. Rittika Dey
2nd year, BBA in Hospital Management
NSHM Knowledge Campus, Durgapur
Dr. Babita Das Paul
Professor, Hospital Management Deptt,NSHM Knowledge Campus, Durgapur
(1.0) Policy Framework and Vision
(a) Evolution of Digital Health Policy in India
(i)National Health Policy 2017: emphasis on digital technologies -The National Health Policy (NHP) 2017 of India gave a strong push to the use of digital technologies for improving healthcare delivery and accessibility. The policy recognized that India’s vast population and geographical diversity require innovative solutions beyond traditional healthcare infrastructure. It emphasized the adoption of electronic health records (EHRs), telemedicine services, and mobile health applications to extend healthcare to rural and remote communities where doctors and hospitals are often scarce. To guide this digital transformation, the policy proposed the establishment of a National Digital Health Authority (NDHA), which would be responsible for standard-setting, regulation, and promoting secure health information systems. A major focus was on real-time data collection, disease surveillance, and effective monitoring of national health programs through digital platforms. At the same time, it underlined the importance of data privacy and security. This digital emphasis created the foundation for later initiatives such as the Ayushman Bharat Digital Mission (ABDM).
(ii)Launch of ABDM -The Ayushman Bharat Digital Mission (ABDM) was officially launched in September 2021 to transform India’s healthcare system through digital integration. It aims to create a national digital health ecosystem by providing every citizen with a unique Health ID, enabling secure access and sharing of medical records. ABDM promotes interoperability among healthcare providers, insurers, and patients, ensuring efficiency, transparency, and better decision-making. By digitizing health services, it enhances accessibility, reduces duplication, and supports continuity of care across the country.
(b) Core Objectives of ABDM
(i)Creation of a longitudinal health record for every citizen -A longitudinal health record (LHR) is a comprehensive digital record that tracks an individual’s health over their lifetime. It consolidates medical history, diagnoses, treatments, lab reports, and immunizations in a single, secure system. This enables healthcare providers to deliver personalized, informed care, improves disease prevention, facilitates early diagnosis, and supports better health outcomes for every citizen.
(ii)Development of a digital health ecosystem with interoperability- A digital health ecosystem with interoperability integrates diverse healthcare systems, devices, and applications, enabling seamless data exchange across providers, patients, and stakeholders. It ensures real-time access to accurate health information, enhances care coordination, reduces errors, supports informed decision-making, and fosters innovation, ultimately improving healthcare efficiency, quality, and patient outcomes.
© Strategic Significance
(i)Supports Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY)- A digital health ecosystem supports Ayushman Bharat – PM-JAY by enabling efficient patient identification, eligibility verification, and seamless claim processing. It allows hospitals, insurers, and government agencies to exchange data securely, ensures transparency in treatment costs, reduces fraud, and improves service delivery. By digitizing health records, it strengthens access to quality healthcare for vulnerable populations across India
(ii)India’s position as a leader in digital public health infrastructure- India has emerged as a global leader in digital public health infrastructure by developing large-scale, interoperable systems like the Ayushman Bharat Digital Mission (ABDM). The country leverages technology to integrate health records, telemedicine, and data analytics, ensuring accessible, efficient, and transparent healthcare delivery. Innovative initiatives, including health IDs, digital registries, and AI-driven insights, enhance population health management. This robust digital framework positions India at the forefront of leveraging technology for inclusive, scalable, and sustainable public health solutions.
(2.0) Digital Infrastructure and Technology
(a) Key Building Blocks
(i)ABHA (Ayushman Bharat Health Account) – unique digital health ID- The ABHA (Ayushman Bharat Health Account) provides every individual a unique digital health ID, enabling secure access, storage, and sharing of personal health records. It ensures continuity of care, simplifies medical history management, and supports interoperable digital healthcare services.
(ii)Health Facility Registry (HFR) and Healthcare Professionals Registry (HPR)- The Health Facility Registry (HFR) lists all public and private health facilities, while the Healthcare Professionals Registry (HPR) maintains records of licensed medical practitioners. Both enable standardized, accessible, and up-to-date information for planning, regulation, and digital health services.
