In April 2016, the National Payments Corporation of India (NCPI) launched the Unified Payments Interface (UPI) system, which revolutionised India’s payment industry. Today, UPI is the fastest-growing payment platform in the world, accounting for more than a billion transactions per month and has attracted the attention of global policymakers.

On August 15, 2020, the Prime Minister launched the National Digital Health Mission (NDHM), which aims to revolutionise India’s healthcare sector. The NDHM will create an “open digital health ecosystem” similar to what UPI created in financial services. It will serve as a backbone for an integrated digital health infrastructure and provide a platform for private innovations. Key features will include standardised health registries, a unique patient ID, federated health records, automatic claim settlement engines, etc.

A big disruption

The Covid-19 crisis has prepared the ground for widespread adoption of digital healthcare solutions. Till date, over five crore Indians accessed tele-consultation services from across 2,000 towns during the lockdown. The crisis has also brought together the public and private sectors to collaborate and solve urgent healthcare problems. Case in point: the launch of the Swasth alliance and StepOne — both providing Covid care platforms.

Such disruptions are necessary considering India’s weak health system. We believe an open digital health ecosystem can spur a fundamental transformation in India’s healthcare system and unlock economic value worth over $200 billion by 2030. Healthcare demand will increase by a cumulative value of $150-160 billion until 2030 due to improved access and more affordable care solutions. Efficiencies in healthcare delivery will arise from the adoption of standardised digital practices, creating $40-50 billion in savings.

Five themes will drive this transformation.

Information transparency: Currently, there is no reliable repository of data to verify a health facility or a doctor. This promotes quackery and inhibits the patient from receiving quality care. NDHM’s “health registries” will act as a single source of truth for all health stakeholders. This will increase trust in the ecosystem and reduce the administrative burden related to doctor on-boarding, regulatory approvals and renewals, and hospital or payer empanelment.

Interoperability: Across all systems and devices, it will enable a seamless flow of information among stakeholders, making it efficient to collaborate. It will allow the patients to share their health records across providers, enabling those to provide a true continuum of care. Additionally, users will be able to conveniently switch across data systems.

Standardised claim processing: NDHM’s claims engine will enable faster validation of claims and easy fraud prevention, thereby driving improved unit economics for both providers and insurers.

Prescription digitisation: This will lead to a re-balancing of power among health players. The legacy control over retail sales that many stakeholders currently enjoy will shift in favour of new models that are better able to serve in an e-market environment. For example, players that are able to digitally engage prescribers, consume e-prescriptions to up-sell or cross-sell, offer expanded services such as nudges for prescription adherence, will have an upper-edge in the ecosystem.

Innovations: With NDHM, the government’s role will expand to building common playgrounds which can be leveraged by all entities to build innovative patient-centric solutions. A new class of intermediaries will emerge to contribute to these innovations.

Changing dynamics

These themes will drastically change the healthcare market dynamics, threatening existing business models. We expect two big shifts to happen:

From episodic to wellness-oriented care : Currently, challenges across access, quality, and affordability inhibit Indians from seeking care. NDHM will bring transparency, enabling accurate demand-supply matching between patients and providers. With distance no longer a constraint, new opportunities will open for remote primary and post-hospitalisation care.

The reduced cost of claim processing will enable new offerings like out-patient insurance cover and dynamic premiums linked to health outcomes. Further, data and analytics will allow for innovations such as Clinical Decision Support Systems, standardising service quality.

From service-based to value-based healthcare : Currently, incentives across health stakeholders are misaligned. Payers try to withhold money from providers while providers try to increase patient footfall. Patient-centric care is largely ignored. NDHM’s “data analytics” platform will allow population-wide co-relation between stakeholder actions and health outcomes. Its public accessibility will enable patients to select providers that offer value-based healthcare. Additionally, increased transparency will improve provider discoverability, thereby intensifying competition. It will put pressure on prices and encourage providers to enhance their offerings.

NDHM will greatly empower patients by providing increased choice of service providers. We expect this to cause unprecedented change in products and delivery models. Healthcare players can thrive or perish, depending on how quickly they adapt to the new environment. Overall, this could lead to India leapfrogging its healthcare evolution curve.

Sangita is President, FICCI, and Joint MD, Apollo Hospitals Enterprise Ltd, and Janssens is MD and Senior Partner, The Boston Consulting Group Inc