Showing posts with label interoperability. Show all posts
Showing posts with label interoperability. Show all posts

Sunday, July 11, 2021

Stamp of Confidence

The ACCESS Health Digital (AHD) Stamp of Confidence (SoC) for Digital Health Systems is a voluntary program. It is established by AHD to provide for a Stamp of Confidence for Digital Health Systems. Criteria for SoC are established as per as per NDHB Standards and related building blocks notified by Govt of India. The  SoC Program supports the availability of quality Digital Health systems for its encouraged and required use across the National Digital Health Ecosystem. The SoC Program is run as a third-party product conformity assessment scheme for Digital Health systems based on the principles of the NDHB, EHR and MDDS for Health and Meity Open Standards and Opensource policy.

Download: Stamp of Confidence Stages and Criteria

As a part of its Social Entrepreneurship Accelerator (SEA) program designed to guide the healthcare industry in adopting open and uniform digital health standards, ACCESS Health Digital recently launched the Stamp of Confidence initiative that will recognize health startups based on the extent of their adoption of globally applicable digital health standards. 

The Stamp of Confidence (SoC) is an endorsement issued to each of the SEA members based on the extent and depth of their compliance, placing them in different stages of compliance maturity. It is a mark of accomplishing technical and functional compliance to the recommended standards laid out in the National Digital Health Blueprint. 

The SoC is structured in a way that helps startups transition gradually and smoothly from nonstandard healthcare industry to a standardized, open yet secure industry. The idea is to accelerate the adoption of the National Digital Health Blueprint standards and other Government of India notified digital health standards (including Metadata and Data Standards, SNOMED, Electronic Health Records, and Fast Healthcare Interoperability Resources) in a systematic and progressive way to make National Digital Health Ecosystem a reality.

The SoC has been adopted by the National Health Authority’s- Market Access Program (MAP) to bring in a structured approach to compliance and adoption under the Pradhan Mantri Jan Aarogya Yojana (PMJAY). ACCESS Health Digital is among the leading partners of the NHA under the MAP. 

The SEA program run by ACCESS Health Digital is aimed to help Indian HealthTech startups and vendors implement Open Digital Health Standards that are applicable globally. With the introduction of the Minimum Viable Product [MVP], ACCESS Health Digital seeks to address the absence of interoperability between members of this vast ecosystem, which has been impeding the scale and speed of data and knowledge flow that are vital to achieve universal health coverage.  The dedicated effort in this direction includes: 

Minimal Viable Product Deļ¬nitions (MVP):  For various care delivery settings across primary, secondary, tertiary and health insurance segments. 

Techno-functional evaluation and mentorship: To provide technical and functional mentorship for the implementation of the Minimal Viable Products (MVPs) into the partner products and to help build the micro services and Application Programming Interface (APIs) together with the product teams of the SEA community.

AHD Stamp of Confidence: At the end of the mentorship, the startups are assessed objectively against the custom recommendations provided for them during their initial techno-functional evaluation. The SoC milestone is recognized with the issuance of the Stamp of Confidence which certifies the area and stage of compliance. 

Tiered Compliance Stages

The tiered approach of the Stamp of Confidence enables startups to join the network even when they are successful in implementing only the early “terminology standards”; thus giving them an opportunity to participate in the digital ecosystem. Early adopters in the stage 1 category are expected to implement other standards such as audit trails, Health Data Dictionary and pay attention to scalability along with the implementation of terminology standards. Also, every stage in the tiered system has room to accommodate anomalies or exceptions as the healthcare technology market is characterized with high degree of diversity in digital maturity, thus highlighting ‘inclusiveness’ in its design.

Stage 2 expects the startups to come forward to implement the eObjects and microservices which requires significant amount of commitment to interoperability and scalability in design. Stage 3 is conferred on those advanced players who can demonstrate the implementation of Data privacy and security principles in their design owing to the fact that they have the required data standards and terminologies implemented to enable them to achieve this stage.

Once the startups have completed their mentorship phase and are ready to be considered for the SoC, they are evaluated objectively using a techno-functional checklist which allows them to be scored against a stepwise implementation of every component within the specific stage.

Achieving a score ‘4/5’ in this objective assessment qualifies the startup to be considered ‘compliant’. Implementation of these standards in real world is the demonstration of excellence and provides them with a score ‘5/5’.

