Digitising the health data of a billion people sure has its benefits, but government think-tank NITI Aayog has also ruffled some feathers by floating a consultation paper on the ‘National Health Stack’ (NHS).
The draft, which suggests that health data would be used for marketing, may not go down well with the masses.
It defines the NHS as a national electronic registry usable by both the Centre and the States across public and private sectors.
One of the components of the proposed project is to store every Indian’s Personal Health Records (PHRs). This will involve medical history, medication and allergies, immunisation status, laboratory test results, radiology images, vital signs, personal stats such as age and weight, demographics, and billing information, and use of multiple health applications.
“Various layers of the National Health Stack will seamlessly link to support national health electronic registries, coverage and claims platform, a federated personal health records framework, a national health analytics platform, as well as other horizontal components. The stack will embrace health management systems of public health programmes and socio-demographic data systems,” the draft says.
“The population level base of such an IT system would be individual health records logged through the Health and Wellness Centres in rural areas, and corresponding primary health care in urban areas,” said VK Paul, Member (Health), NITI Aayog.
The design of NHS is based on India Stack, a voluntary project designed by Nandan Nilekani, a former CEO of Infosys and a former Chairman of the Unique Identification Authority of India (UIDAI), and several others, many of whom worked on the Aadhaar project. The National Health Stack rests on the JAM trinity of Jan Dhan accounts, Aadhaar, and mobile numbers.
For example, one of India Stack’s services — Aadhaar Bridge is run by Khosla Labs, which is registered with the UIDAI, and is an online service which makes it easier for companies to access the Aadhaar National ID system for authentication purposes. At the moment, Aadhaar Bridge has 250-plus corporate clients, including Piramal, Star Union Dai-Chi Life Insurance, Hinduja Leyland Finance, etc who pay Khosla Labs to use services. NHS goes a step further, so as to give ‘access with consent’, to private players.
Denny John, a Delhi-based health economist says it was extremely important to safeguard health data, because it is sensitive. “Marketing ploys of private companies, big pharma could be based on access to such data. Also, the draft needs to make clear the process of obtaining such consent. Pharma companies are dying to have real-world evidence which could now be available to them through the stack,” John said.