(iii)Health Information Exchange & Consent Manager (HIE-CM)- Health Information Exchange & Consent Manager (HIE-CM) enables secure sharing of patient health data across providers, ensuring privacy by managing patient consent for access, exchange, and usage of their medical information.
(b) Technology Integration
(i)Cloud storage, APIs, and interoperability standards- Cloud storage securely stores health data online, allowing easy access. APIs (Application Programming Interfaces) enable different systems to communicate and exchange data. Interoperability standards ensure uniform formats and protocols, allowing seamless, accurate, and efficient sharing of healthcare information.
(ii)Linkages with e-Sanjeevani (telemedicine), CoWIN (vaccination), and Aarogya Setu- These linkages integrate digital health services: e-Sanjeevani enables telemedicine consultations, CoWIN manages COVID-19 vaccination tracking, and Aarogya Setu provides health monitoring, alerts, and contact tracing for public safety.
© Emerging Tools
(i)AI-driven diagnostics, wearable devices, mobile health apps-AI-driven diagnostics analyze medical data to detect diseases accurately and early. Wearable devices continuously monitor health metrics like heart rate, activity, and sleep. Mobile health apps offer personalized guidance, track progress, and enable remote patient care and engagement.
(ii)Blockchain potential for secure record keeping-Blockchain ensures secure, tamper-proof, and transparent health record management. By creating decentralized, encrypted ledgers, it allows authorized access, prevents data breaches, maintains patient privacy, and enhances trust, interoperability, and accountability across healthcare providers and digital health systems.
(3.0) Accessibility, Equity, and Inclusiveness
(a) Bridging Rural–Urban Divide
(i)Teleconsultations for rural and remote areas- Teleconsultations use digital platforms to connect patients in rural and remote areas with qualified healthcare professionals, overcoming geographic and infrastructure barriers. They enable real-time video or audio consultations, remote diagnosis, and prescription services, reducing the need for travel. Teleconsultations improve access to specialized care, support continuous monitoring of chronic conditions, and facilitate timely medical advice. By integrating with local health workers and digital tools, they enhance healthcare outreach, efficiency, and overall patient outcomes in underserved regions.
(ii)Integration with public health centers-Integration with public health centers connects digital health solutions with local healthcare infrastructure, enabling seamless sharing of patient records, test results, and treatment plans. This collaboration improves service delivery, strengthens disease surveillance, supports preventive care, and ensures continuity of care. By linking digital tools with on-ground health facilities, it enhances accessibility, efficiency, and quality of healthcare for communities.
(b) Equity in Access
(i)Empowering patients with control over health data-Empowering patients with control over their health data allows individuals to access, manage, and share their medical information securely. This fosters informed decision-making, enhances transparency, and strengthens trust between patients and providers. By giving patients authority over their records, it encourages active participation in care, improves personalized treatment, and supports better health outcomes.
(ii)Promoting public–private partnerships-Promoting public–private partnerships (PPPs) in healthcare leverages the strengths of both sectors to improve service delivery and innovation. Governments provide regulatory support and infrastructure, while private entities contribute technology, expertise, and investment. PPPs enhance resource efficiency, expand access to quality care, drive digital health adoption, and foster collaborative solutions that address public ealth challenges effectively.
(c) Challenges
(i)Digital literacy gap among patients and providers-The digital literacy gap refers to the difference in understanding and using digital health technologies between patients and healthcare providers. Many patients, especially the elderly or those in rural areas, may struggle with apps, telemedicine platforms, or electronic health records. Conversely, some providers may be highly tech-savvy but lack awareness of patients’ limitations. This gap can hinder effective communication, reduce adoption of digital health tools, and impact the quality and accessibility of healthcare services.
