IDHN is a Harvard-wide research and policy collaborative focused on the development of a patient-centric, provider-friendly, API-enabled health exchange ecosystem. Our key partners in India include government agencies, healthcare enterprises, clinical providers and researchers from across the country.
The IDHN initiative was launched with seed funding from the Provost Fund for Interfaculty Collaboration and the Asia Center at Harvard University, and the Tata Trusts
India’s 1.3 billion people seek healthcare through a maze of public and private providers – the majority of these interactions are captured on hand-written paper records, or not at all. In January 2018, the Government of India announced what is potentially the world’s largest health insurance scheme, offering coverage for up to ₹500,000 (USD 7600) to approximately 500 million people. The need to monitor and evaluate services and payments for this vast insurance scheme will provide the impetus needed to jumpstart the health ecosystem. This greenfield also allows India to envision a bold new architecture for digital health data that avoids the shackles of redundancy and inaccessibility faced by health information exchange in the United States.
To realize the full potential of health data application for advancing clinical care, scientific discovery, and healthcare access, India needs to first build and seed its digital health data ecosystem. Our Roadmap presents an API-enabled federated architecture for India, anchored on the Personal Health Record, in stark contrast to the siloed and monopolistic US model.
Our team of scientists from India and Harvard are developing scalable prototypes for health data exchange that will build on the core principles outlined in our ROADMAP, published here, and on the Blue Book released by the NITI Aayog, available here.
- A Federated Architecture underpinned by Personal Health Records
- Prioritization of Patient and Population Needs overbilling and compliance
- Substitutability, that allows for a play-and-plug model of highly customizable applications that can address varying context-specific needs, and that respond to market incentives for better user-interfaces
- Data-minimization that allows the creation of an “EHR-lite”
- Technological solutions to ensure adherence to data and privacy regulations in India. Such Privacy by Design will be further supported by automated, consented and audited data flows.
Our partnership includes key research and healthcare institutions across the entire delivery system, including the St. John’s Research Institute (Bangalore), Seth G.S. Medical College & KEM Hospital (Mumbai), Government of India NCD Program and Dell EMC (Karnataka), iSPIRT, and primary care centers in both rural and urban India, committed to training, capacity building, prototyping and developing a federated API-enabled exchange ecosystem. The proposed model will avoid expensive proprietary health information silos and monolithic homogenous EMRs with centralized repositories, both of which are riddled with concerns for security, timely data transfer, usability, and high physician burnout
The First 12 Months
We are currently working in four main domains, in parallel with the development of the National Health Stack proposed by NITI AAYOG in collaboration with the iSPIRT:
- The creation of EHR “lites”- Electronic Health Records for small and mid-size health centers, that are easy to deploy and customize.
- The creation of an open access decision support platform for primary care (to capture reliable primary care data, while ensuring quality of care)
- Field-testing of large and small digital tool rollouts (including GoI’s NCD program)
- Prototype demonstration of a city-wide Personal Health Record that will draw data from multiple nodes in the system (proposed city: Bangalore)
- Reimagining Health Data Exchange: An Application Programming Interface–Enabled Roadmap for India. Journal of Medical Internet Research, Vol. 20 (7). (2018) doi: 2196/10725
- Responses to the White Paper of the Committee of Experts on Data Protection Framework for India: A Lens on Health Data. FXB Center for Health and Human Rights, Harvard University. (2018)