[PPT] - National Health Stack Open House Discussion 23rd May 2020 iSPIRT PowerPoint Presentation

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National Health Stack

Open House Discussion

23rd May 2020

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iSPIRT Overview

SLIDE 3 30 yr Architects 10 yr Planners 5 yr Doers

Think Tanks
Universities
Research Labs
VCs
Policy Makers
Incumbents
Challengers

iSPIRT Foundation: a non-profit Tech Think-and-Do Tank Driving 30-year Orbit Shifts Powered by no-greed and no-glory volunteering!

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India Stack Overview

SLIDE 5 Bill Gates Gates Foundation India is on the cusp of leapfrogging and leading the world in digital Financial inclusion and is becoming the most digitalised economy. 2016 Adam Minter Author, Junkyard Planet China has invested more than $125B in Africa. An Indian innovation, however, could be what African countries really need. India Stack would boost growth as much as Chinese-built

infrastructure. .2018

Prof Kenneth Rogoff Harvard Economist The world has much to learn from Aadhar. 2017 Prof Vasant Dhar NYU Stern, Ed. Big Data If we want control over data, the Indian model

ffers a path toward

individual data empowerment for the Internet age. 2018 Global Digital Public Goods Alliance India with likely co-founders: Norway, Singapore, Japan. Interested Members: Philippines, Morocco, Rwanda, Kenya, Indonesia, Myanmar, Nigeria, Tanzania, Afghanistan, Bangladesh, Togo,

The world is noticing India Stack!

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India Stack has three layers

Identity Layer Giving every resident a unique id and enabling them to prove “I am who I claim to be” Payments Layer Allowing anyone to pay anyone else! interoperable, fast and cheap - not just smartphones. Data Empowerment To enable secure sharing of data ➔ Unified Payments Interface ➔ Aadhaar Payments Bridge ➔ Aadhaar Enabled Payment Service ➔ Aadhaar ➔ eKYC ➔ eSign ➔ Consent Artefact ➔ DigiLocker ➔ Account Aggregator I d e n t i t y L a y e r Payments Layer Data Layer 6

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INDIA STACK powers many Use-cases

Direct Benefit Transfer Jan Dhan Financial inclusion Lending Transactions Wealth Management Insurance New Business Services India Stack Infrastructure Identity Layer P a y m e n t s L a y e r D a t a L a y e r 7

SLIDE 8 Needs a loan Sees many types of loan offers Accepts best

ffer

Receives loan Sells Goods Repays loan Agrees to share data Electronic Data Consent Credit marketplace app Credit marketplace Paperless contract Transaction a/c & app Payment app Collections app Aadhaar/eK YC NBFC Account Aggregator API for Loan Offers eSign Digilocker UPI Public Credit Registry E-lien, Eman- dates BBPS

India Stack is about democratizing credit for Rajni!

Work started in 2013 8

SLIDE 9 Needs a loan Sees many types of loan offers Accepts best

ffer

Receives loan Sells Goods Repays loan Agrees to share data Electronic Data Consent Credit marketplace app Credit marketplace Paperless contract Transaction a/c & app Payment app Collections app Aadhaar/eK YC NBFC Account Aggregator API for Loan Offers eSign Digilocker UPI Public Credit Registry E-lien, Eman- dates BBPS Market Innovators Build the Middle Layer Digital Public Infrastructure 9 1 2 3 4 5 6 7 8

SLIDE 10 Needs a loan Sees many types of loan offers Accepts best

ffer

Receives loan Sells Goods Repays loan Agrees to share data Electronic Data Consent Credit marketplace app Credit marketplace Paperless contract Transaction a/c & app Payment app Collections app Aadhaar/eK YC NBFC Account Aggregator API for Loan Offers eSign Digilocker UPI Public Credit Registry E-lien, Eman- dates BBPS India Stack has led to creation of two new trade-bodies: Market Innovators Build the Middle Layer Digital Public Infrastructure 10

SLIDE 11 Shift for Market Players New world where Digital Public Infra is coming in place first v/s 11

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National Health Stack Overview

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Our objective is to build a world class universal health system with radically low cost, high access and good quality

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SLIDE 14 Improve the efficiency and capacity of the care delivery system through a strong digital foundation Re-align incentives to shift the approach

f care delivery from transaction, curative

focused to longitudinal, wellness focused Leverage Ayushman Bharat for experimentation and scale-up By designing a three-pronged approach 14

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National Health Stack

ELECTRONIC REGISTRIES Doctor registry Facility registry Procedure registry Drug registry ... PERSONAL HEALTH RECORDS E-prescription E-discharge summary Diagnostic e-reports ... ELECTRONIC CLAIMS SWITCH E-claims Ayushman Bharat e-Vouchers ... Plumbing Layer Streamlining flow of patients, health information and money Gamifier Payers Preventive Care Fiduciary Treatment Care Fiduciary GOVT & PRIVATE APPS & PLATFORMS Diverse user experiences & innovative solutions CONSUMER APPS/PORTALS HEALTH PROVIDER APPS/PLATFORMS JAM & INDIA STACK JAM & INDIA STACK Cross domain generic building blocks Private Sector Other Apps HIMS/ LIMS Other Platforms Public Sector PROTOCOL SERVER PERCEPTRON/ DIAGNOSTIC BOTS MATCHING ENGINE Augmentation Layer Enhancing capabilities

f all actors

Digital Public Infrastructure Private Innovation 15

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Personal Health Records

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PHR is part of the Data Empowerment & Protection Architecture (DEPA)

