Thursday, December 11, 2014

Proper way to implement ICT tools for the National Health Assurance Mission (NHAM)

What practical steps can a country take to begin to develop a NeSF (National eHealth Standards Framework) that supports health care delivery and UHC initiatives? The following are recommended by Ritz, Althauser and Wilson [2014] as useful, actionable steps:

1. Storyboard: Develop a set of characteristic user stories that illustrate both the care workflows and the health insurance workflows common to the country. These stories should be aligned with the country’s health strategic goals (e.g., if improving maternal health outcomes is a strategic goal for the health ministry, draft stories describing maternal care delivery activities).

2. Stack: Based on the requirements and the constraints in the country, choose a “stack of standards.” [MoHFW, Government of India has already notified the Standards for EHR in India in August 2013. The National Health Portal also offers a Help Desk for that.]

3. Scope: Narrow the initial implementation scope and grow the scope over time. Any country embarking on a national-scale eHealth infrastructure effort will be well served by focusing on a few key areas. [A “crawl, walk, run” strategy “from the essential to the optimal” is more practical.]

Keeping the above recommendations in mind, India needs to incorporate the NeSF within its National eHealth Strategy / Policy (NeHS/NeHP) that has to be formulated by the Proposed National eHealth Authority (NeHA). It will be good if the NeHA is set up immediately so that the NeHS/NeHP for India can be outlined, in consultation with all the stakeholders, especially the state governments, as Health is a State subject in India. India’s NeHS/NeHP has to be aligned with the National Health Policy, Digital India initiatives, as well as the proposed National Health Assurance Mission (NHAM) policies, so that a focused and judicious use of ICT can make the healthcare delivery systems more efficient and transparent. It will be good to build the ICT policies of NHAM upon the existing ICT mechanisms of the National Health Mission (NHM) and the Rashtriya Swasthya Bima Yojana (RSBY) instead of reinventing the wheels.