National Health Stack Open House Discussion 23rd May 2020
iSPIRT Overview
iSPIRT Foundation: a non-profit Tech Think-and-Do Tank Driving 30-year Orbit Shifts • Think Tanks 30 yr Architects • Universities • Research Labs • VCs 10 yr Planners • Policy Makers • Incumbents 5 yr Doers • Challengers Powered by no-greed and no-glory volunteering!
India Stack Overview
The world is noticing India Stack! Bill Gates Adam Minter Prof Kenneth Rogoff Prof Vasant Dhar Global Digital Public Gates Foundation Author, Junkyard Planet Harvard Economist NYU Stern, Ed. Big Data Goods Alliance If we want control over India with likely co-founders: India is on the cusp of China has invested more The world has much to data, the Indian model leapfrogging and leading than $125B in Africa. An learn from Aadhar. 2017 Norway, Singapore, Japan . offers a path toward the world in digital Indian innovation, however, individual data Financial inclusion and is could be what African Interested Members: empowerment for the Philippines, Morocco, Rwanda, becoming the most countries really need. India Internet age. 2018 digitalised economy. 2016 Stack would boost growth Kenya, Indonesia, Myanmar, Nigeria, Tanzania, Afghanistan, as much as Chinese-built infrastructure. .2018 Bangladesh, Togo, 5
India Stack has three layers Identity Layer Aadhaar ➔ Giving every resident a unique id and enabling eKYC ➔ I d e n t them to prove “I am who I claim to be” i t eSign y ➔ L a y e r Payments Layer Unified Payments Interface ➔ Aadhaar Payments Bridge Allowing anyone to pay anyone else! Payments Layer ➔ Aadhaar Enabled Payment Service interoperable, fast and cheap - not just ➔ smartphones. Consent Artefact Data Empowerment ➔ DigiLocker Data Layer ➔ To enable secure sharing of data Account Aggregator ➔ 6
INDIA STACK powers many Use-cases Transactions Lending Wealth Management Identity Layer Jan Dhan Insurance Financial inclusion P a y m e n t s L a y e r D a t a Direct Benefit New Business L a y e r Transfer Services India Stack Infrastructure 7
Aadhaar/eK YC NBFC Credit Account marketplace app Aggregator Public BBPS Credit Electronic Registry Needs a Collections India Stack is about Data loan app Consent Agrees to Repays democratizing share data loan credit for Rajni! Credit Sees market- many Sells Work started in 2013 place Payment types of E-lien, Goods API for app loan offers Eman- Loan dates Offers Accepts best Receives offer loan Transaction Paperless a/c & app contract eSign UPI Digilocker 8
Aadhaar/eK 1 YC 4 NBFC Credit Account marketplace app Aggregator Digital Public Public BBPS Infrastructure Credit Electronic Registry Needs a Collections Data loan 8 app Consent Agrees to 5 Repays share data Market Innovators Build loan the Middle Layer Credit Sees market- many Sells place Payment types of API for E-lien, Goods app loan offers Loan Eman- Offers dates Accepts best Receives 7 offer loan 6 Transaction Paperless a/c & app contract 2 eSign UPI Digilocker 3 9
Aadhaar/eK YC NBFC Credit Account marketplace app Aggregator Digital Public Public BBPS Infrastructure Credit Electronic Registry Needs a Collections Data loan app Consent Agrees to Repays share data Market Innovators Build loan the Middle Layer Credit Sees market- many Sells place Payment types of API for E-lien, Goods app loan offers Loan Eman- Offers dates India Stack has led to Accepts best Receives creation of two new offer loan trade-bodies: Transaction Paperless a/c & app contract eSign UPI Digilocker 10
Shift for Market Players New world where Digital Public Infra is coming in place first v/s 11
National Health Stack Overview
Our objective is to build a world class universal health system with radically low cost, high access and good quality 13
By designing a three-pronged approach Improve the efficiency and capacity of the care delivery system through a strong digital foundation Re-align incentives to shift the approach of care delivery from transaction, curative focused to longitudinal, wellness focused Leverage Ayushman Bharat for experimentation and scale-up 14
