Ayushman Bharat Digital Mission (ABDM): A Transformative Step Towards Universal Health Coverage (UHC) in India

Author: Deepali Kausshik, Young Professional, National Health Authority

In India, the pursuit of universal health coverage (UHC) has been a long-standing goal, aiming to ensure that all individuals and communities have access to quality, affordable healthcare services without facing financial hardship. While significant progress has been made in expanding healthcare access, disparities in healthcare utilization and outcomes persist, particularly for underserved populations. The Ayushman Bharat Digital Mission (ABDM), a flagship initiative of the Government of India, has emerged as a transformative initiative, poised to revolutionize healthcare delivery through digital transformation and pave the way for achieving UHC in the country.

The Pillars of Transformation: Components of ABDM

1. Ayushman Bharat Health Account (ABHA): A 14-digit unique identifier, that assures a strong and universally accepted identity within India’s healthcare landscape, facilitating seamless access of health records across healthcare providers. It unifies healthcare benefits and aids in eradicating registration hassles, streamlining access to individuals over their health records [1]
2. Health Professional Registry (HPR) and Health Facility Registry (HFR): Comprehensive registries like the Healthcare Professionals Registry (HPR) and Health Facility Registry (HFR), ensure better coverage by connecting patients with verified practitioners and diverse health facilities across India. HPR serves as a certified repository, guaranteeing registered healthcare practitioners for modern and traditional medicine systems [3], while the Health Facility Registry includes a repository of diverse health facilities (both private and public), fostering accessibility to hospitals, clinics, laboratories, and pharmacies across the healthcare systems [4].
3. Drug Registry: A centralized repository standardizing drug information across medical systems, ensuring authenticated drug supply and enhancing patient healthcare experiences. [5]
4. Unified Health Interface (UHI): Enabling seamless communication among stakeholders and facilitating diverse health services’ accessibility through various applications, akin to UPI in payments. [6]
5. ABHA Application: Empowering individuals with control over their Personal Health Records (PHR), consent-based sharing of records, fostering informed decision-making, and longitudinal health record creation. [2]
6. National Health Claims Exchange (NHCX): A platform enabling seamless information exchange among payers, providers, beneficiaries, and relevant entities by ensuring accuracy and trustworthiness through interoperability, machine-readability, and open standards, fostering reliable health claim transactions. [7]

ABDM Adoption Initiatives:

• Scan and Share: It ensures the paperless registrations of the patients resulting in instant token generation that helps the patients skip the long queue during their treatment. [8]
• Digital Health Incentive Scheme (DHIS) and Microsites: Initiatives like DHIS [9] and Microsites [10] were launched to increase digital health adoption and participation by the private sector (especially the small and medium-scale healthcare providers) for providing a strong push to the digitization efforts across the country.

ABDM: A Multi-Pronged Approach to UHC

ABDM is not merely a technological advancement; it is a comprehensive strategy that addresses the multifaceted challenges of achieving UHC in India. It rests on its key components and initiatives that collectively contribute to improving healthcare access, quality, and affordability-

Seamless Access to Healthcare Services: ABDM is creating an integrated healthcare ecosystem where citizens can easily access healthcare services from any provider [11], regardless of their location or socioeconomic status. The unified health interface (UHI) will serve as a single point of entry for online appointment scheduling, teleconsultations, and access to health records by eliminating geographical barriers and empowering citizens to seek care from the most appropriate provider [6]. Example: A patient in a rural area can easily find and book an appointment with a specialist in a nearby city through the UHI, eliminating the need for long-distance travel and ensuring timely access to specialized care.

Empowered Citizens and Improved Patient Engagement: ABDM empowers citizens to take control of their health information through ABHA. ABHA provides secure access to personal health records, enabling informed decision-making, self-management of health conditions, and better engagement with healthcare providers [1]. This patient-centric approach would foster trust and encourage preventive care, leading to improved health outcomes. Example: A patient can access their test results and medical history through ABHA, allowing them to discuss their health concerns with their doctor in an informed manner and make informed decisions about their treatment plan.

Enhanced Care Coordination and Continuity: ABDM promotes seamless sharing of health records between healthcare providers, ensuring continuity of care and informed treatment decisions. This interoperable infrastructure will break down silos between different healthcare institutions, eliminating duplication of tests and improving patient outcomes. Healthcare providers will have a comprehensive view of a patient’s medical history, enabling them to provide more effective and personalized care. Example: A patient’s medical history and recent test results from a hospital visit can be easily accessed by their regular physician, allowing for seamless continuity of care and avoiding unnecessary tests or duplicate treatments.

Challenges and Future Outlook

While ABDM holds immense promise, challenges like digital literacy, infrastructure disparities, data security, and behaviour change remain. Overcoming these hurdles demands concerted efforts from stakeholders, policymakers, and healthcare providers. Looking ahead, ABDM’s success hinges on continued innovation, collaboration, and adaptability. Sustained investments in digital infrastructure, capacity building, and regulatory frameworks will be vital in scaling up its impact.

Conclusion: A Paradigm Shift in Healthcare Delivery

Ayushman Bharat Digital Mission (ABDM) represents a paradigm shift in healthcare delivery in India, transforming it from a fragmented, provider-centric system to a patient-centric, data-driven, and accessible one [11]. It empowers citizens, enhances care coordination, promotes evidence-based decision-making, and addresses the challenges of reaching underserved populations and bridging the digital divide. As ABDM unfolds, its impact will be closely monitored, and emerging challenges will be addressed to ensure its continuous adaptation to the evolving healthcare needs of the Indian population. With its comprehensive approach and unwavering commitment to universal health coverage (UHC), ABDM holds immense promise to revolutionize the healthcare landscape and pave the way for a healthier, more equitable India.