Author: Jyotika Rimal, Advocacy Officer, Menstrual Health and Hygiene Management Partners’ Alliance (MHM PA) Note: October 18th, 2023 marks World Menopause Day…
Author: Kritika Walia, National Health Authority, Government of India
Understanding the Unique Health IDs:
The landscape of healthcare is evolving towards a patient-centric approach, where patients actively manage their health. Unique Health IDs play a pivotal role in this transformation, breaking away from the traditional provider-centric model to empower patients and enable personalized care.
UHIDs are individualized digital codes that provide access to a person’s medical history and health data. These IDs are unique to each person and serve as a digital key to their medical history, treatment records, and health-related information. The primary objective of UHIDs is to accurately identify patients, streamline data exchange, and enhance the overall quality of healthcare services.
Enabling Patient-Centric Care with Unique Health IDs
UHIDs are instrumental in enabling patient-centric care, transforming the patient experience:
- Patient Empowerment: These digital identifiers empower individuals by granting them access to their health records, fostering a sense of ownership and control over their health.
- Seamless Data Access: Healthcare providers can access a patient’s complete medical history, regardless of scattered information sources, leading to more informed decisions and improved care quality.
- Efficient Care Coordination: UHIDs facilitate efficient collaboration among healthcare stakeholders, reducing errors, duplication of tests, and treatment delays.
- Personalized Care Plans: Based on a patient’s health history, providers can tailor treatment plans to individual needs and preferences, aligning with the core principles of patient-centric care.
Enhancing Care Coordination and Continuity
Enhancing seamless coordination of care is vital for patient-centric healthcare, and UHIDs play a pivotal role in achieving this goal. They break down data silos that traditionally separate patient information among providers and facilities, ensuring accessibility to authorized healthcare professionals. By providing comprehensive patient histories, UHIDs reduce the risk of medical errors, leading to safer care. Moreover, they enable proactive follow-up and preventive measures, such as timely screenings and vaccinations. In emergency situations, immediate access to a patient’s health information through their Unique Health ID can be life-saving, improving decision-making and reducing reliance on patient memory.
Global Adoption of UHIDs:
Unique Health IDs are not a concept confined to a single country or region; they are gaining traction worldwide. Different nations are implementing their own versions of these digital identifiers to improve healthcare services:
- United States: HIPAA mandates unique individual identifiers to enhance patient matching, reduce medical errors, and facilitate healthcare transactions. 
- United Kingdom: The NHS has introduced unique patient identifiers to improve care coordination and reduce administrative burdens on healthcare providers. 
- Australia: The Individual Healthcare Identifier (IHI) enhances communication among healthcare providers, ensuring accurate data access in the ‘My Health Record’ system. 
- Taiwan: NHI IC cards and the eID merge various digital IDs, including health IDs, for streamlined billing and online government service access, prioritizing data security and accuracy. [3,4]
- India’s Unique Health Identifier- ABHA: The Government of India has launched the Ayushman Bharat Digital Mission (ABDM), aimed at building digital health infrastructure for the nation. ABDM places a strong emphasis on security and privacy, aligning with the National Policy on Security of Health Systems and Privacy of Personal Health Records, which complies with the latest PDP Bill.  The key component of ABDM is the Ayushman Bharat Health Account (ABHA), which comprises a randomly generated 14-digit numeric unique identifier  that distinguishes individuals within the vast healthcare ecosystem. The ABHA number is closely linked to an alias known as the ABHA address, typically in the form of yourname@abdm.  This design allows individuals to link their ABHA number to multiple addresses, prioritizing individual privacy in healthcare.
As of September 10, 2023, ABDM has amassed around 45 crores of ABHA registrations, with 30 crores of health records linked . This linkage of health records eliminates the need to carry physical documents such as OPD slips, various reports, and specific medical histories, simplifying healthcare access.
Hospital Journey of a Patient: An Experience Based on ABHA
A classic example of patient-centric care is through the usage of ABHA, where the patient visits a hospital and scans the ABHA-based QR code where all his previous health records are stored in the ABHA and are visible to the doctor, this below process helps the patient in seamless interaction with the doctor:
Policy Challenges & Implications during the UHIDs implementation:
The implementation of Unique Health IDs is closely tied to several pressing public policy issues:
- The implementation of providing UHIDs across the large healthcare systems, to the whole population of a diverse country like India is itself a challenge.
- Limited Public Awareness: Many people are unaware that UHIDs even exist. Patients who are unaware of UHIDs may not be able to access their own medical records or participate in their care decisions fully.
- Healthcare Provider’s Inclusion: Some providers may not fully understand or prioritize their usage, leading to missed opportunities for patient care.
- Fragmented Healthcare: Without the ability to share and access comprehensive medical histories, patients may receive fragmented care, leading to potential misdiagnoses, duplicate testing, and compromised treatment outcomes.
- Digital Divide: Some individuals, particularly in underserved or elderly populations, may lack access to the technology necessary to participate in UHID systems, further exacerbating the issue.
- Affordability and Access: The integration of UHIDs requires significant investment in technology infrastructure so that the technology is accessible to all.
UHIDs are driving the shift to patient-centric healthcare by empowering individuals, improving coordination, and enabling data-driven decisions. While challenges like privacy and security exist, their role in shaping the future of healthcare, including telehealth, and global interoperability, is undeniable. As patients take a more active role, UHIDs will be their key to personalized, high- quality care. Policies should address the financial burden on healthcare providers, particularly smaller practices, and ensure equitable access to these technologies for all. Balancing innovation with privacy and equity considerations is a challenge and opportunity, which would require a coordinated effort from policymakers, healthcare organizations, and technology companies.
- White Paper on unique health identifier for individuals- https://aspe.hhs.gov/white-paper-unique-health-identifier- individuals#:~:text=HIPAA%20requires%20use%20of%20the,associated%20ad ministrative%20and%20financial%20activities.
- Unique health identifiers for Universal Health Coverage- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6800486/
- Deploying unique health identifiers: Case study of India, Taiwan, and Australia- https://www.orfonline.org/expert-speak/deploying-unique-health- identifiers-case-study-of-india-taiwan-and- australia/#:~:text=Australia’s%20unique%20health%20ID%20for,My%20Health
4. An Overview of the healthcare system in Taiwan- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3960712/
5. ABDM Website- https://abdm.gov.in/
6. ABHA Website- https://healthid.ndhm.gov.in/
7. ABDM Dashboard- https://dashboard.abdm.gov.in/abdm/