The Social Entrepreneurship Accelerator Program (SEA) strongly positions the early adopters of standards in its network as National Digital Health Blueprint (NDHB) Standards compliant products and the SoC is a major milestone that is required for the members to graduate to the coveted Early adopters club. Some of the early adopters in the SEA community like Plus91, Srishti Soft, UNIMEDNET, MarSha, Raxa, Invoker Tech, DocEngage have been identified and recognized to be the champions, leading the way in this journey.  Saathealth, an MAP member has been one of the first few to receive the Stamp of Confidence. With greater and faster adoption of standards, other MAP members are expected to follow suit.

Wednesday, June 30, 2021

Lab SIG - Interoperability

Lab SIG - Interoperability

Charter: ACCESS Health Digital together with development sector partners and provider industry associations had convened the pan-India Provider Working Group [PWG] and published the PWG report in Q1 of 2021 ( The Diagnostic Working Group was one of the 3 main Working Groups under PWG. The Diagnostic Working Group consultations clearly revealed that approaches to Laboratory Data Interoperability can be the first step in creating an open-source standards-based digital health assets for seeding India’s National Digital Health Ecosystem (NDHE). As a follow through on the Diagnostic Working Group proceedings referred above, Laboratory Special Interest Group (SIG) was constituted as a subset of the PWG’s Diagnostic Working Group, to continue work on the Laboratory Data Interoperability. 

Interim Report: This is an interim report on the significant progress made by the Lab SIG. The report explores Standardizing the LOINC at Lab Information Management Systems [LIMS] level versus Standardizing the LOINC at the Lab Analyser output level. The interim report clearly proves the Hypothesis that Standardizing the LOINC at the Lab Analyser output level is more amenable to adoption and change management. However more research continues to map the LOINC and the output of most used Lab Analysers in the market.

Download: Lab SIG Interim Report on Interoperability

Tuesday, June 1, 2021

Telemedicine Hut: Solutions for Rural India

Lesson from the Covid19 Pandemic – Leveraging Telemedicine and Digital Health to offer 'Appropriate Care' in Rural India

Download Here! 

The Second Wave of Covid19, in a manner of speaking, was a ‘Baptism by fire’ for Public Health Governance in India.

Besides streamlining of provisioning of material resources, one of the key lessons learnt in managing the crisis was clearly, that ‘Appropriate Care’ i.e. Triage was able to take care of about 80% of patients reporting Covid-like symptoms and allowing them to be treated with simple and minimal protocols, at home without overburdening Hospitals in the secondary and Tertiary care segment and thus ensuring better outcomes and better patient experience. Resources could remain available for suitable cases.

Less could Indeed be more!

Now that we see the disease making inroads into Rural India which is relatively poorly served in terms of first line of care, and anticipate larger numbers that need to be provided ‘Appropriate Care’ we need to develop methods to do so.

Access Health Digital has developed a simple concept for Leveraging Telemedicine and Digital Health Technologies to offer Triage in Rural India with minimal infrastructural requirements and easily available solutions. Please see attached slides on how Telemedicine can be leveraged to do so.

A more detailed vision Document is being developed in partnership with a leading Academic Institution and will follow soon. Watch this space!

Download Here!

Saturday, August 22, 2020

eClaims - Payer eObjects

This document presents the design specifications for electronic claim objects and associated standard processes for their exchange between Payers and Providers, through a Health Claim Platform that was recommended in the report “Common IT Infrastructure for Health Insurance Claims management” by IRDA-NHA joint working group. 

The health claim platform is intended to improve current claim processes, enforce transparency and facilitate on time provider payments for Health insurance Claims in India. Usage of Standard Electronic Claim related objects will facilitate auto adjudication of claims by both Public and Private Health Insurance Payers with reduced operational costs.

eDischarge Summary Object: Pick the eDischarge Object from Provider eObjects v2

Standard Value Sets for eClaims Objects

Standard Value Sets for eDischarge Objects

Summary of Insurance eObjects

The eObjects concept was introduced by ACCESS Health in Theme papers in Nov 2018, that became the Chapter 5 of the book ‘Health Systems for New India’, published by Niti Aayog in Nov 2019. Prof Dennis Streveler and Dr Pankaj Gupta are the Authors of the Chapter 5 in the Health System for New India book. The eObjects concept was again recommended in the ‘NHA-IRDA joint working group report’ to facilitate electronic, codified data exchange between providers and payers. The eObjects concept was then detailed out into Provider and Payer eObjects including the data standards recommended in the National Digital Health Blueprint. ACCESS Health has now released the eObjects design and code in opensource under MPL 2.0 license.

eObjects are evolving, check with us for the latest versions. Reach out to us for any help to understand or implement the eObjects. We can set up a group call with all of you to explain these eObjects in detail or even can set up one to one calls.