(ii)Uneven internet penetration and affordability concerns- Uneven internet penetration and high costs limit access to digital healthcare, especially in rural or low-income areas. Poor connectivity and expensive data plans prevent patients from using telemedicine, health apps, and online resources, widening healthcare inequities.
(4.0) Outcomes, Challenges, and Future Prospects
(a) Early Achievements
(i)Over 50 crore ABHA IDs generated (latest government data)- As of April 5, 2025, over 76 crore Ayushman Bharat Health Accounts (ABHA) have been created under the Ayushman Bharat Digital Mission (ABDM), marking a significant milestone in India’s digital health transformation. These unique health IDs enable citizens to access and manage their health records digitally, fostering a more efficient and transparent healthcare system.
The ABDM aims to establish an interoperable digital health ecosystem that connects patients, healthcare providers, and systems. This initiative facilitates the creation of longitudinal electronic health records for every citizen, enhancing the quality of healthcare delivery. As of April 5, 2025, more than 52 crore health records have been linked with ABHA IDs, demonstrating the growing adoption of digital health tools across the country.(Press Information Bureau)
The widespread generation of ABHA IDs signifies a transformative shift towards a digital-first approach in healthcare, aiming to improve access, efficiency, and equity in health services across India.
(ii)e-Sanjeevani crossed 20 crore consultations-As of April 6, 2025, India’s e-Sanjeevani platform has facilitated over 36 crore teleconsultations since its inception in 2020, establishing itself as the world’s largest telemedicine service for primary healthcare. The platform operates in two variants: e-Sanjeevani AB-AAM (Ayushman Bharat Ayushman Arogya Mandirs) and e-Sanjeevani OPD, offering remote and outpatient services respectively. With 130 specialties available, it has onboarded over 2.3 lakh healthcare providers and established more than 1.3 lakh spokes and 17,000 hubs across the country. Notably, the platform has supported over 1 million consultations in a single day, with a peak of 5,10,702 consultations. e-Sanjeevani has played a pivotal role in enhancing healthcare accessibility, particularly in rural and remote areas, by providing free and equitable medical consultations.
(iii)Integration of start-ups and private hospitals-The integration of start-ups and private hospitals into India’s digital health ecosystem strengthens healthcare delivery by leveraging innovation, technology, and additional resources. Start-ups contribute cutting-edge solutions such as AI diagnostics, telemedicine platforms, wearable health devices, and mobile apps, enhancing patient engagement and monitoring. Private hospitals, on the other hand, expand service reach and bring specialized expertise to digital networks. Collaborating with government initiatives like ABHA and e-Sanjeevani ensures standardized, interoperable systems. This public–private partnership model improves efficiency, accessibility, and affordability of healthcare, especially in underserved areas, fostering a more inclusive and technology-driven healthcare landscape across the country.
(b) Key Challenges of digital health
Digital health has emerged as a powerful tool to improve healthcare delivery through telemedicine, electronic health records (EHRs), mobile apps, and artificial intelligence. These technologies promise better accessibility, efficiency, and patient-centered care. Yet, despite their potential, several challenges limit their widespread adoption and effectiveness.
One of the primary challenges is the digital divide. Rural and remote areas often lack strong internet connectivity and affordable digital devices. Elderly patients or those with limited digital literacy also find it difficult to use online health platforms. This results in unequal access, where advanced services benefit only urban and technologically skilled populations, leaving vulnerable groups behind. Bridging this divide is essential to ensure equity in digital healthcare.
Another major issue is data privacy, security, and interoperability. Health information is highly sensitive, and any breach may cause serious harm to patients. Cyberattacks, unauthorized use, or weak security systems reduce trust in digital platforms. Additionally, the lack of standard formats for data exchange creates fragmented records, duplication of tests, and inefficiencies in treatment. Strong data protection laws and universal interoperability standards are necessary to overcome these barriers.
A third challenge is integration into healthcare workflows. Doctors and healthcare staff often find digital tools time-consuming or difficult to adapt to existing practices. Many experience digital fatigue, while unclear reimbursement policies discourage providers from adopting telemedicine or remote monitoring widely. To succeed, digital health must complement clinical practices through training, simple interfaces, and supportive insurance policies.
