Publication Type: Journal Article

Using lessons from deploying national digital health systems, IDHN faculty and collaborators propose an enterprise architecture framework for national-scale IT solutions for comprehensive primary care.

We propose that traditional methods to protect patient privacy and control won't work in the new digitized health ecosystem where data is collected, transmitted, aggregated across thousands of nodes instantaneously. We examine the merits and limitations of proposed alternatives like the fiduciary framework that imposes accountability on those that use the data; privacy by design principles that rely on technological safeguards against abuse; or regulations.

We call for the inclusion of regulatory sandboxes in the nation’s digital health ecosystem, as successfully done in the fintech sector, to provide a real-world testing environment for mHealth solutions before deploying them at scale.

AI can help universalize healthcare but to roll this vision out globally, thoughtful reconnaissance is needed of what problems need solving, what data are needed to solve them and how best technology can be leveraged to collect these data.

In a roadmap published in the Journal of Internet Medical Research, we proposed a federated, patient-centric, and application programming interface (API)–enabled health information ecosystem that enables the exchange of health information in conformity with India’s evolving data protection and privacy laws. Our proposed model has been adopted and implemented by policymakers in India — first by the NITI Aayog in its approach paper for the National Health Stack, and then by the Ministry of Health and Family Welfare in its National Digital Health Blueprint.

In this submission to the Journal of Public Health, we describe the development of an inexpensive, tablet-based digital system for conducting disease surveillance and monitoring resource utilization at the Allahabad Kumbh Mela in India, a 55-day festival attended by over 70 million people.