Ayushman Bharat Digital Mission: Big opportunity for healthtech startups

Finding the right doctor is just one part of the puzzle. A lot of times, we see diagnosis going wrong, patients wanting a second opinion and treatment taking longer than expected because of disease complications.
 
Why is that so?
 
Well, it is very difficult to come up with an accurate prognosis if the patient can’t recount their past medical conditions.
 
So, what if there was a health locker of sorts, containing all of the patient’s past medical tests, lab reports, details of previous conditions, their diagnoses, etc.
 
And this health locker were to be linked to a randomly-generated 14-digit unique Health ID, similar to other unique identifiers like Aadhaar.
 
With each visit to the doctor, the patient would just have to provide their Health ID for the doctor to access their past medical history.
 
This is what the government aims to do with its recently launched Ayushman Bharat Digital Mission.
 
There are some other details we need to look into:
 

• One can get a Health ID by self-registering on the ABDM portal
• They can also request for the creation of a Health ID at a participating medical health facility
• Health ID can be created via mobile or Aadhaar
• Beneficiaries will also have to sign into a Health Information Exchange and Consent Manager (HIE-CM)
• These consent managers will be mobile apps that will enable the sharing of personal health records with doctors

 
Here’s how this will work.
 
You go to a doctor and they ask for your past medical records.
 
They will raise a request for accessing your personal health records, which you will have to approve through the consent manager app.
 
In the future, there will likely be multiple such consent manager apps for beneficiaries to choose from. So, it will be very similar to how UPI works, or the upcoming Account Aggregator framework for financial services.
 
The ABDM is expected to be a major boon for India’s healthtech startups.
 
From telemedicine to online pharmacies to startups that are developing health lockers, the India online healthtech market is vast.
 
According to a media report:
 

• India has 5,295 healthtech startups
• Of these 133 eHealth startups have raised funding
• Market is expected to expand at a CAGR of 39.6% between 2020 and 2025 to $10.6 bn
• Telemedicine, which includes startups like Practo, MFine, DocTree, DocPrime and CallHealth, has the highest potential and may reach $5.4 bn by 2025

 
The portability of electronic medical records through Health IDs will provide a major fillip to startups.
 
Telemedicine startups offer online doctor consultations.
 
Now, with Health IDs encapsulating a patient’s entire medical history, telemedicine will only grow more robust.
 
Besides the Health ID, the ABDM will also see the creation of a national registry of doctors practising acceptable forms of medicine, as well as medical and diagnostic facilities.
 
According to Dr Ajay Bakshi, a volunteer with the Indian Software Product Industry Roundtable or iSPIRT, trust is very important in healthcare. India struggles with fake doctors and quacks. ABDM’s national registry of doctors and medical facilities will enhance citizens’ trust in the healthcare provider they’re approaching.
 
Every allopathic doctor in India caters to 1,511 people on average. This is much higher than the World Health Organization (WHO)-prescribed norm of 1 doctor per 1,000 people.
 
Moreover, most of these doctors are concentrated in the metro cities, leaving rural areas vastly underserviced and at the mercy of fake doctors and quacks.
 
While improving the doctor-population ratio will take time, India’s techno-solutionism may have figured out a workaround.
 
The recently launched Ayushman Bharat Digital Mission (ABDM) will create a Unified Health Interface (UHI).
 
This will be:
 

• An interoperable system that would allow a patient to take the services of a doctor irrespective of whether they were on the same technology platform as the doctor
• Patient could seek teleconsulation from doctors registered with multiple eHealth platforms, without having to create an account on each app
• eHealth startups will gain access to patients through the UHI

 
Dr Bakshi also shed light on the importance of UHI:
 

• Will enable any citizens in India to discover any doctor in India, set up teleconsultation
• Chronic shortage of doctors, most of them concentrated in large cities
• If you’re living in a Tier 3 or 4 city, you may not have ready physical access to a good cardiologist or a speech therapist

 
All this is not to say that the ABDM won’t have its problems.
 
Already, there are concerns over data privacy.
 
While the government has maintained that the creation of a Health ID is voluntary, reports indicate that many Covid-19 vaccine beneficiaries have already been given a Health ID, without them even knowing about it.
 
Some state governments also feel that the creation of a separate Health ID is not necessary, suggesting that personal health records can instead be linked to Aadhaar numbers.
 
However, a Health ID covering one’s entire medical history sounds like a good idea for improved treatment and preventive healthcare. The ABDM will have to build on this solid premise.