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Oct 23

India’s National eHealth Authority taking shape

India flagJust over a year after the Modi government came to power it released a concept note announcing its plans for a National eHealth Authority (NeHA) under the ‘Digital India’ campaign. The promotional and regulatory body, it said, would guide and support India’s journey in eHealth and leverage the benefits of information and communication technology (ICT) intervention to put the country’s ailing health sector in order. India currently spends around 4.1 per cent of its gross domestic product on health. But the contribution from the government is just about 1.1 per cent of the overall spend. Since the insurance penetration is low, the out-of-pocket expenses for patients are very high; it is estimated at more than 60 per cent, which is perhaps the highest in the world. India’s life expectancy stands at 66 years for both male and female population and infant mortality rate under five is still high at 43.8 in males and 56 among females per 1,000 live births. The maternal mortality ratio currently stands at 190 per 1,000,000 live births. The proposal also clearly spelt out the proposed functions and governance mechanism of the e-health body which drew from global experience.

3 key objectives of the Agency

  • Technology can play an enabling role in addressing the issue of the absence of qualified service delivery personnel in remote areas
  • Improving the efficiency of the healthcare system
  • Bettering the quality of care

3 challenges they will have to overcome

  • The fragmentation of healthcare service over the public and private sectors. The Indian health sector, excluding drugs, is largely unregulated. Due to the lack of resources and infrastructure, the public health system is in a shambles, forcing over 60 percent of patients to rely on private healthcare. Private hospitals are, however, prohibitively expensive. According to BP Sharma, Secretary of the Health Ministry, the resources and infrastructure gap can’t be addressed overnight and hence “information technology can serve our need in the meanwhile”.
  • Establishing a business model and funding stream that supports not only this project but also the ongoing innovation in eHealth required in India.
  • The enormous scale of the problem they are trying to solve to establish records for their 1.28 billion people.

The progress of the NeHA formation has recently been reported. Significant work has been undertaken in the standardization of healthcare interoperability. India’s Electronic Health Record Standards by the Ministry of Health and Family Welfare were published online for comments. The National Law University, Bengaluru, signed a memorandum of understanding in February to address major privacy and security related issues with the electronic health record and prepare draft legislation.  This is complicated by the countries ambitions of using this data to address fraudulent claims. It is reported that a substantial portion of the total claim made by policy holders are exaggerated and fraudulent.

However the biggest hurdle for NeHA will be the nature of the proposed body: whether it will be a regulatory body, if it will have teeth for enforcement, or if it will be a mere coordinating agency. While the objectives of this agency are very similar to the majority of national eHealth agencies, the challenges they are trying to overcome make them unique. The establishment of the authority is slated to be formalised by early 2017.

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