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Year : 2020  |  Volume : 1  |  Issue : 1  |  Page : 21-22

National digital health blueprint of India: A need for implementation research

1 Department of Community Medicine, HIMS, Dehradun, Uttarakhand, India
2 Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A and M University, Texas, USA

Date of Submission17-Nov-2020
Date of Acceptance07-Dec-2020
Date of Web Publication31-Dec-2020

Correspondence Address:
Prof. Sudip Bhattacharya
Department of Community Medicine, HIMS, Dehradun, Uttarakhand
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jascp.jascp_5_20

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How to cite this article:
Bhattacharya S, Hossain MM. National digital health blueprint of India: A need for implementation research. J Appl Sci Clin Pract 2020;1:21-2

How to cite this URL:
Bhattacharya S, Hossain MM. National digital health blueprint of India: A need for implementation research. J Appl Sci Clin Pract [serial online] 2020 [cited 2023 Mar 29];1:21-2. Available from: http://www.jascp.org/text.asp?2020/1/1/21/306102

Dear Editor,

The National Health Policy of India has emphasized on patient centered approach, quality of care, easy accessibility, and universal health coverage.[1] There is also a focus on leveraging the power of digital technologies to support these ventures. This vision is reinforced in the recently released National Digital Health Blueprint. It strives upon building a digital health ecosystem in India, comprehensively covering multiple domains. It also provides a set of principles and domain-specific components like universal health coverage, inclusiveness, security, privacy, education, and empowerment of the citizens. There is also a focus on technology-based components like building blocks, interoperability, multiple registries for single source of data. These policy discourses are facilitating the advancement of digital health in India.[2]

In consonance to the digital blueprint, Government of India formulated “Telemedicine Practice Guidelines 2020.” The objective of these guidelines is to encourage primary care physicians and frontline health workers by incorporating telemedicine in their day to day practice. This telemedicine guideline can empower primary care physicians and frontline health workers by providing current knowledge in real-time. It can also help the needy patients by providing effective and safe medical care. This guidelines emphasized about the protocols relating to- “physician-patient relationship; issues of liability and negligence; evaluation, management and treatment; informed consent; continuity of care; referrals for emergency services; medical records; privacy and security of the patient records and exchange of information; prescribing; and reimbursement; health education and counseling.” Various technical information like digital platforms, digital tools, which are available to the medical practitioners and its integration with the primary care has been described in detail. It also covered the legal aspects of telemedicine to safeguard the patients' interest. Like any other technology, telemedicine has also its limitations, risks, and drawbacks we assumed that it can be minimized through proper training, enforcement of standards, protocols, and guidelines.[3]

However, the implementation of digital health systems and interventions remain suboptimal across the nation. Two systematic reviews indicate a rather slow development and inequitable distribution of digital health technologies in India, attributable to several factors.[4]

Digital technologies provide easier access to several social determinants of health including employment, housing, education, and social networks. However, little is known about these digital determinants (ease of use, access, digital literacy, consumer segmentation approach, sustainability, cost etc.) in India. The evidence base on how digitalization is impacting these determinants is relatively poor. This is more critical for rural populations of India, who have lesser availability and accessibility of digital tools and technologies. Moreover, digital divide in health technologies is prevalent in different regions of India.[4] A systemic review from India found that digital interventions are low and it is heavily skewed on the urban region of southern part. This highlights a need to understand why other regions have low digitalization of healthcare interventions. Furthermore, sociocultural attributes of the users and providers of digital health services are likely to be diverse in the context of India, which is home to multi-ethnic and multi-cultural population groups. Both at the service delivery and institutional levels, these factors can inform how the ongoing efforts to promote digital health can be facilitated optimizing the operational aspects and fulfilling the population health needs in India.[5]

To address the existing digital divide and develop sustainable digital health in India, it is pertinent to examine Bourdieu's theories of social inequities evaluating how the social, cultural and economic capitals interact to reinforce and reproduce inequities in the era of continued digitalization of healthcare organizations and services.[6] It is necessary to determine how people's existing capitals shape their access to and use of digital technologies and what the implications of exclusion from the technologies are likely to be for the social determinants of health in the context of India. Such understanding may inform how people may overcome the vicious cycles of social health inequalities as well as digital divide due to lack of digital literacy and other challenges, which is yet to be explored. The policy makers and healthcare providers in India should acknowledge these challenges and facilitate implementation research examining how multi-level barriers affect digital health behavior among diverse population groups in India. Such evidence may contribute to better implementation of digital health initiative in India and facilitate reduction of health inequities in the era of digitalization.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

National Health Policy 2017: A cautious welcome | Indian Journal of Medical Ethics. Available from: https://ijme.in/articles/national-health-policy-2017-a-cautious-welcome/?galley=html. [Last accessed on 2020 Feb 17].  Back to cited text no. 1
Final Report on National Digital Health Blueprint (NDHB) | Ministry of Health and Family Welfare | GOI. Available from: https://mohfw.gov.in/newshighlights/final-report-national-digital-health-blueprint-ndhb. [Last accessed on 2020 Feb 17].  Back to cited text no. 2
Transforming Indian healthcare via telemedicine - Express Healthcare. Available from: https://www.expresshealthcare.in/covid19-updates/transforming-indian-healthcare-via-telemedicine/418106/. [Last accessed on 2020 Jun 18].  Back to cited text no. 3
Globalising artificial intelligence for improved clinical practice | Indian Journal of Medical Ethics. Available from: https://ijme.in/articles/globalising-artificial-intelligence-for-improved-clinical-practice/. [Last accessed on 2020 Feb 17].  Back to cited text no. 4
Hossain MM, Tasnim S, Sharma R, Sultana A, Shaik AF, Faizah F, et al. Digital interventions for people living with non-communicable diseases in India: A systematic review of intervention studies and recommendations for future research and development. Digital Health 2019;5:2055207619896153.  Back to cited text no. 5
Abel T. Cultural capital and social inequality in health. J Epidemiol Community Health 2008;62:e13.  Back to cited text no. 6


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