PMJAY in National Digital Health Ecosystem

1. PMJAY in National Digital Health Ecosystem Health & Wellness for All J Satyanarayana 30 Sept 2019

2. Uniqueness of Health Sector We need to design an Ecosystem, NOT Systems !

3. Key Features of National Health Policy 2017 • Universal Health Coverage • Continuum of Care • Better Access • Better Quality care at lower cost • Citizen-centricity • Accountability for performance • Holistic Approach • Federated National Health Information Architecture

4. National Digital Health Blueprint First Step in building a Digital Health Ecosystem

5. Evolution of NDHB Final Report expected shortly Stakeholder Consultation (Aug 19) Draft NDHB Report Published (July 19) Expert Committee formed by Health Ministry (Dec 18)

6. Digital Health Ecosystem Digital Health Ecosystem Electronic Health Record Standards Unique Health Identifier Security & Privacy Federated Architecture

7. Evolution of Digital Health Eco-System Technology Health Domain DH Vision

8. Principles of Digital Health Eco-system Domain Principles Technology Principles Interoperability (Public, Private) Universal Inclusive Building Blocks Educate, Empower Health & Wellness Architecture Think Big Start Small Scale Fast Single Sources of Truth (SORs) Security & Privacy by Design Open APIs National Portability Minimalist Design Performance, Accountability Leverage Legacy

9. Principles of Federated Architecture (for NDHB) • All Health Data and Applications are held at 3 levels – National, State (Regional) and Local (Facility) levels • following the Principle of Minimality at each level • Patient Data is held at the Point of Care or closest to it • Systems of Record (SoR’s) shall hold the primary data and all others will have access to it only through links • subject to the applicable permissions and consents. 4. Well-defined data protection obligations and compliances

10. Citizen Access Health Locker Health Portal(s) MyHealth App(s) Federated Architecture of NDHB Infrastructure Building Blocks S Application Building Blocks Application Building Blocks Application Building Blocks NDHB Ecosystem at the National Level NDHB Ecosystem at the State Level N Distributed Local Centralized Technology Building Blocks Technology Building Blocks NDHB Ecosystem at the Facility Level F Technology Building Blocks Data Building Blocks Data Building Blocks Data Building Blocks Public/ Private Public/ Private Public Assets Infrastructure Building Blocks Infrastructure Building Blocks

11. Citizen Access Federated Architecture of National Digital Health Ecosystem

12. Standards recommended • Consent • ISO 17975:2015 • Content & Interoperability • FHIR R4, SNOMED CT, ICD-10, LOINC • Privacy & Security • Information Security Stds , Access Control (ISO 22600:2014) • Patient Safety • BIS Standards for Electrical-Medical equipment

13. Implementation Framework • National Digital Health Mission • A new organization for Digital Health • Design & Implementation of Core Building Blocks • Promoting creation of other BB’s as per laid down Standards • Capacity Building & Change Management • 5-Year Action Plan

14. PMJAY & NDHB

15. Citizen Access Federated Architecture of National Digital Health Ecosystem

16. PMJAY can play a Pioneering Role in NDHB • Adopt the Principles & Standards defined by NDHB • Implement already available Standards in PMJAY 2.0 • EMR, EHR, FHIR R4, ICD x, SNOMED CT, LOINC • Set Standards or Processes, where none exists • UHID • e-Claims, Health Claims Platform, Continuum of Care • Consent Management-as-a-Service, Privacy Operations Centre • Establish Linkage with Wellness side • Identify, define and publish Open API’s to promote VAS

17. Thank You j.satya@nic.in

18. Recommendations • Constitute Multi-disciplinary teams • Domain & Technology experts • Architects, Designers, Practitioners • Design artefacts • MVA/ MVP • Forms & Formats • APIs • Consent/ Privacy processes • Sandbox, Pilots