What is ABDM?

ABDM, or Ayushman Bharat Digital Mission, is a flagship program of the NHA (National Health Authority). Originally named NDHM, standing for National Digital Health Mission, it has since been rebranded as ABDM. However, its acronym, ABDM, bears resemblance to the Ayushman Scheme (PM-JAY), causing considerable confusion among healthcare professionals and patients alike. Over time, there has been a gradual understanding of the differences between the two initiatives.

This article focuses solely on ABDM, excluding discussion of the PM-JAY scheme. Nonetheless, prevalent myths persist among Indian healthcare professionals regarding ABDM, prompting the need to address and dispel these misconceptions.

ABDM's primary objective is the digitization of health records, ensuring their availability to patients in a longitudinal format, thereby enabling every Indian citizen to possess a comprehensive health record. However, India's diverse and democratic nature presents unique challenges. Healthcare delivery involves a mix of public and private enterprises, each healthcare facility operating differently and catering to varying needs.

Establishing uniformity in longitudinal health records for patients, especially considering their frequent visits to different healthcare providers, poses a significant challenge. Unlike the UK's centralized NHS, India's approach necessitates the development of protocols and systems tailored to the native healthcare landscape. To establish longitudinal medical histories of patients, there is a need for interoperable software across the nation, such as HIMS and PHR.

ABDM's architecture prioritizes the federal nature of data, analogous to India's structure as a Union of States. This means that patient data generated remains at the place of its generation, typically with healthcare providers. Only the links to this data are indexed with the NHA gateway. When a patient visits another hospital, with their permission, the data gateway signals the indexed link to send a copy of the data to the requesting healthcare facility.

Major components of ABDM:

Healthcare provider/Health repository providers (HRP), ABDM gateway, and Health information users. These three are primary components of ABDM.

Healthcare provider/Health repository providers (HRP):

Many healthcare providers get confused between healthcare provider and health repository providers. These two are functionally the same but may be different physically. If this still confuses you, I will clarify. For creating records, healthcare providers do not develop software themselves; they depend on vendors. From the standpoint of ABDM, although health repository provider and healthcare provider are similar or the same, physically they may not be the same entity.

ABDM gateway:

This central repository stores only the index of patient data, indicating which data of which patient is present where. It does not store any actual patient data. Patient data must be with healthcare providers. Healthcare providers, via health repository providers, are supposed to send information of patient data being generated at their place whenever it occurs. Healthcare providers need not worry about this; it all happens automatically each time without taxing healthcare providers any extra effort, provided they use the software, i.e., HIMS, which is ABDM compatible. There are three milestones which HIMS must complement in order to become ABDM compatible, more about this below.

Health information users:

Health information users are entities who only have read-only access to patient data, of course with patient consent. This could again be another hospital itself when a patient of another hospital comes there with their digitized records. This could also be a PHR app, which is a patient-side app that can have a personal copy of health records in the digital lockers of their choice. It could also be an insurance company that handles patient health claims as they need patient health records.

Milestones for ABDM-compatible software or HIMS:

ABDM has prescribed three milestones for software vendors to become ABDM compatible. Milestone 1 is about the creation of ABHA card, milestone 2 is about linking patient data with the ABDM Gateway and sending the data to needed ABDM-compatible software when signaled to do so, and the third milestone is about accessing and displaying patient data from another healthcare provider.

ABHA card:

This is similar to the Aadhar card but it is related to health data. It contains the ABHA number, a 14-digit number different from the Aadhar number but is generated using it, and also the ABHA address, very much similar to an email ID but ending with more often @abdm reflecting the name of the consent manager attached to the ABDM gateway. As of now, there is only one consent manager, but in the future, there could be more than one consent managers. This becomes the UHID of the patient, and all ABDM-compatible software must store data marking them linked to this ID, i.e., ABHA address. You could learn more about ABHA from this article.

HFR and HPR:

Similar to ABHA for patients, even healthcare facilities will also have registries and IDs, HFR for healthcare registry and HPR for healthcare professionals. This includes, along with doctors, nurses, technicians, etc. You can learn more about this from this article.

HCX Health Claim Exchange:

Health claim exchange is another facet of this ABDM ecosystem. This helps automate health claims, thus increasing insurance penetration. This will help to take the load of health claims. You can read more about this from this link.

UHI:

This is also one more facet of ABDM dealing with teleconsultation and also remote care. You can get more information about this from this link.

Nice HMS:

Nice HMS is one of the few software HIMS which is ABDM triple milestone compliant. You can get a demo by filling the form below or writing to us at this email admin@nicehms.com. Our HIMS is user-friendly and has been designed with Indian healthcare entities in mind. This is very cost-effective.

Conclusion:

In conclusion, ABDM, the Ayushman Bharat Digital Mission, spearheaded by the National Health Authority, stands as a transformative initiative aimed at digitizing health records and enhancing healthcare accessibility across India. Despite initial confusion surrounding its acronym and comparisons to existing schemes like PM-JAY, ABDM has steadily gained recognition for its unique objectives and strategies.

By prioritizing the digitization of health records in a longitudinal format, ABDM endeavors to empower every Indian citizen with a comprehensive health record. However, the diverse nature of India's healthcare landscape poses challenges, necessitating the development of tailored protocols and interoperable software solutions like HIMS and PHR.

The architecture of ABDM underscores the federal nature of data, ensuring patient information remains with healthcare providers while facilitating seamless access through the ABDM gateway. With milestones set for software compatibility and initiatives like the ABHA card and HCX Health Claim Exchange, ABDM is poised to revolutionize healthcare delivery in India.

As ABDM continues to evolve and address prevalent myths and misconceptions, its impact on healthcare accessibility and efficiency is poised to be profound. Through collaborative efforts between stakeholders and the adoption of innovative technologies, ABDM holds the promise of realizing a more digitized and patient-centric healthcare system for the nation.