Ayushman Bharat Will Change The Face of Healthcare In India: Sohit Kapoor

What are the kinds of offerings that you started offering on Driefcase? 

So our core offering has been the personal health lockers.  It's like a locker, it's a place where you can in a secured environment, store all your health information, all your health records. Over our journey, we would have spoken to hundreds and thousands of users. And universally this concept is loved, well loved. I talk to you. I tell you what if I can get all your family's medical records on a phone? You will say, it's a no brainer. Let's do that. Having said that, no one does. And that is what we realised was the real challenge that while there was a need for this, there was this big issue of quality user inertia. So our core offering was targeted at resolving this pain point that give people a secured environment to host to store all their health information, yet not have to put in the effort to kind of keep loading.

We spoke to hundreds of doctors and thousands of doctors, the idea was to go to them because digitisation of healthcare is not possible only to target one stakeholder which is the patient, you have to target all the stakeholders. So we added Driefcase Connect as a solution for doctors to digitise their practice. And because Driefcase and Driefcase Connect get connected at the backend, it also makes communication between the doctor and the patient seamless. 

So what did you do differently to solve this problem?

So a personal health locker had been there, it is not a new product. I would say that every meaningful app, healthcare app in the past has had a locker as a feature. So if you pick up any diagnostic chain, and you have the big diagnostic change app, they would say, Hey, you can store your health information here. Or you look at any of your you know, large healthtech apps of the past, everyone would say you have a repository. The real challenge, as I said, is the repository is there, but who will load records. And all these expected the user to load records into it to tag information.

Now let's see if you have 50 records at home. And I told you to click 50 pictures for all these 50 Records mentioning the date of the document, what's the type of document, what's some tag for this document so that it becomes easy for you to retrieve because binding storage is one part. And that sometimes is easy. You can say I'm gonna Google Drive, I've scanned and put everything,  retrieval is equally or sometimes I'd say more important. Can you find that document in a matter of seconds? And that is where we were different from what we tried to create. We tell users with minimal effort, you can load records into the app. And when you have to search for any document promised to our users, it won't take you more than 10 seconds.

How do we achieve that? So uploading, as I said, there are multiple ways of uploading records. Simplest is you can actually WhatsApp your document to a centralised number. So patient WhatsApp records to our centralised number and it goes in their account automatically. Or you can email or you can click a picture and upload. And the way the email works is it's kind of your unique identifier. It's not necessary, you email it, the lab, the hospital you go to you give this as your registered email address to them. So the moment a report is generated, they send it out on email. Instead of going to your registered email it comes to this Driefcase ID goes in your account and gets forwarded to your email address. So a bypass mechanism gets created which ensures that your account is updated as well as you get the report on your registered email ids.

But what happens in case of an emergency, does the healthcare institution or a doctor have access to your records?

So there are two aspects to this one is that it's the aspect of this emergency care, which is where the construct of family account also becomes more relevant. So if you look around in every family there is that one member of the family who's the core primary health caregiver, for example, in your family, it could be you or your spouse. So in my case, for example, it is me, I know, the health issues not only of my parents, but of my child, my spouse and I know where the health information is.

But yes, what happens in case, I am the one who is subjected to an emergency, and which is there, this whole family account construct that any of your family members can retrieve the information and share it with the care provider. So that's one aspect of it right? With the Ayushman Bharat Digital Mission (ABDM), there are use cases being built. So I call it break the glass kind of use case where there could be certain elements of your emergency health information that you can designate to be shared with a care provider in case of an emergency, even when you are not capable of giving them. So yes, those use cases are also being built to automate that process. In the absence of that your family members kind of step in and play that role of sharing.

And how do you ensure the privacy of this? How do you ensure that data does not leak out? And because health records are typically very highly protected for privacy laws? And also, would this data be available or accessible at any point in time to your insurance company?

So let me start by talking about firstly the aspects of privacy from a regulatory perspective. The good thing is that over the last 5-7 years, data privacy norms in this country are becoming kind of clearer and clearer. Today, it is quite clear that the healthcare information ownership rests with the patient. And the reason I stress on that is because it's a question that has floated around for far too long as to who owns the data. Today regulatorily that ownership question is in our minds completely settled, it belongs to you as a patient.

How do we follow that is that no specific data, healthcare data can be shared without your action.  Now, thanks to the ABDM, thanks to the data privacy laws, consent does not mean a blind tick on the form. Consent means a specific consent in a specific format for Driefcase over the last 5-7 years, even in the pre ABDM era. The way we did that is we used to call it positive action by the customer so you can go decide to share your records with your doctor with your insurance company with your friends, whatever you want to do briefcase will not share that.

But also, how do you ensure it in practice, so we've taken a lot of steps on the security aspect of data. So your transmission of data is encrypted, your storage of data is encrypted with a second layer of encryption. So we follow the best practices that are followed around the world. As far as data security is concerned. And the analogy we give to our customers to our user, this think of it the same way that you think of a banking transaction is the kind of similar level of security that we are treating this database.

So the issue that has always been there is the interoperability problem. So are you planning on creating interoperability with the say, similar players in the international market or other players in India?

When we started to case, the idea was that we would create an interoperable ecosystem ourselves. And that's what we had started doing. But along the way came the health stack, the ABDM. So now actually speaking, we don't need to create that interoperability. The government through this mission is creating interoperability. So what's happening is, if you look at the US, the US digitised their healthcare 10 years back thanks to Obamacare. And today, their system is beautifully digitised. But it missed on this point of interoperability. So today, the US system works in silos. So if you are within those silos, you're fine. If you are within the network of your insurance company, you're fine. But God save you if you're trying to move from one silo to the other, because then that's where the nightmare is. Thanks to us now, starting at a time where we have seen success of interoperability through UPI, we've seen success with digital identity , we've been able to actually leapfrog that. So today, the way the health stack is playing out, the focus is more if you ask me on interoperability, then only digitisation so as a participant in the ABDM.

And as an early participant, we are seeing it play out in actually a fabulous manner, I'd say. So, the way the framework is designed, you can go to any hospital, you can go to any lab, you can go to any doctor, if that healthcare provider is a participant in the mission is as plugged in or integrated into the ABDM, then your data is available for you to fetch anytime 24 by seven, and share basis, your consent. So there it works in a very seamless manner. In an interoperable setup, the layer that precedes brings in all the functionality that we face brings to you there is twofold.

Can you explain for the benefit of our readers? What is  ABDM? And how does it make a difference to our lives?

We believe that the ABDM will change the face of healthcare in India, it will change the way we traverse our health journey from now. So what is this ABDM? It's a digital framework that is being created by the government of India to enable interoperable and seamless digital healthcare in India. What does that mean, for people like you and me? Today, when we go to a doctor, we are carrying all our health records and all our health information in a bag, we store these records at home in a drawer.

The idea behind the digital mission is to make sure that how you are as I mentioned very early on, all your banking has become digital so that you don't need to carry paper around. Similarly, in a healthcare journey, you don't need to carry paper. So you go to a doctor and your past reports are available to the doctor based on your consent in a digital format, the doctor issues the prescription to you in a digital format. If you get hospitalised, then your entire health information is in a digital format. Your insurance claim post processing is paperless.So that's the kind of impact we see how checks and demand drafts are relics of the past. We believe your healthcare records will also follow the same route. And most importantly, it will make diagnosis for your doctors far more robust and far easier. 

(Watch The Full Interview Here: https://youtu.be/sKbR3OcSPXc)