Can India leverage its DPI to improve health outcomes for citizens?

India has built one of the world's largest digital health identity ecosystems, registering over 900 million Ayushman Bharat Health Accounts (ABHAs) as of this May. 

Rather than operating as isolated digital systems, data exchanges such as the Healthcare Professionals Registry (HPR), Health Facility Registry (HFR), Unified Health Interface (UHI) and

National Health Claims Exchange (NHCX) are also creating an ecosystem where healthcare providers can work together. 

Digital ID and data exchange are the two key pillars of digital public infrastructure (DPI) that form India's national digital health initiative, known as the Ayushman Bharat Digital Mission (ABDM). 

ABDM is managed by the National Health Authority (NHA), connecting patients, doctors, and hospitals through a shared digital system. 

More than 450 public and private health tech solutions have integrated with ABDM, enabling secure and consent-based exchange of health information across hospitals, laboratories, clinics and digital health applications.  

The next challenge of ABDM is turning infrastructure into more accessible healthcare and better outcomes for citizens. 

Creating demand—not just infrastructure 

National Health Authority (NHA)’s former Project Coordinator, Dr Hardik Sankhla, says to GovInsider that the next phase of ABDM is less about integrating more healthcare providers and more about creating meaningful use cases for citizens.  

During his time at NHA, he worked with more than 40 healthtech companies to support their integration with ABDM and helped simplify the mission's sandbox ecosystem. 

"Today, much of the focus is on integrating hospitals, laboratories, pharmacies and digital health platforms. But digital ecosystems become truly self-sustaining only when the end user actively wants to participate," he explains.

A faster, interoperable and largely paperless claims process would mean quicker approvals for patients, lower administrative burdens for providers, and more efficient workflows for insurers.  

These are tangible improvements that people notice in their healthcare journey. 

As more citizens experience these benefits, digital participation becomes less of a policy objective and more of a public expectation. 

Prevention is the next frontier 

Connected health records alone, however, will not transform healthcare. 

The next opportunity lies in using India's digital health ecosystem to identify disease earlier and shift healthcare from treatment to prevention. 

"India is facing a silent epidemic of chronic lifestyle diseases," says Redcliffe Labs Founder and CEO, Aditya Kandoi. Redcliffe Labs is a diagnostics provider that is currently working towards integration with ABDM. 

In India, non-communicable diseases (NCDs) account for 68 per cent of all deaths annually, with 55 per cent of deaths occurring before the individuals turn 70 years old, according to World Health Organisation (WHO)’s statistics cited by a recent study. 

As majority of NCDs are caused by lifestyle choices, early diagnosis and preventative health interventions stop the disease from developing or worsening. 

"People often think of diabetes, hypertension and high cholesterol as separate diseases. In reality, they are closely interconnected through metabolic health," Kandoi says. 

Although India has increased life expectancy over the past few decades, healthy life expectancy has not improved at the same pace.  

Although Redcliffe Labs has not yet integrated with ABDM, the diagnostics provider has initiated the process and sees significant potential for the ecosystem to improve preventive healthcare and continuity of care.  

Diagnostics account for only a small proportion of overall healthcare spending despite informing the vast majority of clinical decisions, he says.

Yet many people avoid preventive testing because of fear, inconvenience, or cost. 

To lower those barriers, Kandoi suggests use of artificial intelligence (AI)-powered facial scan capable of estimating several health indicators - including heart rate, stress levels, body mass index and hypertension risk - in around 30 seconds without requiring a blood sample. 

The objective is not to replace laboratory diagnostics, but to encourage more people to take the first step towards understanding their health. 

Technology, however, cannot create behavioural change on its own. 

He says awareness remains equally important as the first step towards prevention. 

From DPI to healthier citizens 

The conversations with Sankhla and Kandoi point towards a common conclusion. 

India's next phase of digital healthcare is unlikely to be defined by the number of digital identities created or the number of hospitals connected to the network. 

Instead, success will depend on whether DPI delivers services that citizens genuinely value. 

For some, that may mean faster insurance claims, seamless access to medical records, or better continuity of care across providers. 

For others, it may mean affordable preventive screening that identifies disease before symptoms appear. 

Alongside these services, trust will remain essential.  

Citizens will only embrace digital healthcare if they are confident that their personal health information remains secure, consent-driven and protected under India's Digital Personal Data Protection Act. 

Today, the challenge for the Indian government is no longer building the infrastructure, but ensuring citizens experience enough everyday value that digital healthcare becomes the natural way to navigate the system.