If it walks like a duck and quacks like a duck, is it a duck? In India, the answer may actually be no. The country has a longstanding problem of “quacks” – individuals who pretend to be doctors despite not having proper medical accreditation.

These amateur physicians have a very superficial understanding of health issues, but they nevertheless prescribe antibiotics and other drugs, says Dr RS Sharma, Chief Executive of India’s National Health Authority, adding that their treatments may end up hurting unsuspecting patients.

However, digitalisation may offer a solution, and Dr Sharma tells GovInsider about one such initiative: the Ayushman Bharat Digital Mission (ABDM), a scheme designed to digitalise and improve India’s healthcare system.

Creating more reliable healthcare

The ABDM was launched last September to help accelerate the digitalisation of healthcare across India, Dr Sharma says. Although the country’s larger hospitals started adopting digital tools years ago, many smaller clinics and hospitals are still reliant on pens and paper for service delivery.

But when Covid-19 hit, healthcare institutions were forced to go digital. Teleconsultations, online prescriptions and medicine delivery became commonplace. “Covid-19 has been a disaster for the whole world, including India, but at least there was one positive which came out of it – accelerated digitalisation,” Dr Sharma says.

Under the ABDM, India will introduce an array of digital platforms to facilitate the digitalisation of healthcare services. One way it is doing so is through the creation of digital registries of verified healthcare professionals and healthcare facilities nationwide.

This can help improve reliability in healthcare by introducing transparency. Currently, patients can gather feedback on which doctors are good or not based only on word of mouth. The digital registries will allow citizens to verify that their doctors are qualified and are not quacks.

“We’re creating a framework where everybody will be able to come on a single platform, and patients will be able to search for doctors, hospitals, drugs and so on,” Dr Sharma says.

Another way the ABDM promotes reliability is by integrating digital identity services. Digital identities can help healthcare organisations verify the identities of patients during teleconsultations, preventing possible scams or instances of identity theft.

Ensuring affordability through telehealth

The ABDM also supports a digital health account for all citizens in India. The Ayushman Bharat Health Account (ABHA) comprises a unique number that allows patients to link their electronic health records across disparate healthcare systems. Through it, doctors can access a patient’s medical history and make better diagnoses, reducing the overall cost of treatment, Dr Sharma says.

The ABHA number is also of considerable value for telehealth purposes. With digital health accounts, doctors need not rely on patients to report their health history, which may be prone to mischaracterisation. In a large country such as India, telehealth can also play a crucial role in making healthcare more affordable by eliminating the need for travel.

Another way in which teleconsultations make healthcare more affordable is by increasing accessibility to a larger number of doctors. “You are now connected to an entire national grid of doctors because the physical distance is immaterial,” Dr Sharma says.

In the past, healthcare resources were not optimised, as doctors in some parts of the country are overworked, but doctors in others suffer from a shortage of patients. Teleconsultations allow doctors to consult patients across the country, solving demand and supply concerns, and reducing the overall cost of healthcare.

Driving inclusive healthcare innovation

India is an extremely diverse country whose constitution recognises 26 official languages among hundreds of dialects and a range of differing scripts. In addition to language barriers, India also faces the problem of unequal education – illiteracy and educational deprivation exist side by side with high levels of educational attainment.

“When we design any digital system in our country, we have to ensure that it is inclusive. It should not exclude people who are digital have-nots,” Dr Sharma says.

This is why the National Health Authority places a strong emphasis on interoperability, which allows any IT system to connect with the ABDM, as long as it complies with its open published standards.

By ensuring its system is interoperable, the ABDM allows India’s healthcare sector to flourish with innovations catering to different demographics. For instance, tech providers can build telehealth apps in different languages, such as Tamil or Malayalam, and are still able to access patient health records easily through the ABDM network.

“We’re not the guys who are innovating,” Dr Sharma says. “We’re creating the underlying framework and allowing the innovators to innovate on top of it.”

To date, the ADHM has more than 800 partners creating various healthtech applications to help India’s healthcare institutions cater to increased numbers of patients.

Improving digital accessibility

As plentiful as the benefits of digital health are, citizens are unable to enjoy them if they lack access to the internet and mobile networks, making expansion of the country’s ICT infrastructure a prerequisite for healthcare digitalisation.

India is making strides in this area, with more than 1 billion mobile connections, 800 million internet connections and in excess of 600 million smartphones in use, Dr Sharma says. The country also promotes equal access to digital tech by keeping mobile connectivity prices low.

“We have the cheapest data rates in the world,” Dr Sharma says. Citizens can obtain one gigabyte of data for just US$0.10. “Good ubiquitous connectivity, cheaper data rates and 4G connectivity makes everything easier,” he adds.

The National Health Authority has taken it upon itself to bring tech to the forefront of India’s healthcare industry through the ABDM. And although tech is not a panacea for India’s healthcare challenges, it is an enabling tool that will help the country better cater to the health needs of its massive population.