Identity Layer Giving every resident a unique id and enabling them to prove “I am who I claim to be” Payments Layer Allowing anyone to pay anyone else! interoperable, fast and cheap - not just smartphones. Data Empowerment To enable secure sharing of data ➔ Unified Payments Interface ➔ Aadhaar Payments Bridge ➔ Aadhaar Enabled Payment Service ➔ Aadhaar ➔ eKYC ➔ eSign ➔ Consent Artefact ➔ DigiLocker ➔ Account Aggregator I d e n t i t y L a y e r Payments Layer Data Layer 17

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1 2 3

India is making digital infrastructure as public goods. Indians are becoming data-rich. Indians are Going Digital

SLIDE 19 WHAT THE DATA IS USED FOR Data is used to sell things to the user Data to be used to empower the user WHO CONTROLS THE DATA P u t t h e u s e r s i n t h e c e n t r e !

We Need To Invert The Status Quo

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SLIDE 20 Classification of Data LONGITUDINAL PERSONAL HEALTH RECORD PUBLIC HEALTH/ EPIDEMIOLOGY MEDICAL RESEARCH/ BOT TRAINING RESOURCES 20

SLIDE 21 MeitY Consent Artefact - National Standard Compliant with the ORGANS Principles: Open, Revocable, Granular, Auditable, Notice, Secure <consentcollector> CC </consentcollector> <dataconsumer> DC </dataconsumer> <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> <revocable> YES </revocable> <access> VIEW| STORE| QUERY </access> </datatype> <datatype type=”profile”> </datatype> <loggingInfo> … </loggingInfo> <purpose code=””> LOAN </purpose> <signature> #@%%#@$$##$@ </signature> Identifier Section Data Section Logging Section Signature Section Purpose of Data Access 21

SLIDE 22 Tech Institution Law

Data Empowerment & Protection Architecture (DEPA)

Who can use my data and Why? How can I be sure my data is not misused? What can I do if my data is being misused? Tools for restoring agency to the user 22

SLIDE 23 The Account Aggregator by RBI/SEBI/PFRDA/IRDA will facilitate consented sharing of financial information in real-time Bank Mutual Fund House Insurance Provider Tax / GST Platform Flow-Based Credit Personal Finance Management Wealth Management Robo Advisors Financial Information Providers Financial Information Users (NBFC Account Aggregator) Request for Data Consent to Share Encrypted Data Flow Registry 23

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Story of Health Data Today

User Lab Report Prescription Discharge Summary Physical Folder that user carries with himself Clinic Lab Hospital

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Historic Data accessible through Standardised Discovery Protocol

User E- Lab Report ID = PM-JAY ID E- Prescription ID = Mobile+Demo E - Discharge Summary ID = Aadhaar Lab Health Locker Longitudinal Health Records Hospital Clinic saurabh@healthlocker

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Federated Health Data Storage

User Health Locker Repository Repository providers store provider

data. Locker may store duplicates.

(Same design as DigiLocker) Hospital Repository Repository Standardized APIs Repositories must be highly “available” Clinic Incentives enable an ecosystem of repository providers to emerge

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Sharing of Health Data with Consent

User Health Locker Repository Hospital Repository Repository Treating Doctor Doctor App Standardized APIs Standardized APIs MeitY Electronic Consent Clinic

SLIDE 28 Hospital Lab Health Apps Hospital Health Lockers Doctor / Specialist Insurance Provider Personal Health Apps Health Information Providers Health Information Users Consent & Healthcare Data Flows based on India’s Data Empowerment & Protection Architecture (DEPA) Request for Data Consent to Share Encrypted Data Flow 28

SLIDE 29 Minimal, one-time change required in existing systems 29

Schema-level standardisation

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Features of Personal Health Record Framework

Federated Architecture (Real-time aggregation

f health records from

different sources) Privacy Prouection (Use of Electronic Consent and Consent Managers) Schema-level Standardisation (Minimal change to data formats of existing health records) 30

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PHR Demo

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SLIDE 32 Lab 1 Lab 2 Gateway CM 1 LIMS 1 Control flows (account discovery, account linking, consent) Health Information Providers (HIPs) Clinic 1 Aggregator Software Hosp 1 Hosp 2 HIMS 1 Hosp 3 API Bridge 1 API Bridge 2 Lab 3 CM 2 Consent Managers (CMs) Hosp 4 Hosp 5 HIMS 2 API Bridge 3 HealthTech App API Bridge 4 Clinic 1 Aggregator Software Hosp 4 Lab 5 Data flow Health Information Users (HIUs) Lab 3 LIMS 2 CM Registry Bridge Registry User Consent & Healthcare Data Flows Architecture 32

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Open APIs - Personal Health Records https://projecteka.github.io/content/d

cumentation.html

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PHR Pilot

If you’re interested in participating in the pilot as a:

Health Information Provider
API Bridge
Health Information User
Consent Manager

please drop us an email at community@ispirt.in 34

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Next Open House Discussion

Clarifications on PHR, Design of Doctor Registry

11:30 AM to 12:30 PM, 30th May 2020
Please Register Here: https://bit.ly/NHS-OHD (Technical Session)

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Thank You