What is Unified Health Interface (UHI) & how it can transform Healthcare in India?

Disclaimer: This is my personal blog. The opinions expressed in this blogpost are my own & do not necessarily represent the opinions, beliefs or viewpoints of my current or any previous employers.

The Digital India journey, started in 2014, has created many fundamental building blocks which form the basis of numerous public programs and initiatives run by the Government of India (GOI) today. It envisaged making India, a digitally empowered society and knowledge economy. There were two key early focus areas for building Digital India:

1. Create digital infrastructure and connectivity as a utility to the citizen. Unless we are connected, we can’t create a digitally empowered society. With the proliferation of cheaper smart mobile phones, internet connectivity has skyrocketed. Jio, Airtel and other players have ushered an internet revolution in India. We now have 1.2 billion mobile connections with 800 million internet connections. We have the cheapest data rates in the world. We leap frogged our way to internet connectivity without fixed line connections. 600K villages in India have 4G connections (with 5G on horizon) to deliver the benefit of digital government programs to netizens.
2. Foundational public software services, developed by the government, to empower digital innovation and delivery. Digital identity to plug into transactions, authentication & electronic KYC for security, digital lockers for secure storage of documents and electronic signature on demand are some of the initiatives, undertaken by government, to create an open and scalable platform to enable digital innovation. UPI or Unified Payment Interface, a scalable and frugal payment system developed as part of these foundational services, is clocking close to 4.2 billion transactions a month. Just to set the perspective, that’s close to ~100,000 transactions a minute.

Above two initiatives acted as enablers for the government to roll out many schemes to Indian citizens. One such scheme is Ayushman Bharat Yojana. It aims to provide health insurance and services to economically vulnerable citizens, who need healthcare. Though the scheme helped different sections of Indian society, it faced many challenges because of fragmented health infrastructure.

India still lacks the standards and infrastructure for health data that is needed to enable the accelerated adoption of digital health services. Covid highlighted the importance enabling digital health services. Below are primary structural challenges that hinder the delivery of digital health services.

1. Ecosystem Challenges: There is a non-standardized process for digital health services. The lack of digital records proves to be a hinderance for accurate delivery of health services.
2. Technical Challenges: There is fragmented health data standards and infrastructure. Thus, the engagement between provider and patient is dictated by the platform provider uses.

A decentralized, inclusive and open network may spur adoption of digital health services to address critical healthcare ecosystem needs. It can start with addressing problems in three key areas:

1. Discovery: Reliable and accurate search for hospital beds, drugs, O2 etc.
2. Booking: Easy scheduling appointments for treatment or vaccination.
3. Fulfillment: Teleconsultation with verified professionals.

As part of Ayushman Bharat, the Indian government has recently launched Ayushman Bharat Digital Mission (ABDM), with a vision to provide connected, affordable, accessible and quality healthcare to India citizens. This program plans to fill the gap created by fragmented and closed health systems and enable them to become open and interoperable.

As part of ABDM, the Indian government is developing different components which are going to play an important role in realizing the vision of providing connected, affordable, accessible and quality healthcare to India citizens. There are primarily four stack components which will work in tandem to realize this vision:

1. Drug Registry. A registry of all authentic drugs available across providers. It will be a boon for discovery of drug and its availability.
2. Health Facility Registry. A reference registry which will help locate health facilities like hospitals, labs, primary care centers etc, along with their capacity, services and other details.
3. Health Professional Registry. A registry of all health workers including doctors, Ashas, nurses and all health workers in the country. This will help everyone locate specialized doctors and nurses in a particular area.
4. Personal Health Record (PHR) Registry. The accessibility to PHR applications through a uniform registry will help patients get a horizontal view of their health records across different hospitals or health facilities. The access to these records will obviously be controlled by patients, who own it, and will be available only after adequate consent. The Health ID or Ayushman Bharat Health Account (ABHA) ID will be used to securely and uniquely identify and share health records with patient’s consent.

All the above components will help create an open and interoperable system with a unified gateway called Unified Health Interface or UHI. UHI will help enable massive innovation in the Indian health-tech space to provide different health services to Indian citizens in a very open and transparent manner. Telemedicine, health insurance, remote patient monitoring & healthcare, e-prescriptions, fast and seamless at-home blood testing service are some examples which can be facilitated by this open platform. UHI is one the most innovative and forward-looking initiatives rolled out by any government across the world. It has potential to bring the same transformation to healthcare as UPI brought to payment.

UHI ecosystem will have three stakeholders: Patients, Health Service Provider (HSA) and Technology Service Provider (TSA). Below diagram describes the communication between stakeholders:

Source: National Health Authority (NHA)

As a “Technology Service Provider”, software companies and startups have a great opportunity to bring innovation while creating a backbone for connecting Patients and Health Service Providers (HSA) for impacting Billion+ citizens.

Below diagram provides a detail view of UHI architecture, usage flow and its components.

Source: National Health Authority (NHA)

Though the core tech powering UHI will be built by an open community, National Health Authority (NHA) will provide gateway and governance support to run it in a reliable, efficient and fair way.

UHI is an amazing initiative and is currently under development. I am super excited to see how it will change the life of 1.39 billion Indian citizens. NHA and ABDM team recently conducted a hackathon to encourage developers to build on UHI platform. You can find more details about the initiative here: NHA | Official website Ayushman Bharat Digital Mission (abdm.gov.in)

Source:

NHA | Official website Ayushman Bharat Digital Mission (abdm.gov.in)

NDHM Sandbox (abdm.gov.in)