Thank You for your continuous association with us.

-- ACCESS Health Digital --

Contact for Clarifications:
Access Health Digital

Sunday, July 26, 2020


Digital Health 101 is a basic set of webinar recordings from AHD Academy. Suitable for Doctors/Nurses/Clinicians, Public Health and Healthcare Managers, Government Administrators and Technologists interested in Digital Health. The Courses are spread across Basic, Specialist and Expert Levels. It is a video based learning model and It is free. 

Disclaimer: AHD Academy is a Library of Live Webinar Recordings from AHD on various Digital Health topics. It is opensource material meant for learning from experts at your own pace. This is Not an Academic Course material. Please do not confuse these webinar recordings with regular recognized courses run by universities/colleges. You may contact your College, University, Organization for properly moderated Lectures, Trainings, Courses on Digital Health.

Basic Course for Digital Health Enthusiasts: Suitable for Clinicians, Healthcare Managers, Govt Administrators and Technologists interested in Digital Health. Will take approximately 40 Hours to read up the material and listen-in to these 101 webinars.


Reading Material Lesson 1. Note: This is a preparatory Lesson that will open your mind and help you understand the higher lessons. Reading material for this Lesson is based on white paper written by Dr Pankaj Gupta on the same topic.

Reading Material for Lesson 1: HEALTHCARE IT IS DIFFERENT


Reading Material for Lesson 2. Note: This is a preparatory Lesson that will open your mind and help you understand the higher lessons. Reading material for this Lesson is based on white paper written by Dr Pankaj Gupta on the same topic.

Reading Material for Lesson 2: GOVERNANCE AND FINANCIAL LEVER


Note: This is a preparatory Lesson that will open your mind and help you understand the higher lessons. Reading material for this Lesson is based on white paper written by Dr Pankaj Gupta on the same topic.

Reading Material for Lesson 3: FUZZY BOUNDARIES FOR GOVERNANCE


Note: This is a preparatory Lesson that will open your mind and help you understand the higher lessons. Reading material for this Lesson is based on white paper written by Dr Pankaj Gupta on the same topic.

Reading Material for Lesson 4: LINES ARE BEGINNING TO BLURR!


Reading Material for Lesson 5




Reading Material for Lesson 8


Additional Reading material:


Specialist Course: Suitable for Healthcare Managers wanting to Specialize in Digital Health. Will take approximately 50 Hours to listen-in to these 101 webinars. Pre-requisite is Basic Course for Digital Health Enthusiasts. Technologists can jump to the Expert level Course.

Reading Material for Lesson 1






Additional Reading material:


Expert level Course: Suitable for Technologists aspiring for Expertise in Digital Health. Will take approximately 60 Hours to listen-in to these 101 webinars. Pre-requisite is Basic Course for Digital Health Enthusiasts. Specialist Course is not required for Technologists. 





LESSON 5: Bootcamp 2 PART 1
Discussions on NDHB, Federated Architecture, HDD, Registries,

LESSON 6: Bootcamp 2 PART 2
Discussions on SNOMED,

LESSON 7: Bootcamp 2 PART 3
Discussions on eObjects, FHIR,

LESSON 8: Bootcamp 2 PART 4
Discussions on Microservices,

LESSON 9: Bootcamp 3 PART 1
Discussions on eObjects Implementation,

LESSON 10: Bootcamp 3 PART 2
Discussions on SEA Members eObjects Experience,

LESSON 11: Bootcamp 3 PART 3
Discussions on Microservices Implementation,

LESSON 12: Bootcamp 3 PART 4
Discussions on HIEAF,

Additional Reading material:


Masters level Course: Suitable for Academic Excellence in Digital Health. Content similar to Basic, Specialist and Expert level course is used in Last semester of the Masters course, but obviously with more in-person teacher-led classroom sessions.



Congratulations! This completes the AHD Academy's Digital Health 101 Webinars. Best of Luck for implementing the concepts on the field.

Your feedback is welcome, Write to

Note: All Content is released under MPL 2.0 License. It is free to use with proper attributions.

