Unified health interface key to accessible health services

public health, Indian healthcare
As the private medical system is unaffordable to a majority of citizens, the PHC-UHC approach can be adopted to improve access to the public health system.

The digital healthcare market in India is worth between $5 billion and $10 billion, according to various estimates. While it is one of the fastest growing markets, the users and health service providers are scattered across different platforms. There is a need to bring them on a single platform to improve access to healthcare services. Towards this objective, the National Health Authority has launched the unified health interface (UHI) under the Ayushman Bharat Digital Mission (ABDM). UHI is an open network designed to enable interoperable digital health service delivery.

In 2017, the National Health Policy published the key principles of citizen centricity, quality of care, improved access, universal health coverage, and inclusiveness. All of these principles can be realised primarily through the use of digital technologies such as national health electronic registries, a claims platform, a federated personal health records framework, a national health analytics platform, and other horizontal components.

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Interoperability of healthcare services

The healthcare system can benefit greatly from interoperability as information can be shared quickly and easily between systems. It can particularly improve patient care and safety. Interoperability in the healthcare system is crucial because patients may receive care from multiple providers that work in multiple healthcare systems and may be enrolled in multiple panels. Healthcare providers can make an informed decision about the course of care without repeating tests, thanks to information exchanged between platforms. This lowers the cost of healthcare by helping avoid unnecessary testing.

Additionally, it lessens the needless gathering of data from the patient. It also reduces the time taken by patients to brief their healthcare providers on their medical history, allowing for more time for clinical discussions about health concerns, thereby improving patient care. Interoperability will reduce patient/doctor empanelment costs, reduce patient education cost and improve healthcare penetration in the society.

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Unified health interface

Health ID, healthcare professionals registry (HPR), health facility registry (HFR), health information exchange and consent manager, and unified health interface are some of the key building blocks of Ayushman Bharat Digital Health Mission (ABDM), conceived by the National Health Authority.

ABDM aims at creating an ecosystem that will ensure seamless interoperability of health-related data enabled by UHI. The UHI network is an open network of end-user applications and participating health service provider (HSP) applications. An end-user application is any application chosen by the user to access health services and HSP applications provide digital health services which includes individual doctors, hospitals, labs, pharmacies, and companies that aggregate health services.

UHI will enable faster discoverability of verified healthcare service providers across platforms for the user leveraging the building blocks of ABDM. The unified payment interface (UPI) which enables users to make seamless payments from their bank account or wallet to any other bank account is the best example of a comparable interoperable model from the financial services industry.

An open network

Currently, the delivery of digital health services is fragmented and non-interoperable. UHI uses open protocols, which are a set of universally accepted technical norms that are not specific to any one entity and are not restricted to that entity’s line of products, in order to facilitate interoperability. In order to obtain a digital health service (say tele-consultation or booking an appointment) the platform approach requires both patients and health service providers to use the same platform, this problem is addressed by UHI’s open protocol as it brings all health service providers and users on a common platform.

For digital health services, open networks and open protocols would allow interoperable connections over a national, decentralised, open, secure, and inclusive network. Health service providers can choose how much to charge for their services and can be found by any patient in the open network. They can use any health service provider software application to avail the service. The open network should make it simple for patients to find, request, and pay for digital health services from anywhere in the open network, and it should broaden the market for healthcare providers.

Services under UHI

UHI will enable a wide variety of digital health services between patients and health service providers (HSPs) including:

  1. Discovery of healthcare providers
  2. Booking a Healthcare Appointment- For both physical / digital consultations
  3. Discovery of Hospitals and their facilities
  4. Discovery of Labs and their services
  5. Discovery of Pharmacies
  6. Discovery of availability of medicine
  7. Discovery of available critical care beds
  8. Booking an ambulance service
  9. Booking an appointment for home collection of samples
  10. Ordering medicines for home delivery

Benefits of UHI

There are a number of digital health applications in the market, but they all require that the patient and the health service provider use the same platform which makes it challenging for patients to connect with numerous doctors and vice versa. Patients with serious illnesses who seek a second opinion bring physical copies of their MRI, CT, and X-ray scans on CDs, as well as their own organised medical records wherever they go.

Patients can easily find doctors using UHI by any of the UHI Network apps. Patients will be able to find a doctor, schedule an appointment, make payments, get prescriptions and store their data digitally using any app of their choosing which are part of the ABDM ecosystem. Doctors will be able to manage their availability for online consultations using any app of their choice. By allowing the doctors to view the records at all hospitals and facilities, the patients can easily share their medical records with any doctor.

A number of new features will be added to UHI in addition to these services such as support for patients who need routine care. These include reminders and reviews of their medical conditions, health bots which will review their medical histories, send reminders, offer advice based on their trends, and assist doctors in managing chronic care. Patients can check if drugs that they require are available in pharmacies near their location. They can even place the order, and have it home delivered if the local pharmacy provides such services. Group consultation will also be available, to properly diagnose patients with multiple disorders and ambulance services via health facility registry.

New players and health-tech start-ups will also benefit from joining UHI as it will provide them easy discoverability and access to a larger market. The UHI will act as a market enabler while providing a variety of services. UHI will offer a level playing field for millions of health service providers and health tech start-ups, making quality healthcare accessible and affordable to all.

(Dr Saurabh Ingole is a young professional at the National Health Authority.)

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