This is a good video discussion on ABDM for beginners to this space. Here @Angshuman Sarkar, (Architect of Bahmni) & Mrs Rupa Rao (co-founder HealtheLife) speak about why ABDM is transformational for India, and how will it pan out over the next 2-10 years. Link: https://www.youtube.com/watch?v=BJAuGNXHYG0&t=1326s
Interview of @Angshuman Sarkar printed in Economic Times, explaining WHY Bahmni and ABDM.
The Ayushman Bharat Digital Mission (ABDM) aims to develop the backbone necessary to support the integrated digital health infrastructure of the country. Ayushman Bharat Digital Mission will connect the digital health solutions of hospitals across the country with each other. The Mission will not only make the processes of hospitals simplified but also will increase ease of living. The Digital Ecosystem will also enable a host of other facilities like Digital Consultation, Consent of patients in letting medical practitioners access their records, etc. With the implementation of this scheme, old medical records cannot get lost as every record will be stored digitally.
How does it benefit me as a patient ?
Under the ABDM ecosystem, patients can create their unique identification ID called ABDH ID (previously known as Health ID). With the help of the ABHA ID the patient would be able to link and access their medical records in the PHR (personal health record) app. This removes the burden of carrying physical documents for the patient and also ensures that the medical records are never lost. It also enables the patient to share their health data with their doctors digitally.
Apart from storing, accessing and sharing their health records, the time required in the registration desk would also reduce for patients as with the help of the ABHA ID, the demographic details of the patient will be fetched and entered into the hospital management system automatically.
What is HRP, HIP, HIU, HRF and HPR ?
HRP: Health repository providers are software service providers who offer ABDM compliant software and long-term record storage to hospitals, diagnostic centres and clinics. The HRP service enables healthcare providers to become HIPs or HIUs and meet their obligations of sharing and securely maintaining health records of patients digitally. HRPs offer long term storage of health records on behalf of a HIP.
For example, a hosted lab information management system provider (LIMS) may update their software to become a ABDM compatible Health Repository Provider. Any lab using this LIMS software can rapidly become a HIP by adopting the software.
HIP : Any healthcare provider who creates health information in the context of providing healthcare related service to a patient and agrees to share the same digitally with the patient using the consent framework adopted by ABDM is called a health information provider (HIP).
All hospitals, diagnostic centers, clinics, public health programs, telemedicine players, etc are encouraged to become HIPs. HIPs use ABDM compliant software that implements the HIP software specifications.
HIU : Any entity that would like to access health records of an individual is called a Health Information User. This would include hospitals / doctors who would like to view medical history of patients, mobile applications that want to display health data to users including Personal Health Record applications, etc. Access to Health data is available to a HIU only with the individual’s consent. HIUs use a ABDM compliant software that implements the HIU software specifications.
HFR : ABDM maintains the national directory of all healthcare facilities. Any participating facility needs to sign up in the health facility registry at http://facility.ndhm.gov.in This ensures they are a valid facility that is authorised to issue health records in the ecosystem.
HPR: Healthcare Professionals Registry is a comprehensive repository of registered and verified practitioners delivering modern as well as traditional healthcare services across India. The Ayushman Bharat Digital Mission (ABDM) empowers the HPR to onboard healthcare professionals onto India’s digital health ecosystem and connect patients to healthcare providers or vice versa with last mile coverage. Every name visible to the public is certified and authorised to practice medicine in the country. The HPR ensures that only healthcare practitioners suitably trained and qualified to practice medicine with competence and ethical compliance can register with HPR. This ensures public good.
How is Bahmni ABDM integrated?
Bahmni is an open source hospital management system and electronic medical record software. Bahmni is ABDM compliant, i.e it has successfully integrated all the required milestones/ guidelines mandated by the NHA to be an ABDM compliant software.
The user can capture and verify the ABHA ID and fetch the demographic information of the patient.
The facility can act as a HIP, i.e. create medical records which can be shared digitally.
The facility can act as a HIU, i.e. request and view patient’s records in the software.
