Beneficiary Registry Recommendations for India

Since the start of the Millennium, India has been trying to overcome the problem of interoperability and fragmented healthcare delivery ecosystem across states, health policies and vertical health programs to deliver seamless or uninterrupted continuum of care. With the launch of the Pradhan Mantri Jan Arogya Yojna (PMJAY), that covers & provides free healthcare to approximately 40 % of the Indian population, it has become critical to identify each patient uniquely. The criticality for unique identification of individuals got highlighted when India was hit by the COVID 19 pandemic – when patient tracking and relevant health information on comorbidities was not available for effectively and efficiently executing surveillance. States and government could only collect aggregated data in non-standard and an unstructured format via door to door screening, which was extremely inefficient and poorly suited for response planning and to effectively combat a pandemic of this size and scale.

UHID is a critical building block from a Universal Health Coverage perspective and is also the missing link in enabling a true longitudinal health record for the patient. This is critical in providing all individuals, equal access to quality healthcare at all times. The first step towards enabling UHC for a country is to identify uniquely all individuals who seek healthcare as patients. 

Many developed countries as well as some developing countries have already implemented the concept of UHID. These can provide valuable inputs to India, in finalizing our UHID implementation policy. It was found that different countries have followed varied methodologies and approaches for UHID implementation at the National Level. In the more advanced countries with robust civil or social protection laws, UHID is generated and assigned at the time of birth and is utilized for every healthcare transaction throughout a person’s life.

India is a democratic country where health is a state subject with flexible regulations, which gives States and citizens freedom of choice to adhere to the health policies they want to adopt. In such an environment, to enable access to quality healthcare for all, it is critical to define a well thought out UHID strategy that can seamlessly encompass various use cases and scenarios specific to India. 

The recommended UHID approach is - Create a National Unique Health Identifier for every person in the country and link it with Aadhaar or with any Government verifiable ID for authentication and validation of the persons information.

The categories and recommended approaches are provided here for ready reference. 

https://drive.google.com/file/d/1FeqmVkGMLTSeWexjGx1XluA4j8lATdne/view?usp=sharing

Various use cases were identified and studied to arrive at the recommendation. The population can be divided into 5 major categories with an associated approach to assign a UHID to the identified population group. The minimum data elements recommended for the Beneficiary Registry are also provided. 

We are also publishing the recommended minimum data elements for the Health Delivery Information Systems minimum viable product for Personal Health Records [PHR].

https://drive.google.com/file/d/1HU7cf6D4MmNx9YzNO1DpX2TInRgue1N5/view?usp=sharing

NDHB has also recommended a Health Locker to Maintain the Personal Health Records of the Individuals in the Health System. The Health Locker is a standards‐based interoperability specification that can be implemented by multiple players to enable the creation of a Personal Health Record. A personal health record, or PHR, is an electronic application through which patients can maintain and manage their health information (and that of others for whom they are authorized) in a private, secure, and confidential environment. The healthlocker either stores patient’s record in digital format pushed by various providers or can store eObject pointers to the patient record or summary stored in a source system against the Unique Health ID of the patient.

The health lockers enable creation of a longitudinal health record from the various eObject links/pointers available and enables retrieval and storage of the EHR for continued clinical decision making. All the related eObject pointers and ID documents can be loaded to the Healthlocker for the PHR, giving the individuals the right to their information and control the information which they may like to share with other stakeholders.

For More Information write to: info@librasocial.org