Finally, ethical and regulatory concerns remain critical. AI-based diagnostics can sometimes reflect bias, raising doubts about fairness and accuracy. Patients also fear losing the personal touch in healthcare or misuse of their data by private firms. Regulatory frameworks must evolve quickly to ensure safe, ethical, and trusted use of digital tools.
In sum, digital health offers great promise but faces challenges of access, security, integration, and trust. Addressing these systematically can make digital healthcare inclusive and sustainable
© Future Roadmap
(i)Moving towards Universal Health Coverage (UHC) with digital backbone-Digital health acts as a strong backbone for achieving Universal Health Coverage by improving access, affordability, and quality of care. Tools like telemedicine, electronic health records, and digital health IDs ensure inclusivity and continuity of services. By reducing geographical and financial barriers, digital platforms make healthcare more patient-centric, transparent, and accessible to all citizens.
(ii)Expansion of AI, IoT, and personalized medicine-The growing use of Artificial Intelligence (AI), Internet of Things (IoT), and personalized medicine is transforming healthcare delivery. AI enables faster diagnosis, predictive analytics, and clinical decision support, while IoT devices like wearables allow real-time monitoring of vital signs. Personalized medicine, driven by genomics and data analytics, tailors treatments to individual patient needs. Together, these technologies improve accuracy, efficiency, and patient outcomes, paving the way for smarter, preventive, and patient-focused healthcare systems.
(iii)Potential for India to become a global model in digital health-India has the potential to position itself as a global leader in digital health by leveraging its scale, innovation, and robust public health initiatives. With over a billion people, diverse health needs, and growing digital penetration, India provides an ideal testing ground for scalable health solutions. Flagship initiatives such as the Ayushman Bharat Digital Mission (ABDM), e-Sanjeevani telemedicine platform, CoWIN vaccination portal, and ABHA health IDs have already demonstrated the ability to deliver technology-driven healthcare efficiently, even in rural and underserved regions. India’s emphasis on interoperability, affordability, and inclusivity makes its model particularly relevant for other low- and middle-income countries. Moreover, active collaboration between government, start-ups, and private hospitals strengthens the digital health ecosystem. By prioritizing innovation, data security, and patient-centered care, India can not only meet its domestic health challenges but also provide a blueprint for sustainable digital health transformation worldwide.
Reference
1. Duffy, Christie & Moreno (2022) – The Challenges Toward Real-world Implementation of Digital Health Design Approaches: Narrative Review
Explores design methodologies like user-centered, patient-centered, and human-centered design, emphasizing the need for hybrid collaboration between digital and health experts humanfactors.jmir.org.
2. Akbar, Coiera & Magrabi (2020) – Safety Concerns with Consumer-Facing Mobile Health Applications: A Scoping Review
Reviews security and privacy challenges in mHealth apps, including issues of effectiveness, evaluation, and trust in digital health tools MDPI.
3. Angerer et al. (2022) – The Management Perspective in Digital Health Literature: Systematic Review
Investigates digital health from an organizational and managerial standpoint, highlighting research gaps, limited strategic focus, and the need for quantitative impact assessment JMIR mHealth and uHealth.
4. Canali et al. (2022) – Found in BMC Health Services Research (via a scoping review)
Addresses challenges and recommendations for wearable devices in digital health—touching on data quality, interoperability, health equity, and fairness BioMed Central.
5. Nguyen (2023) – Challenges of Blockchain Applications in Digital Health: A Systematic Review
Analyzes the potential and constraints of applying blockchain in healthcare, such as regulatory compliance, energy use, standards, and stakeholder accessibility arXiv.
6. Frontiers (2025) – Data Interoperability in Context: The Importance of Open-Source Implementations when Choosing Open Standards (J Med Internet Res, 2025)
Discusses the vital role of interoperability in digital health ecosystems and how open-source standards can support seamless data exchange across platforms Frontiers.