AHD Academy Partners and Collaborators for Digital Health capacity building, research, content and pedagogy: 

More MoU in pipeline...

Monday, July 20, 2020

Social Entrepreneurship Accelerator

Social Entrepreneurship Accelerator [SEA]

ACCESS Health Digital [AHD] is a a not for profit think tank working on NDHB Digital Health Standards for India. We run a Social Entrepreneurship Accelerator [SEA] for helping Indian HealthTech startups and vendors to implement Open Digital Health Standards that are applicable globally. #AtmaNirbharBharat #VocalForLocal

SEA Silver Club

Silver Club has implemented the Standards and achieved our Stamp of Confidence.

SEA implements the eObjects Interoperability framework. eObjects were first written by Prof Dennis Streveler and Dr Pankaj Gupta in a white paper in Nov 2018 that was published by Niti Aayog in the book Health Systems for New India, Chapter 5 - Reimagining India's Digital Health Landscape Wiring the Indian Health Sector in Nov 2019.

SEA Objectives

SEA Cohort 1

SEA Cohort 2

In late October 2020, India's National Health Authority' Market ACCESS Program [MAP] put 12 startups under mentorship of ACCESS Health Digital's Social Entrepreneurship Accelerator [SEA] -- the second of three cohorts to join the SEA family, now home to almost 40 startups that range in sector and specialty from primary care delivery and telemedicine to electronic health records and disease management. Like the previous cohort, SEA aims to provide its newest members with mentorship, market access, and a stamp of confidence, among other basic building blocks that will situate them in the digital health landscape. Together, they're working toward a single transformative purpose: building a vibrant national digital health ecosystem.

SEA Cohort 3

Parallelly Cohort 3 has also started to take shape, mostly on reference from Cohort 1 and requests from Partner organizations.

The Social Entrepreneurship Accelerator launched by ACCESS Health Digital has become an official Amazon AWS Activate Provider. AWS Activate works with accelerators, angel investors, and venture capital firms to provide startups with free AWS credits, technical support, training, resources, and more. These exclusive benefits are designed to help startups quickly get started on AWS and grow their business. Startups associated with an AWS Activate Provider are able to apply for AWS Activate Portfolio.

The new partnership with Amazon Web Services will help the Social Entrepreneurship Accelerator create new opportunities for its startups, providing them with access to Infrastructure as a service [IaaS], Platform as a Service [PaaS] and Software as a Service [SaaS]. This gives the startups entry into a Plug-and-Play integrated software development environment. Just adopt the PaaS and all startups in the accelerator can turn into SaaS companies.

SEA is an Exponential Organization (ExO) whose impact will be disproportionally large as compared to its peers because it leverages exponential technologies.

Additional Reading material:

Will update soon...keep checking this space..

-- ACCESS Health Digital --

Contact for Clarifications:
Access Health Digital 

Thursday, July 9, 2020

Beneficiary Registry Recommendations for India

Since the start of the Millennium, India has been trying to overcome the problem of interoperability and fragmented healthcare delivery ecosystem across states, health policies and vertical health programs to deliver seamless or uninterrupted continuum of care. With the launch of the Pradhan Mantri Jan Arogya Yojna (PMJAY), that covers & provides free healthcare to approximately 40 % of the Indian population, it has become critical to identify each patient uniquely. The criticality for unique identification of individuals got highlighted when India was hit by the COVID 19 pandemic – when patient tracking and relevant health information on comorbidities was not available for effectively and efficiently executing surveillance. States and government could only collect aggregated data in non-standard and an unstructured format via door to door screening, which was extremely inefficient and poorly suited for response planning and to effectively combat a pandemic of this size and scale.

UHID is a critical building block from a Universal Health Coverage perspective and is also the missing link in enabling a true longitudinal health record for the patient. This is critical in providing all individuals, equal access to quality healthcare at all times. The first step towards enabling UHC for a country is to identify uniquely all individuals who seek healthcare as patients. 

Many developed countries as well as some developing countries have already implemented the concept of UHID. These can provide valuable inputs to India, in finalizing our UHID implementation policy. It was found that different countries have followed varied methodologies and approaches for UHID implementation at the National Level. In the more advanced countries with robust civil or social protection laws, UHID is generated and assigned at the time of birth and is utilized for every healthcare transaction throughout a person’s life.

