NDHM: The nationwide implementation of the ambitious mission

About Author: Gaurav Gupta, Co-Founder & COO,  Navia Life Care. Gaurav leads the business team at Navia and is passionate about building a quality solution for the healthcare industry. Prior to this, Gaurav has successfully built two sustainable businesses, one being an enterprise solution for large billion-dollar enterprises and the other being a consumer product. An MBA from Indian School of Business, and an engineer from NSIT Delhi, Gaurav specializes in Strategy, Business Development and Marketing.

With a vision to create a digital healthcare ecosystem, the government of India announced the implementation of the National Digital Health Mission (NDHM) in the country. It addresses the inequalities in healthcare coverage by strengthening rural and urban healthcare infrastructure and improving delivery models. This results in a desirable requirement to ensure universal health coverage where dynamic healthcare systems and models can be regulated for cost-effective and quality care. Considering the scenario, it requires the involvement of healthcare stakeholders to overcome the challenges and fill critical gaps in achieving universal health coverage.

In a country like India, access to quality healthcare is a complex concept. Additionally, due to scarcity of resources, healthcare management becomes challenging. Given the dynamics of the sector, NDHM is expected to significantly improve cost efficiency and transparency of healthcare services across regions. Furthermore, digitization of conventional healthcare systems will enable patients to store their medical records electronically giving the practitioners better accessibility to patient’s medical history while ensuring appropriate treatment.

Implementation of NDHM

The development of healthcare in a digitized economy is the need of the hour. It will require an agile and strategized approach to achieve the sustainable goal of NDHM. The implementation of the mission is based on the approach of ‘Think Big, Start Small, Scale Fast’. It will occur in three phases deliberately planned to ensure universal health coverage in the country.

Roll out in Union Territories

This is the pilot phase of NDHM in which all technological platforms were desired to be developed by August 15, 2020. As an initial stage, the implementation of NDHM will be done to build the capacity of stakeholders in selected Union Territories – Andaman & Nicobar Islands, Chandigarh, Dadra & Nagar Haveli, and Daman & Diu, Lakshadweep, Ladakh, and Puducherry.

As part of the development stage, private and public institutions will be selected to initiate field testing of the product. Simultaneously, artefacts and building blocks of NDHM – HealthID, DigiDoctor, Health Facility Registry, eHospital, Patient Health Records will be leveraged to comply with the mission’s core principles. To ensure proper implementation, Phase 1 should be carried out in a time-bound manner. This will also include the utilization of the platforms by all stakeholders such as hospitals, doctors, medical clinics, pharmacies, patients, etc. Additionally, the work on implementing change management will be in full swing to ensure doctors’ training to digitize their internal workflows.

Expansion – States & Services

NDHM is aimed at ensuring universal health coverage. To enable that, the second phase of the implementation will involve the expansion of the work initiated in UTs to states. To onboard the process in other states, there will be a dedicated team to roll out the management of the mission. Carrying out such an expansive mission on a vast level requires people on every level. From initiation of the rollout to monitoring the mission, it will require extensive support from stakeholders.

For smoother implementation, the support from state mission teams, and specialists will play a crucial role in expediting the rollout process. Apart from this, the integration of all related state schemes will be promoted. On the other hand, the private sector in healthcare works differently than the public sector. Thus, there will be a focus on putting a dedicated team in place for the sector’s onboarding.

Nationwide roll-out

The final stage of NDHM’s implementation will involve the roll out of the platforms’ components across the country. It emphasizes development, beta testing, and Go Live for components which will be done zone-wise. Since India’s population is highly scattered into rural and urban areas, the implementation of NDHM will be initiated by marking zones.

Considering the rollout on each building block of the mission, the work in the implementation process will vary. In the final phase, real-time feedback and rating of doctors will be taken. Additionally, unified application forms, automated benefits enablement and linked to healthID, etc. will be taken into consideration for the effective implementation of the mission.

Agile Implementation Methodology

NDHM is one of the biggest missions in the history of the Indian healthcare sector. It will be based on the principles of the Agile India Enterprise Architecture (Agile IndEA) Framework. These principles involve – identification, definition, and assessment of value, development of Just Enough Architecture (JEA), Just in Time (JIT), adoption of the minimalist approach in all aspects and stages, designing federal architecture model, API-based access and Integration, evaluation and enhancement of individual experience, and following agile procurement methods. The agile implementation methodology of NDHM is projected to break the silos in the healthcare sector that was restricting its advancement and growth. With the agenda of ensuring universal health coverage, NDHM will support the national portability of services in the healthcare sector. When implemented properly, it can effectively streamline the entire system, benefit the key stakeholders, and achieve its goals smoothly.