Let us begin with the cliche that most people cannot read what doctors write on a prescription—only pharmacists can. Like most cliches, there is some truth to this.
Now let’s use that as a metaphor to highlight the barriers to healthcare faced by millions of people who may not have the skill set to understand what the exact nature of care they need is. If you think this barrier is restricted to just the unlettered, let me tell you a story.
About half a decade ago, after years of desk-driven inactivity, I needed to urgently lose weight. In that process, I thought it would be wise to consult a doctor. So I went to one of the most senior and renowned endocrinologists in Delhi, a grey-haired don with innumerable awards, at one of the most expensive private hospitals in the city.
My basic test results would have told a doctor of his experience that I probably did not have any thyroid issue, so he proceeded to suggest that to lose weight I take under-the-counter injections from his assistant. What saved me was Google. When they showed me the packet of the injection, I Googled it on my phone and saw that it was a steroid. Naturally, I said no.
The following week, I went to the All India Institute of Medical Sciences (AIIMS) where consultation was free. The doctor scoffed when I asked for medicines. What you need is to eat less sweets and walk vigorously more, and you will be fine in two months, he said. The incident made me convert to state-run, good quality healthcare and also gave me a glimpse of what might happen if one did not have the right technology at hand.
The digital health ID is as much a tool for democracy as it is for healthcare access. When India became the world’s biggest destination for monetary transactions using digital technology, or what is commonly called fintech, it showed us one important thing—as far as usability is concerned, digital technology has now become ubiquitous and commonplace in the country.
So the next natural step, in this age of Covid-19, must be to use such technology in healthcare: improving data collection, access, diagnosis and treatment. The digital health ID allows people, should they choose to use it, a place to gather the record of their health history for use anytime, anywhere.
It is to be noted that the concept of consent is embedded in every layer of the digital ID programme—nothing is aimed to be done without the explicit consent of the citizens who access it. This should be emphasised, as healthcare data deserves the maximum levels of privacy possible. Its aims are simple: No one should be misled in the process of healing their own bodies. Information about past diagnosis and other crucial details should be available at any given time for comparative analysis.
Such an ID also means that people who are in need of urgent medical assistance from the state can receive it without any ambiguity about their identity or the specific nature of the care they need. Anyone wanting to be part of the programme will be provided a randomly generated 14-digit number that will be their unique health ID. This is meant to resolve three key issues: identifying patients, authenticating them and providing a linkage where the patient’s diagnosis and treatment over time can be seen and understood in a historical light.
But these are the micro-problems that such a programme aims to solve. We have not spoken about the macro-picture yet.
If you take a step back, especially after Covid and the coming disruptions to healthcare from global warming, nations need to see the entire picture now more than ever. And as far as possible—keeping in mind consent rules—such a digital health ID application along with the stack of applications that shall undoubtedly be built upon this allows this big picture to emerge. It also ensures there is a digital point of contact and reference for any redressal.
This digital ID should be seen as a continuance of the process of using digital technology to bring the goods of governance closer to the citizens. It furthers the process that began with Direct Benefit Transfers, Aadhaar, Unified Payment Interface (UPI) and other such programmes.
Reforming Indian healthcare is not a side task to the process of growth, it is perhaps the most important constituent in the list of tasks and the rollout of the digital health ID programme recognises this.
Hindol Sengupta
Vice President & Head of Research at Invest India, GoI’s national investment promotion agency
(hindol.opinion@gmail.com)