National Health Stack CONSUMER APPS/PORTALS HEALTH PROVIDER APPS/PLATFORMS Private Public Other HIMS/ Other GOVT & PRIVATE Innovation Sector Sector Apps LIMS Platforms Private APPS & PLATFORMS Diverse user experiences & innovative solutions Gamifier Payers Preventive Care Fiduciary Treatment Care Fiduciary Augmentation Layer PERCEPTRON/ DIAGNOSTIC Enhancing capabilities PROTOCOL SERVER MATCHING ENGINE BOTS Digital Public Infrastructure of all actors ELECTRONIC PERSONAL HEALTH ELECTRONIC CLAIMS Plumbing Layer REGISTRIES RECORDS SWITCH Streamlining flow of Doctor registry E-prescription patients, health Facility registry E-discharge summary E-claims information and money Procedure registry Diagnostic e-reports Ayushman Bharat Drug registry ... e-Vouchers ... ... JAM & INDIA STACK Cross domain generic JAM & INDIA STACK building blocks 15
Personal Health Records
PHR is part of the Data Empowerment & Protection Architecture (DEPA) Identity Layer Aadhaar ➔ Giving every resident a unique id and enabling eKYC ➔ I d e n t them to prove “I am who I claim to be” i t eSign y ➔ L a y e r Payments Layer Unified Payments Interface ➔ Aadhaar Payments Bridge Allowing anyone to pay anyone else! Payments Layer ➔ Aadhaar Enabled Payment Service interoperable, fast and cheap - not just ➔ smartphones. Consent Artefact Data Empowerment ➔ DigiLocker Data Layer ➔ To enable secure sharing of data Account Aggregator ➔ 17
18 1 2 3 India is making Indians are Indians are Going digital infrastructure becoming Digital as public goods. data-rich .
We Need To Invert The Status Quo WHO CONTROLS THE WHAT THE DATA IS DATA USED FOR Data to be used to empower the user Data is used to sell things to the user P u t t h e u s e r s i n t h e c e n t r e ! 19
Classification of Data LONGITUDINAL PERSONAL PUBLIC HEALTH/ MEDICAL RESEARCH/ BOT HEALTH RECORD EPIDEMIOLOGY TRAINING RESOURCES 20
MeitY Consent Artefact - National Standard Compliant with the ORGANS Principles: O pen, R evocable, G ranular, A uditable, N otice, S ecure <consentcollector> CC </consentcollector> <dataconsumer> DC </dataconsumer> Identifier Section <dataproducer> DP </dataproducer> <user type=”UID” > 123412341ABC </user> <datatype type=”transactional” > <attribute-list> … </attribute-list> <duration> 6 months </duration> <datalife> 10 days </datalife> <frequency> YEARLY </frequency> Data Section <revocable> YES </revocable> <access> VIEW| STORE| QUERY </access> </datatype> <datatype type=”profile” > </datatype> Logging Section <loggingInfo> … </loggingInfo> Purpose of Data Access <purpose code=”” > LOAN </purpose> Signature Section <signature> #@%%#@$$##$@ </signature> 21
Data Empowerment & Protection Architecture (DEPA) Tools for restoring agency to the user Law Tech Institution Who can use How can I be What can I do if my data and sure my data is my data is being Why? not misused? misused? 22
The Account Aggregator by RBI/SEBI/PFRDA/IRDA will facilitate consented sharing of financial information in real-time Request for Data Consent to Share Encrypted Data Flow Financial Information Providers Financial Information Users Bank Flow-Based Credit Mutual Fund Personal Finance House Management (NBFC Account Insurance Wealth Aggregator) Provider Management Tax / GST Robo Advisors Platform Registry 23
Story of Health Data Today Lab Lab Report Clinic User Prescription Hospital Discharge Summary Physical Folder that user carries with himself
Historic Data accessible through Standardised Discovery Protocol Lab E- Lab Report ID = PM-JAY ID Health Clinic Locker User saurabh@healthlocker E- Prescription Longitudinal ID = Mobile+Demo Health Records Hospital E - Discharge Summary ID = Aadhaar
Federated Health Data Storage Repository providers store provider data. Locker may store duplicates. Repository Lab (Same design as DigiLocker) Standardized APIs Health Clinic Repository Locker User Repository Hospital Incentives enable an ecosystem of repository providers to emerge Repositories must be highly “available”
Sharing of Health Data with Consent Repository Lab Standardized APIs Health Clinic Repository Locker User Repository Hospital Standardized MeitY Electronic APIs Consent Treating Doctor App Doctor
Consent & Healthcare Data Flows based on India’s Data Empowerment & Protection Architecture (DEPA) Request for Data Consent to Share Encrypted Data Flow Health Information Providers Health Information Users Health Lockers Hospital Lab Doctor / Specialist Health Apps Insurance Provider Personal Health Hospital Apps 28
Schema-level standardisation Minimal, one-time change required in existing systems 29
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