National Health ID: The Key to Improving Healthcare Coordination and Efficiency
National Health ID: The Key to Improving Healthcare Coordination and Efficiency
By Sumit Singh, Founder & CEO, Timus Solutions, May 5, 2023
A Brief Background
As delivery of healthcare has evolved over time, a major innovation that came into mainstream over the past few decades was the advent of computerization to enable and enjoy the fruits of efficiency it delivers along with ready access at the point of care. A major player in this space is the Hospital Management Information System (HMIS) hosting Electronic Medical Records (EMR) that also saw major evolution in its own capabilities over time starting from easy low hanging fruits such as billing and appointments to more and more sophisticated use cases being added over course of time. To uniquely identify each patient in the HMIS, it became very apparent early on to have a unique identifier for each patient in it rather than rely by the patient name.
Having tasted quick success when compared to a paper-based institution, adoption of technology quickly resulted in a proliferation of systems within a single health center itself with a unique specialization such as for use in laboratory, radiology and so on. These systems faced similar conundrum and so went ahead to create their own way of identifying each patient uniquely. Now if this is the case in one hospital or health center, imagine when patient steps out and visits different centers due to necessity or choice for treatments for various ailments that might occur in the course of a lifetime. It won’t take long to extrapolate the various ways a single person will be identified in these multiple healthcare IT systems. This is the genesis for the need to have a Electronic Health Record (EHR) that cuts across various systems and not limited by place of treatment. And a need to uniquely identify patients across these systems also arose and the concept of National Health ID also came into being.
But is it a Good Idea?
In my mind, this is not much of a debate and has the potential to deliver many benefits for all players involved. To start with, whenever a patient visits a healthcare facility, the registration and the lookup process could be much eased and quite seamless with a National Health ID. Further, it has the ability to assist in sharing patient information, streamline communication and enhance coordination of care. It can be further argued that it will lead to enhanced system to system interoperability and thus sharing of patient data real time. This then has all the ingredients of a longitudinal medical health record for the patient which directly addresses the problem of incomplete or outdated data coming in to play. As one can imagine, it has a huge potential not only reduce costs by eliminating unnecessary or repetitive medical tests which could be still useful reducing costs, but also reducing errors of various kind. Both of these, that is reducing cost of care and making it easier to get medical service, deliver direct benefits to the patients by enhancing the quality of care.
Further, access to health data will also be easier for the patients and their care givers as well which will enhance adherence by taking a more active role over the treatment regimen. Thus the patient is better engaged and empowered to be in control more than before. With reduced overall costs and standardized way to access to healthcare, the barrier to care is reduced. This will have a positive impact on the underserved and underprivileged patients who were left out of the healthcare system otherwise. Moving on, population health management is a very important area which tries to improve overall health and mortality paraments from immunizations to infectious disease management. This was clearly evident during the Covid-19 pandemic. A National Health ID enables to monitor and address related concerns in a more precise and accurate methods quickly which could otherwise be less effective. One can also imagine in case of emergency situations, such during natural disaster or drug recalls, a National Health ID can hasten the speed to reach the effected patients to advice the best course of action. Further, with the advent of better tools and methodologies on the back of artificial intelligence, machine learning, etc., the quality of research utilizing data analytics is greatly enhanced with all likelihood to reach grass root levels sooner than later making cheaper, greater and faster impact. I also feel this will lead to improvement in patient privacy as access to patient data would be far more controlled with holistic checks and balance, specially to sensitive data that could lead to discriminations of various kind, with the alternate being left to an unsystematic approach left to individual systems peppered across a nation.
What is the current state for National Health ID?
With so many benefits, has there been significant progress in this arena globally? UK’s National Health Service (NHS) has been using the NHS Number for a while and is working for improving digital health infrastructure including the use of EMR. India has embarked on the Ayushman Bharat Digital Mission (ABDM) for the past few years and has been creating the India’s Digital Health Ecosystem. It has been assisting every individual in creating Ayushman Bharat Health Account (ABHA) and providing a ABHA Number with the intent to store the medical history of the patient. In the US, a single number is not in use, but under the Health Insurance Portability and Accountability Act (HIPAA), it has set a number of standards for electronic exchange of healthcare information and use of EHR for similar purposes. The EU region also does not have a single unifying Health ID, rather leaving it to its member nations to manage it, but it has European Health Insurance Card (EHIC) which allows for a patient access across EU. While both Brazil and China though have taken concrete steps for a National Health ID, other nations like Russia, Indonesia, Mexico and Nigeria have not done much on this space. However, it is quite evident that most large economies have taken some concrete steps that envisages ways to reap the benefits some of which I listed earlier.
Things to Look Out For
To start with, the setup of a National Health ID is not an easy task and the implementation will pose quite a challenge due to scope. This will include spends on new technology and infrastructure. Further, it will require various players in the sector to join hands to make it successful. Additionally, with an easier access to full longitudinal medical record of a patient, it is very important to have necessary steps to both prevent from cybersecurity related issues and breach of privacy, specially as in all likelihood it will contain sensitive data, from users who may not be authorized and lead to misuse or more. This may also lead to potential discrimination and strict controls are required to be put in place. Finally to conclude, it is imperative that the data that the National Health ID will lead to is both accurate and complete. If certain sections are not included, say for example radiology images at the initial stages, it must say so very clearly so as to be very clear as any missing or wrong information could in all likelihood lead to poor treatment.
Do drop in a line with your thoughts or comments at sumit.singh@timussolutions.com.
Timus Solutions will be happy to collaborate and work with you on your business challenges.