India is a democratic country where health is a state subject with flexible regulations, which gives States and citizens freedom of choice to adhere to the health policies they want to adopt. In such an environment, to enable access to quality healthcare for all, it is critical to define a well thought out UHID strategy that can seamlessly encompass various use cases and scenarios specific to India. 

The recommended UHID approach is - Create a National Unique Health Identifier for every person in the country and link it with Aadhaar or with any Government verifiable ID for authentication and validation of the persons information.

The categories and recommended approaches are provided here for ready reference.

Various use cases were identified and studied to arrive at the recommendation. The population can be divided into 5 major categories with an associated approach to assign a UHID to the identified population group. The minimum data elements recommended for the Beneficiary Registry are also provided. 

We are also publishing the recommended minimum data elements for the Health Delivery Information Systems minimum viable product for Personal Health Records [PHR].

NDHB has also recommended a Health Locker to Maintain the Personal Health Records of the Individuals in the Health System. The Health Locker is a standards‐based interoperability specification that can be implemented by multiple players to enable the creation of a Personal Health Record. A personal health record, or PHR, is an electronic application through which patients can maintain and manage their health information (and that of others for whom they are authorized) in a private, secure, and confidential environment. The healthlocker either stores patient’s record in digital format pushed by various providers or can store eObject pointers to the patient record or summary stored in a source system against the Unique Health ID of the patient.

The health lockers enable creation of a longitudinal health record from the various eObject links/pointers available and enables retrieval and storage of the EHR for continued clinical decision making. All the related eObject pointers and ID documents can be loaded to the Healthlocker for the PHR, giving the individuals the right to their information and control the information which they may like to share with other stakeholders.

-- ACCESS Health Digital --

Contact for Clarifications:
Access Health Digital 

Monday, June 8, 2020

Health Data Dictionary Published in XSD Formats

The Public and Private Health System in India is struggling with multiplicity of information systems being used at central as well as at state level. Each of these systems is unable to exchange data and information with each other. To overcome similar challenges across ministries, the Ministry of Communication and Technologies initiated semantic standardization across various domains under Metadata and Data Standards (MDDS) project. The intent was to promote the growth of e-Governance within the country by establishing interoperability across e-Governance applications for seamless sharing of data and services. MDDS for health domain was created by adopting global standards in such a way that existing applications could be easily upgraded to the MDDS standards. 

The exercise yielded approximately 1000 data elements. These data elements were expected to serve as the common minimum data elements for development of IT applications for various sub domains of health care. The need for the CDE arose because most of the primary and public health IT applications are being developed without any standards by different agencies and vendors in public and private sector in India. Each application is developed for standalone use without much attention to semantic interoperability. Later when the thought of interoperability emerges – it becomes difficult to connect the primary and public health systems and make them talk to each other because they were never designed for that purpose. 

Even if technical and organizational interoperability is done the semantic interoperability may remain a challenge. For example – all primary and public health applications must have the same Facility Master. When application A sends the ANC data for facility 123, the receiving application B should understand ANC and uniquely identify facility 123. Another example is if a hospital application sends the insurance reimbursement bill to insurance company/government, the recipient application should be able to understand and represent the same meaning of bill information. Ministry of Health & Family Welfare has initiated development of the national health facility registry. The registry was intended to standardize facility masters used across public health information systems. 

Standardization of facility masters is required for two purposes, first when exchanging data the sending and receiving applications should be able to identify health facility similarly. For example – when application A sends the maternal health data for facility 123, the receiving application B should understand maternal health data and uniquely identify facility 123. Second, in public health, performance of each of the facility is assessed using aggregate indicators and facility master serve as the secondary data source on which primary program specific data is aggregated. For example- data from number of doctors from system A and total outpatient attendance data from system B could be analyzed to get per doctor patient load across health facilities only when both applications use common facility masters.

MDDS for Health Final Part I Report in PDF:

Here is the link to MDDS for Health in XSD Format in GITHUB folder. This includes about 1000 Data Elements and about 140 Code Directories in technically usable formats such as - CSV, JSON, XML, XSD: 

It also has a readme file for your reference.

Thank You for your continuous association with us.

-- ACCESS Health Digital --

Contact for Clarifications:
Access Health Digital 

Saturday, June 6, 2020

National Health Facility Registry - Concept Note

What is a Registry?

