While the covid-19 crisis has already put immense pressure on India’s poor health infrastructure, limited government resources will further accentuate the problems in the implementation of NDHM, which comprises six essential digital building blocks—Health ID, DigiDoctor, health facility registry, personal health records, e-pharmacy and telemedicine, they added.

The technology-based initiative is a potential game changer, but is expected to face hurdles, especially in rural India, considering low internet penetration and little digital health resources.

“Digital literacy and accessibility of digital records is a particular concern in rural areas. The government will need to train and equip healthcare workers in digital technology,” said Vikram Thaploo, CEO of Apollo TeleHealth.

A senior health ministry official, requesting anonymity, said most villages do not have the required digital infrastructure to support doctor consultations through a telemedicine platform as it requires a minimum speed of 2 Mbps.

India has over 350 internet service providers but broadband penetration is around 6%, according to the government.

When it comes to electronic health records (EHR), a 2018 report by the ministry of electronics and information technology, titled Adoption of EHR: A Roadmap for India, had highlighted the shortage of basic needs to implement the system. The report said government hospitals and dispensaries had limited information and communications technology infrastructure with only a few major public hospitals having computers and connectivity. The report said huge investments in hardware and software were required.

“EHR is the foundation for NDHM and implementation based on international classification of diseases is a challenge in itself. The disparity in quality and availability of health services, makes it extremely difficult to implement,” said Dr Vispi Jokhi, CEO of Masina Hospital in Mumbai.