How can my clinic / hospital / diagnostic centre/ become part of the ABDM ecosystem using Bahmni ?
Since Bahmni is an HRP which is an ABDM compliant software provider, it has the power to register multiple HIPs (facilities) in the ABDM ecosystem. However, since we are not providing hosting services, we would request implementers to register as HRPs in the sandbox application form.
Any implementor planning to register in the ABDM ecosystem using Bahmni can fill the checkboxes as shown above to initiate the application process.
How does Bahmni benefit me as a facility if I need to apply through the sandbox process?
Even though you would need to apply through the sandbox application, with Bahmni you would not need to write codes to make the software ABDM compliant since Thoughtworks has already worked on developing the features required for approval. Bahmni would serve as a ready-to -use software, which the facility can easily make use of to register itself as an HRP , HIP and HIU.
What are the steps to get ABDM certified as a facility using Bahmni ?
You would need to set up Bahmni or get in touch with any of the implementing partners to set up Bahmni with ABDM features. Once that has been set up, you can register in the sandbox application process.
The next step would be to integrate the mandatory ABDM features . (This step would not be necessary using Bahmni as Thoughtworks has already developed the mandatory features).
This is followed by filling the form in your sandbox user account to initiate exit. There are 4 steps in the exit process:
Functional and non functional testing of the application by an internal NHA team
Engagement with relevant agencies to obtain and submit the “Safe-to-Host” certificate to NHA
A final round of approval for application go-live will be sought from the internal team at NHA. Applicants will be required to share the following before the committee:
Functional testing report for integrations completed (step 1)
Safe-to-Host certificate for the application (step 2)
Summary details of the application duly filled in
Once approved, access will be shared for integration in the production environment. Kindly ensure the partnering HIP is registered on Health Facility Registry in order to interface with the ABDM infrastructure
What benefits does it bring to an ABDM certified facility?
Registration in the HFR will enable health facilities to get connected to India's digital health ecosystem and allow their listing on a national platform. This will instill trust in citizens seeking healthcare services by improving discovery of health facilities. Health facilities signing up will be able to gain access to a host of digital services.
It benefits the facilities in the following ways:
Unique & Trustable Identity- Facility ID for identification of health facilities across the ABDM ecosystem.
Online Presence & Discoverability- Listing of health facilities on a national platform and availability in search results.
Ease of doing business- Digitisation of services reducing the efforts for registration & renewal of various licenses, and empanelment with insurance agencies, TPAs.
Unified Digital Services- Access to telemedicine, digital health records and HMIS solutions.
Does Bahmni have a patient’s app for patients to view their medical records?
No, Bahmni does not have its own patient’s app. However, that does not stop the patient from being able to access the medical records from Bahmni. The patient can do this with the help of the PHR (personal health record) app developed by the NHA. With the help of the PHR app, the patient can fetch and link the medical records from the consultation sessions in Bahmni, and view and share them when they are requested for by any healthcare provider.
Watch this video to learn how the patient can link and share records in the app :
What types of medical records can be linked and stored for a patient treated in a Bahmni implemented facility?
Patients will have the opportunity to link, securely store and access their medical records on their phone or online with the PHR app. Bahmni currently includes prescriptions, OPD consultation notes, diagnostic reports and discharge summaries.
What checklist does ABDM follow to certify a Hospital software product as compliant?
Do I need to link a PHR address to an ABHA number?
ABHA number is a 14 digit number and can be standalone. One PHR address, ie <14digitno>@abdm is automatically available for ABHA numbers and can be used to link health records.
Where do my health records get linked ?
A patient’s health records gets linked to the PHR address which the patient shares with the facility during registration. A patient may have several PHR address linked to a single ABHA number, but it is upon the patient which PHR address they choose to share with the facility in order for the health records to get linked. A patient might want to separate their mental health history and in this case, they might use a different PHR address.
Is it mandatory to link my PHR address to my ABHA number ?
No, it is not mandatory. It is a valid to have a PHR address which is not linked to an ABHA number. In this case, the patient can share the PHR address and the facilities can save the PHR address and link the care context to the PHR address.
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