A registry is an organized system or database that collects, stores uniformed data or information about an entity like patient, person , or facility etc and is kept updated at all times to act as “Single Source of Truth” for the entity in question. The data facilitated by the registry can be accessed as service by information technology applications or by the government for planning initiatives and governance.

How a Registry is different from a Directory?

A registry is an official record keeping database which not only identifies an entity uniquely but also proves its existence in the ecosystem in question. E.g.: ADHAAR- A person must be listed in AADHAAR registry to be able to verify his/her identification as an Indian Citizen with authentic demographic details.

Directory on the other hand does not required to be an official or comprehensive, but mere a collection of data without uniquely identifying entities listed in it and do not serve as “single source of truth”. Example- A telephone directory.

What is a National Health Facility Registry?

A National Health Facility Registry is a centrally maintained registry that stores and facilitates uniform minimum required data or information about both public and private health facilities in the country. It is a building block that is essential to enable nationwide health information exchange. It will do so by identifying each health facility uniquely and creating a unique Identifier for every registered facility. This unique identifier then becomes available to be utilized by states and IT systems as a pointer or primary key to store more facility related data in directories maintained at state/district level, providing comprehensive data on all private and public health establishments

Problem Statement

Indian healthcare has been trying to overcome the problem of interoperability and siloed systems to enable continuum of care. This requires a standard driven health information exchange (HIE), and to enable a HIE, it is essential to uniquely identify each stakeholder and resource (Patient, Provider, facility, health worker) involved in an episode of care.

Also, from a quality of care and governance perspective a facility registry becomes very critical for resource planning to create a reliable, unified registry of country’s healthcare infrastructure & associated resources through associated state or national level repositories like NHRR to show their distribution pattern of health facilities and services areas across the country. This assumes even greater significance in emergencies like Pandemics and disasters.

Several initiatives have been made by the Indian Government in the past to enable a centrally maintained facility registry for India.

Key initiatives undertaken in India for facility registry includes:

  • National Identification Number (NIN) project that was undertaken by National Health System Resource Centre (NHSRC) in 2016 where data pertaining to approximately 1,11,990 health facilities was cleaned and validated by 25 states including longitude-Latitude details. A 10-digit unique National Identification Number (NIN) was allocated to the identified public health facilities. A NIN portal was also developed for missing facilities or new facility registrations and states were provided trainings on the same to keep the NIN facility data updated.
  • National Health Resource Repository (NHRR) project by Ministry of Health and Family Welfare (MoHFW)- In NHRRa Healthcare establishment Census was conducted which included on ground physical survey to enlist all the health facilities as well as resources. NHRR database has listed approximately 8.5 lakhs+ facilities and provides around 7000+ attributes withspatialinformation maintained by the technology partner ISRO.
  • ROHINI (Registry of Hospitals in Network of Insurance)– Dubbed as the AADHAAR of Hospitals by Insurance Information Bureau of India (IIB)- ROHINI is a PAN India registry of hospitals/day care centers that are empanelled with health insurance payers/Third Party Administrators(TPAs) for service delivery to the beneficiaries. It has approximately 35,000 facilities listed so far. Each registered facility is allotted a 13-digit Global unique GS1 identifier, along with geo coding of facility address. ROHINI also has self service portal for registration/inactivation /deletion or amendment of registered facilities. All network hospitals and hospitals involved in cashless reimbursement claims or those that wish to provide this facility, are registered on ROHINI.

All the initiatives as mentioned above had common goals, one to act as single source of truth and second to become single point of reference for facility information as per their identified scope.

Since a lot of effort has gone into each of these initiatives, they should be brought together and harmonized to enable a National Facility Registry that can identify both public and private health facilities uniquely. The data collected under each mentioned initiative can be consumed or exposed as service to get/retrieve additional data about a facility using the same National Unique Facility Identifier that can be allotted by the National facility registry and act as a primary key to stitch the different databases together.

Recommended Approach

1.  Identify Minimum required data elements for Centrally maintained Registry

A central or nationally maintained registry that can be self-sustainable and easy to maintain should not have a long list of data elements or attributes. It should consist of only a set of minimum required data elements that helps to identify the facility uniquely and can be kept updated at all times. The recommended data elements should follow Metadata and Data standards for India (MDDS) which is a standard notified by Ministry of Electronics and Information Technology (MeITY). It is essential to use data standards to collect and store information in a registry, so that if states want to maintain their own facility directories/state registry/database they can use the same standard MDDS elements to define the local registry structure and will be able to push data seamlessly to the National facility registry.

