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Pathways and Pitfalls of Electronic Health Record Adoption

The pandemic has carried about important changes in healthcare, with digital solutions becoming an essential aspect of our lives. Tele-consultations, digital record sharing, and linking vaccination status to identities can now be easily accessed anytime and anywhere through the Co-WIN site. These services, along with others, can be accessed through the Aarogya Setu App.

Imagine an ecosystem where an individual’s medical tests and procedures are stored in the cloud, accessible anytime and anywhere until requested by the individual or authorized person. The goal is to link an individual’s Electronic Health Record (EHR) to a unique health ID, currently known as the Ayushman Bharat Health Account (ABHA) number. This would create a centralized and secure system to access a person’s medical history. The ABHA number could become a one-stop-shop for all healthcare services, allowing seamless access to healthcare facilities and reducing medical errors.

This policy brief highlights the different aspects of human interaction with the EHR ecosystem and discusses potential implementation challenges. The focus is on identifying possible actions that could address these challenges. The brief acknowledges the importance of ensuring a smooth human interface with the EHR system, which is crucial for its successful implementation. It provides a comprehensive summary of potential challenges and recommends potential solutions.

Overall, the aim is to improve the human experience of using the EHR ecosystem and enhance its effectiveness in delivering healthcare services.

Access to ABHA: To create an ABHA account, one must provide basic information such as their name, date of birth, gender, and mobile phone number. Although an Aadhaar number or driving license can generate an ABHA number, it is not mandatory. The Immunization Registry in CoWIN is a great example of how ABHA is intended to function.

To access it, the user must provide an OTP or their username and password on their mobile device. They must also remember their ABHA number or ID (which is the same as their email ID) and have access to the linked mobile number (if not using a password). One notable difference is that multiple ABHA IDs can be created.

The Ayushman Bharat Digital Mission (ABDM) believes that users should have full power over their data and be capable of creating informed decisions about its use. As healthcare is a sensitive matter, the ABDM does not impose restrictions on linking different healthcare data sets to different ABHAs. For instance, if a user prefers to use a different ABHA to access information related to their sexual history, the ABDM allows for such usage. However, for better continuity of care, users should create and use only one ABHA. This ensures a consistent and reliable record of the individual’s medical history and simplifies the process of accessing healthcare services.

Apart from the mobile number, the ABHA login process requires additional information, such as the user’s date of birth and the ability to navigate a captcha. However, this login process may pose challenges, particularly for individuals with digital disabilities, which may include a significant proportion of older and less literate people seeking medical care. Assisting in such cases may compromise the confidentiality of the patient’s data.

To address this issue, other access methods that prioritize confidentiality may be explored. For instance, automated QR code scanning can be used as an alternative to the current login process. This method can preserve confidentiality if the patient has physical possession of the QR code. This approach can also streamline the process of accessing healthcare services, as it eliminates the need for remembering usernames and passwords.

Furthermore, it is crucial to consider the privacy and security concerns that come with implementing new access methods. Careful awareness must be given to keep the patient’s personal and medical information confidential and secure. It is also important to provide adequate education and training to users to ensure they are well-versed in using these access methods and minimize the risk of data violations or other security dangers.

Overall, implementing alternative access methods can provide a more seamless and confidential experience for users, especially those with digital disabilities, while ensuring the security and privacy of their data.

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Scarlet Samson

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