the twin purposes of access to their own health data by patients, and the availability of health data for medical research, which is critical for advancing the understanding of human health;
  4. National health analytics platform that would provide a holistic view combining information on multiple health initiatives, and feed into smart policymaking, for instance, through improved predictive analytics; and
  5. Other horizontal components including a unique digital health ID, health data dictionaries and supply chain management for drugs, payment gateways, etc., shared across all health programmes.

What is the National Digital Health Blueprint (NDHB)?

  • The NDHB is the architectural document for the implementation of the NHS.
  • Its vision is to create a national digital health ecosystem that supports universal health coverage in an efficient, accessible, inclusive, affordable, timely and safe manner, through provision of a wide range of data, information, and infrastructure services.
  • NDHB recognizes the need to establish a specialised organisation, called the National Digital Health Mission (NDHM) that can drive the implementation of the blueprint, and promote and facilitate the evolution of a national digital health ecosystem.

Features

  • The key features of the blueprint include a federated architecture, a set of architectural principles, a five-layered system of architectural building blocks, a unique health ID (UHID), privacy and consent management, national portability, electronic health records, applicable standards and regulations, health analytics.
  • A total of 23 such building blocks have been identified in the blueprint for the NHS to become a viable reality.

Why is the NHS necessary?

  • Currently apart from Ayushman Bharat there are many secondary and tertiary care schemes running in various states.
  • West Bengal has opted out of Ayushman Bharat, and Telangana and Odisha have never been a part of the scheme.
  • Also, there is an urgent need for integration of the two arms of Ayushman Bharat — health and wellness centres which constitute the primary care arm, and PMJAY.
  • This is the secondary and tertiary care arm under which the target is to provide 10.74 crore families with an annual health cover of Rs 5 lakh each.
  • Without integration, the goal of continuum of care cannot be met — and that would mean PMJAY might end up becoming a perpetual drain on resources.
  • Hence, the need for a common digital language for the operationalization and inter-operability of various health schemes, which the NHS seeks to provide.

Is all the data going to be safe/secure?

  • One of the biggest concerns following the high-profile rollout of Ayushman Bharat has been regarding data security and privacy of patients.
  • More than a year after the Justice Srikrishna Committee prepared a draft data privacy law, there has been little meaningful movement on it.
  • Critics have argued that in the backdrop of the Supreme Court’s privacy judgment, the data privacy law should ideally have preceded the implementation of Ayushman Bharat.
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