Medical education regulator tells med schools to mandate ABHA IDs for patients

New Delhi: The medical education regulator has directed all medical colleges to make Ayushman Bharat Health Accounts – or digital IDs -- mandatory for seeing patients. 

The move has two objectives, an official said -- to help patients “share and access their health records digitally” and to get a better handle of how many patients a medical college is seeing when assessing them.

The new assessment criteria for medical colleges will be dependent upon the number or patients registered by these medical institutions through their ABHA IDs.

There are nearly 700 medical colleges (including both private and government) who have to follow this new directives of the National Medical Commission (NMC).

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ABHA ID is an initiative under the Ayushman Bharat Digital Mission (ABDM) which aims to a digital health ecosystem is being implemented by National Health Authority (NHA).

So far, more than 622 million ABHA IDs have been created across the country.

Starting from academic year 2025-26, all decisions for medical colleges -- from increasing the number of seats for undergraduate and postgraduate courses, annual renewals and recognition by the NMC – will be considered on the basis of registration of patients done through these digital health IDs.

“The NMC in its 14th meeting held on 1 May, 2024 had decided that all medical colleges must ensure ABHA ID as pre-requisite for registration of patients visiting for OPD/IPD/emergency services in the hospitals attached to them. All patients OP/IP, must have registration done with ABHA ID in addition to hospital’s registration number,” said Dr B. Srinivas, Secretary, NMC to all medical colleges in a communication seen by Mint.

Strong need for authentication

"The creation of ABHA ID is very simple process and can be facilitated conveniently with possession of Adhaar card that has already been extended to people on a large scale,” he said.

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“However, no patient should be denied treatment without ABHA ID" Srinivas said. 

“For decisions in the assessment for the academic year of 2025-26 and thereafter, the patient and related clinical material authenticated with ABHA ID will only be counted.”

No more ghosts

Another senior official said that creation of ABHA ID for patients will help to ceal with the problem of “ghost patients” – made-up names to impress the government with inflated numbers.  

“So far, ghost patients were counted,” the official said.

“This will bring greater transparency and ensure that there is no fake patient record, which is a problem mostly found in the private colleges,” he said. 

“Whenever our team used to go on inspection at a private colleges, we used to find very few patients (because of high charges). Now we will have data for whole year and this can be monitored live on our system,” said the official.

The official said ABHA ID for patients will help the government take decisions on health policy.

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“We will be able to know how many patients are coming from which region, what health problems they have, which type of disease is prevalent in which city or state and what kind of intervention government has to take,” said the official. 

This, however, points to a larger problem of consent and data privacy. Although ABDM has been built on the principle of ‘privacy by design’, how the concept of ‘consent’ will work in practice with the overwhelming majority of poor patients remains to be seen. 

According to government officials, by law, the electronic medical records generated by healthcare providers are stored in their respective systems. “ABDM only facilitates secure data exchange between the intended stakeholders on the ABDM network after the patient’s consent,” they said.

"From a healthcare policy standpoint, availability of large amounts of health information is important to make customised policies for the country. Decisions based on big data are better than those that rely on individual opinions or data from small numbers of patients.

Naturally lay people might be concerned about leak of data. But data sharing is done only after protecting the ID of the patients through many established processes such as de-identification and aggregation, where only the anonymized information will be shared for research and policy making. This protects patient privacy. These are commonly practised in developed countries," said Rajeev Jayadevan, a public health expert.