The recommended minimum viable data elements are listed in the Annexure.

2.  Map NHRR-NIN-ROHINI Facilities& State verification and updation

Facilities listed in all the three mentioned databases can be mapped using Machine Logic/AI and manual interventions by making use of the key attributes like name, address and longitude-latitude details.

Following steps are recommended to harmonize and enable a National Health Facility Registry

  • Map ROHINI, NIN and NHRR facilities. The facility data from NHRR, NIN and ROHINI data sources will be harmonized by employing Fuzzy logic-based matching of facility data from each of these different sources. Facility data (NHRR, NIN and ROHINI) shall be matched by deploying fuzzy algorithms like Soundex or levenshtein distance matching etc. The unique minimum required attributes as described in appendix 1 shall be loaded in the facility registry database.
  • Develop standard definitions for attributes using MDDS elements as provided in the Annexure I.
  • Identify & publish mismatches and duplicates in the standard definition template and suggests standard process of verification with district and health state departments.
  • State can filter facilities district wise and get the data verified through the respective district health department.
  • Districts can update information in excel format and request corrections if any to the state.
  • State after verification and validation can push the cleaned facility data to the centre.

 3.  Convert the clean, verified data using a technology partner like NIC into a registry.

The first step towards digitalizing the National Facility Registry after receiving clean and validated data is to load the cleaned facility data into the National Facility Registry. The facility registry shall store the source ID of each system (NHRR ID, NIN ID and ROHINI ID) against the set of data attributes loaded from each of these three data sources to facilitate the facility data set retrieval from registry based on different identifiers (e.g. based on ROHINI ID or NHRR ID) and thus it shall not disrupt the design of existing systems which are using this data.

The loading process of facility data into facility registry shall ensure the uniqueness and deduplication of facility data by using validation/data deduplication engine. A National unique facility Identifier shall be generated for each facility populated in the facility registry (the algorithm to generate the unique facility identifier should be decided by the authority implementing the design of facility registry), The facility unique Identifier will be a 10 digit unique Integer value and should not contain any data attribute based logic in the design of identifier code due to volatile nature of the facility data attributes as that may change in future e.g. if facility identifier contains the logic built based on the location of facility e.g. state and district code, the same may change due to administrative change of the location of facility due to addition or deletion of state or district by the respective state government in future. It is recommended that facility identifier should be a running serial number generated based on a selected algorithm like generation of AADHAR NUMBER which generate a unique number which is unique across the lifetime.

4.    Develop a central portal with standard operating procedures on deletion, updation or addition of facilities.

  • Portal for enrolling new public and private facilities into National Facility Registry.
  • Public Portal for access to National Facility Registry data as part of e-governance.  

 5.    Develop a roadmap for training & updation of National Facility database by state users.

 6.    Maintenance of National Health Facility Registry

For maintenance of Facility data in Facility Registry. openAPI/web service standards can be used to add/update or delete facility data. After Initial load of facility in facility registry any new facility shall be added in the Registry by use of openAPIs/webservices. The updation of facility registry shall follow the design principles for registries as laid out in National Health Stack document and will ensure the single source of truth and non repudiablity of facility data in registry.

Advantages of a harmonized facility registry using NHRR, NIN and ROHINI

  • The National Facility Registry will be a single source of truth for all the clinical establishments or healthcare facilities in India and can be a single point of reference for health infrastructure planning.
  • The Facility registry will always also help the Government to plan emergency responses and predict healthcare expenditure by making operational status of facilities available.
  • Harmonizing the different initiatives like NHRR, NIN and ROHINI will help in collating authentic data for facilities which are already recorded under respective initiatives while the initiatives coexist in harmony and expose the data as a service.
  • A repository like NHRR and state repositories if linked with the National Facility Registry can provide more information about a facility’s resources like Doctors, Nurses, equipment etc which will help a state to plan optimized utilization of available resources.

 A harmonized National facility registry can be one shot solution, which can support the Government to manage and optimize healthcare infrastructure & resources effectively and predict the unmet needs to design an effective risk mitigation plans in advance to combat a future pandemic. It can identify key areas of improvement by upgrading existing health facilities or establishing new health facilities keeping in view the population density, geographic nature, health condition, distance.

For Annexures please read the full Health Facility Registry document on slideshare.

Reach out to us for clarifications:

Department of Digital Health, ACCESS Health