Digital health IDs face privacy challenge

The initiative by the state governments is in line with the National Health Policy (NHP), 2017, which seeks to implement the National Health Stack, under the National Digital Health Blueprint, an action plan for implementing comprehensive and holistic digital health. “A health ID is the first step towards creating safer and efficient digital health records for you and your family. You can opt-in to create a digitally secure health ID, which allows you to access and share your health data with your consent…,” according to the government’s National Digital Health Mission website.

The health ID enables citizens to interact with healthcare providers and “allows you to receive digital lab reports, prescriptions, and diagnosis seamlessly from verified healthcare professionals and health service providers”.

However, experts said there are challenges, such as privacy protection and interoperability of databases, which must be addressed. For instance, each state has its own database, and pulling out records from these databases will require very good bandwidth. “Each state creating its own electronics health records (EHR) system is fine. But when you are trying to have one integrated infrastructure across the country, the bandwidth of the connectivity from government hospitals to the cloud infrastructure has to be considerably increased,” said Srinivas Prasad, former chief executive, Philips Innovation Campus, and founder of Neusights.

Having the right bandwidth is key as files with health information will be large, considering that health records may include X-Ray and MRI scans, and one may face glitches in accessing data if the back-end infrastructure is not adequate.

Prasad said interoperability standards to bring the systems by each state into one national network will be a “huge effort and a huge spend”. “Even in a hospital, when decisions are made to upgrade to a certain system, the big picture is never looked into,” he added.

Jayanth Kolla, partner, Convergence Catalyst, who advises healthtech companies, said the systems are operating “in silos”, and implementation is a challenge. “For instance, the Centre’s Aarogya Setu and CoWin platforms, and Tamil Nadu’s and Delhi’s databases are not connected,” he said.

Also, digital health IDs are being introduced in India without a data protection bill in place. The Personal Data Protection (PDP) Bill was presented during the winter session of Parliament earlier this year. “This is a huge reason why we’ve all been talking about why there’s an urgent need to get the PDP out,” said tech policy analyst Prasanto K. Roy. “In the absence of the PDP, you have these completely arbitrary ad-hoc things around privacy rules,” he added.