Sir,
Technology is enhancing all spheres of our activities and health care is not exempt.
The International Medical Informatics Association's recommendations[1] focus on educational
needs for biomedical/health informatics professionals to acquire knowledge and skills
in information processing and information and communication technology in health care.
In India, the need for medical informatics was advocated as early as 1995.[2]
Digital India initiatives were launched in 2014.[3] The initiatives include technology
for health (e-Healthcare) that includes (i) online medical consultation, (ii) online
medical records, (iii) online medicine supply, and (iv) Pan-India exchange for patient
information. Globally, the broad scope of digital health includes categories such
as mobile health (mHealth), health information technology (IT), wearable devices,
telehealth and telemedicine, and personalized medicine.[4] Digital health is about
electronically connecting up the points of care so that health information can be
shared securely. This is the first step to understanding how digital health can help
deliver safer, better quality health care.[5]
I[6
7] have been advocating the incorporation of medical/health informatics in making
health-care delivery more informed in India. Even for achieving universal health coverage,
like the National Health Protection Scheme, announced in the 2018 Budget, the role
of public health informatics cannot be overemphasized. However, the realization that
there is a need for capacity building in health informatics in India seems to have
been unusually prolonged. There is an urgent requirement for the augmentation of current
health professional educational curriculum with concepts and awareness of health informatics.
Health informatics classes have to be embedded within the health professional curriculum
to prepare the future health-care providers who will invariably face digital information
explosion. Health informaticians will be necessary to manage patient documentation
during health-care delivery, while health information managers will manage the data
between the hospital admissions or encounters.
The Ministry of Health and Family Welfare realized the potential of health information
management and brought out a model curriculum in 2015.[8] Earlier they had formed
the Centre for Health Informatics, headed by me, that had developed the National Health
Portal, which hosted a helpdesk for electronic health record (EHR) standards that
had been notified[9] by the ministry.
The National Health Policy-2017[10] advocates extensive deployment of digital tools
for improving the efficiency and outcome of the health-care system. The policy aims
at an integrated health information platform or system which serves the needs of all
stakeholders and improves efficiency, transparency, and citizen experience. Delivery
of better health outcomes in terms of access, quality, affordability, lowering of
disease burden, and efficient monitoring of health entitlements to citizens is the
goal. Establishing federated national health information architecture, to roll-out
and link systems across public and private health providers at state and national
levels consistent with Metadata and Data Standards and EHR standards,[9] will be supported
by this policy. The policy suggests exploring the use of “Aadhaar” (Unique ID or UID)
for identification. Creation of registries (i.e., patients, provider, service, diseases,
document, and event) for enhanced public health/big data analytics, creation of health
information exchange platform and national health information network, use of National
Optical Fiber Network, and use of smart phones/tablets for capturing real-time data
are key strategies of the National Health Information Architecture. The policy advocates
scaling of various initiatives in the area of teleconsultation which will entail linking
tertiary care institutions (medical colleges) to district and subdistrict hospitals
which provide secondary care facilities, for the purpose of specialist consultations.
The policy will promote utilization of National Knowledge Network for teleeducation,
tele-CME, and teleconsultations and access to digital library.
The National Health Policy 2017 of India[10] states that recognizing the integral
role of technology (eHealth, mHealth, Cloud, Internet of Things or IoT, and Wearables)
in the health-care delivery, a National Digital Health Authority (NDHA) will be set
up to regulate, develop, and deploy digital health across the continuum of care. The
first task that the proposed NDHA will need to carry out is the formulation of a robust
National Digital Health Strategy, in consultation with all the stakeholders, for smooth
adoption of digital health throughout India.
Therefore, time now seems ripe to acknowledge and encourage health informatics as
an academic discipline that will decide the success or failure of health-care delivery
in Digital India through capacity building of professionally qualified health informaticians.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.