Ensuring affordability of quality healthcare

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The aim of Ayushman Bharat Digital Mission is to optimise the use of digital infrastructure and digital connectivity to deliver health services efficiently with a major emphasis on patients. Under this, every citizen will now get a digital health ID and their health record will be digitally protected. Dr R S Sharma, Then Chief Executive Officer, National Health Authority, Government of India expresses his views on digital transformation in the health sector

Dr. RS Sharma

Then Chief Executive Officer, National Health Authority, Government of India

CoWIN is the digital backbone of India’s COVID-19 immunisation program. It unites vaccine makers, administrators, vaccinators, vaccination centres, and vaccine re- cipients at various levels of India’s health system. India has achieved the highest vaccination record of 2.5 crore doses administered in a day which is a testimony

of its scalability and capability of handling a high load.

The most recent phase of the vaccination program has allowed residents aged 15-17 years to get vaccinated, as well as HCWs, FLWs, and persons aged 60 years and above, to receive a precautionary dosage. The maximum number of people that can be registered against a single mobile phone number has been increased from 4 to 6. Citizens, health- care personnel, and frontline workers who have completed nine months after receiving the second dose are being sent automated SMS messages encouraging them to take the precautionary dose. In addition, registrations for children aged 12 to 14 years have already made opened. Therefore, considering the flexible nature of the platform, CoWIN is fully geared up for the third phase of vaccination.

This platform was built at a breakneck speed, with a strong focus on scalability. Initially, CoWIN started with an average of 20 lakhs vaccinations per day and grew up to achieving 2.5 crore vaccinations in a single day. The platform has proven that it can handle a large- scale user base. CoWIN’s engineers made changes to the platform at the start of each of the phases to accommodate an influx of new users. The platform’s simplicity increased its usability and acceptance among the recipients.

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“The overarching objective of Ayushman Bharat Digital Mission is to deliver health services in an affordable manner with quality and accessibility.”

The CoWIN platform assisted the government in keeping track of who has been vaccinated and who has not. Disadvantaged beneficiaries with no photo ID choices received targeted vaccination by the creation of special sessions. The platform’s agility and scalability have given policymakers the confidence to scale up the im- munisation program in stages, assuring a smooth procedure for beneficiaries, ad- ministrators, vaccinators, and vaccination centres.

CoWIN connects the last mile beneficiary of the vaccines. It provides a public dash- board and data visualisation tracking metrics that are updated in real-time. Avail- ability of data on a real-time basis allows to track and monitor the equation on the ground (wastage of vaccines, stock supply, and usage, resources required, vaccine status, etc) for better streamlining of processes. Administrators have used this in- formation to research immunisation trends and to streamline their efforts across the country. It also allows administrators to use user feedback to assess the ef- fectiveness of vaccine efforts. Thus, on a single plate, we can know the complete status of the vaccination program and make targeted policy-level decisions.

The eVIN technology was used to track the supply chain of COVID-19 vaccines across India’s vaccine supply chain. Existing infrastructures and plugins were used to implement the Ministry’s mandate of “individualised beneficiary tracking” such as integrated biometric digital identity solutions like Aadhaar into the system. Simi- larly, Certificate, Feedback, and AEFI modules were created using open source soft- ware – DIVOC, Digilocker, and SAFEVAC, respectively. CoWIN also established its open API policy, which has aided in the integration of third-party applications to provide vaccination services to beneficiaries via platforms such as Paytm, Make My Trip, and others.

CoWIN’s key feature is its ease of usage. It has enabled improved vaccine coverage and a systematic rollout of the program across the country by digitising every vac- cine delivery-related workflow at each touchpoint. With a citizen-centric approach in mind, there has been a complete design transformation with minimal data entry which makes the platform a success. Citizens can register and get vaccinated in the comfort of their own location. The CoWIN portal has been designed to ensure a minimum number of clicks while navigating the webpage.

The aim of Ayushman Bharat Digital Mission is to maximise the use of digital in- frastructure and digital connectivity to deliver health services efficiently with major emphasis on patients. Ayushman Bharat – Digital Mission, will now connect the digital health solutions of hospitals across the country with each other. The mis- sion will not only make the processes of hospitals simplified but also will increase ease of living. Under this, every citizen will now get a digital health ID and their health record will be digitally protected. Thus, India is working on a health model that is holistic and inclusive.

Ayushman Bharat Digital Mission has completed 27 major integrations across the Government and the private sector. This is a step toward developing a user-inclu- sive, integrated and interoperable digital healthcare eco-system. ABDM has devel- oped building blocks and interoperable APIs to offer a seamless digital healthcare experience for all stakeholders – health facilities, patients and healthcare profes- sionals.

The overarching objective of Ayushman Bharat Digital Mission is to deliver health services in an affordable manner with quality and accessibility. It enables every pri- vate or public player to integrate with ABDM. This is a wonderful architecture that will enable a scalable system.