What practical steps can a country take to
begin to develop a NeSF (National eHealth Standards Framework) that supports
health care delivery and UHC initiatives? The following are recommended by Ritz, Althauser and Wilson [2014] as useful, actionable steps:
1. Storyboard: Develop a set of characteristic user
stories that illustrate both the care workflows and the health insurance workflows
common to the country. These stories should be aligned with the country’s
health strategic goals (e.g., if improving maternal health outcomes is a
strategic goal for the health ministry, draft stories describing maternal care
delivery activities).
2. Stack: Based on the requirements and the
constraints in the country, choose a “stack of standards.” [MoHFW, Government of
India has already notified the Standards for EHR in India in August 2013.
The National Health Portal also offers a Help Desk for that.]
3. Scope: Narrow the initial implementation scope
and grow the scope over time. Any country embarking on a national-scale eHealth
infrastructure effort will be well served by focusing on a few key areas. [A
“crawl, walk, run” strategy “from the essential to the optimal” is more
practical.]
Keeping the above recommendations in mind, India needs to
incorporate the NeSF within its National
eHealth Strategy / Policy (NeHS/NeHP) that has to be formulated by the Proposed
National eHealth Authority (NeHA). It will be good if the NeHA is set up immediately so that the NeHS/NeHP for India can be
outlined, in consultation with all the stakeholders, especially the state
governments, as Health is a State subject in India. India’s NeHS/NeHP has to be
aligned with the National Health Policy, Digital India initiatives, as well as
the proposed National Health Assurance Mission
(NHAM) policies, so that a focused
and judicious use of ICT can make the healthcare delivery systems more
efficient and transparent. It will be good to build the ICT policies of NHAM
upon the existing ICT mechanisms of the National Health Mission (NHM) and the
Rashtriya Swasthya Bima Yojana (RSBY) instead of reinventing the wheels.
