National Health StackOpen House Discussion

23rd May 2020

iSPIRT Overview

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 TankDriving 30-year Orbit Shifts

Powered by no-greed and no-glory volunteering!

India Stack Overview

Bill GatesGates 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 MinterAuthor, 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 RogoffHarvard Economist

The world has much to learn from Aadhar. 2017

Prof Vasant DharNYU Stern, Ed. Big Data

If we want control over data, the Indian model offers a path toward individual data empowerment for the Internet age. 2018

Global Digital Public Goods AllianceIndia 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 LayerGiving every resident a unique id and enabling them to prove “I am who I claim to be”

Payments LayerAllowing anyone to pay anyone else! interoperable, fast and cheap - not just smartphones.

Data EmpowermentTo enable secure sharing of data

➔ Unified Payments Interface➔ Aadhaar Payments Bridge➔ Aadhaar Enabled Payment Service

➔ Aadhaar➔ eKYC➔ eSign

➔ Consent Artefact➔ DigiLocker➔ Account Aggregator

Identity Layer

Payments Layer

Data Layer

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INDIA STACK powers many Use-cases

Direct Benefit Transfer

Jan DhanFinancial inclusion

Lending

Transactions

Wealth Management

Insurance

New Business Services

India Stack Infrastructure

Identity Layer

Payments Layer

Data Layer

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Needs a loan

Sees many

types of loan offers

Accepts best offer

Receives loan

Sells Goods

Repays loan

Agrees to share data

Electronic Data

Consent

Credit marketplace app

Credit market-

place

Paperless contract

Transaction a/c & app

Payment app

Collections app

Aadhaar/eKYC

NBFC Account

Aggregator

API for Loan Offers

eSign Digilocker

UPI

PublicCredit

Registry

E-lien,Eman-dates

BBPS

India Stack is about democratizing

credit for Rajni!Work started in 2013

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Needs a loan

Sees many

types of loan offers

Accepts best offer

Receives loan

Sells Goods

Repays loan

Agrees to share data

Electronic Data

Consent

Credit marketplace app

Credit market-

place

Paperless contract

Transaction a/c & app

Payment app

Collections app

Aadhaar/eKYC

NBFC Account

Aggregator

API for Loan Offers

eSign Digilocker

UPI

PublicCredit

Registry

E-lien,Eman-dates

BBPS

Market Innovators Build the Middle Layer

Digital Public Infrastructure

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1

2

3

4

5

6

7

8

Needs a loan

Sees many

types of loan offers

Accepts best offer

Receives loan

Sells Goods

Repays loan

Agrees to share data

Electronic Data

Consent

Credit marketplace app

Credit market-

place

Paperless contract

Transaction a/c & app

Payment app

Collections app

Aadhaar/eKYC

NBFC Account

Aggregator

API for Loan Offers

eSign Digilocker

UPI

PublicCredit

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

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Shift for Market PlayersNew world where Digital Public Infra is coming in place first

v/s

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National Health Stack Overview

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

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Improve the efficiency and capacity of the care delivery system through a strong digital foundation

Re-align incentives to shift the approach of care delivery from transaction, curative focused to longitudinal, wellness focused

Leverage Ayushman Bharat for experimentation and scale-up

By designing a three-pronged approach

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National Health Stack

ELECTRONIC REGISTRIES

Doctor registryFacility registryProcedure registryDrug registry...

PERSONAL HEALTH RECORDS

E-prescriptionE-discharge summaryDiagnostic e-reports...

ELECTRONIC CLAIMS SWITCH

E-claimsAyushman Bharate-Vouchers...

Plumbing LayerStreamlining flow of patients, health information and money

Gamifier Payers Preventive Care Fiduciary Treatment Care Fiduciary

GOVT & PRIVATEAPPS & PLATFORMSDiverse user experiences & innovative solutions

CONSUMER APPS/PORTALS HEALTH PROVIDER APPS/PLATFORMS

JAM & INDIA STACK

JAM & INDIA STACKCross domain generic building blocks

Private Sector

Other Apps

HIMS/LIMS

Other Platforms

Public Sector

PROTOCOL SERVER PERCEPTRON/ DIAGNOSTIC BOTS MATCHING ENGINE

Augmentation LayerEnhancing capabilities of all actors

Dig

ital P

ublic

In

fra

stru

ctur

eP

riva

te

Inno

vatio

n

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Personal Health Records

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

Identity LayerGiving every resident a unique id and enabling them to prove “I am who I claim to be”

Payments LayerAllowing anyone to pay anyone else! interoperable, fast and cheap - not just smartphones.

Data EmpowermentTo enable secure sharing of data

➔ Unified Payments Interface➔ Aadhaar Payments Bridge➔ Aadhaar Enabled Payment Service

➔ Aadhaar➔ eKYC➔ eSign

➔ Consent Artefact➔ DigiLocker➔ Account Aggregator

Identity Layer

Payments Layer

Data Layer

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1 2 3India is making digital infrastructure as public goods.

Indians are becoming data-rich.

Indians are Going Digital

WHAT THE DATA IS USED FOR

Data is used to

sell things to the userData to be used to

empower the user

WHO CONTROLS THE DATA

Put the users in the centre!

We Need To Invert The Status Quo

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Classification of Data

LONGITUDINAL PERSONAL HEALTH RECORD

PUBLIC HEALTH/ EPIDEMIOLOGY

MEDICAL RESEARCH/ BOT TRAINING RESOURCES

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MeitY Consent Artefact - National StandardCompliant 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

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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

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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 AccountAggregator)

Request for Data

Consent to Share

Encrypted Data Flow

Registry

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Story of Health Data Today

User

Lab Report

Prescription

DischargeSummary

Physical Folder that user carries with himself

Clinic

Lab

Hospital

Historic Data accessible through Standardised Discovery Protocol

User

E- Lab ReportID = PM-JAY ID

E- PrescriptionID = Mobile+Demo

E - DischargeSummaryID = Aadhaar

Lab

Health Locker

Longitudinal Health

Records

Hospital

Clinic

saurabh@healthlocker

Lab

Federated Health Data Storage

User

Health LockerRepository

Repository providers store provider data. Locker may store duplicates.

(Same design as DigiLocker)

Hospital

Repository

Repository

Sta

ndar

dize

d A

PIs

Repositories must be highly “available”

Clinic

Incentives enable an ecosystem of repository providers to emerge

Lab

Sharing of Health Data with Consent

User

Health LockerRepository

Hospital

Repository

Repository

Treating Doctor

Doctor App

Sta

ndar

dize

d A

PIs

Sta

ndar

dize

d A

PIs

MeitY Electronic Consent

Clinic

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

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Minimal, one-time change required in existing systems29

Schema-level standardisation

Features of Personal Health Record Framework

Federated Architecture(Real-time aggregation of health records from

different sources)

Privacy Protection(Use of Electronic Consent

and Consent Managers)

Schema-level Standardisation

(Minimal change to data formats of existing health

records)

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PHR Demo

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Lab 1

Lab 2

Gateway

CM 1

LIMS 1

Control flows (account discovery, account linking, consent)

Health Information Providers (HIPs)

Clinic 1

Aggr

egat

or

Soft

war

e

Hosp 1

Hosp 2

HIMS 1

Hosp 3

API

Brid

ge 1

API

Brid

ge 2

Lab 3

CM 2

Consent Managers (CMs)

Hosp 4

Hosp 5

HIMS 2

API Bridge 3

HealthTech App

API Bridge 4

Clinic 1Aggregator Softw

are

Hosp 4

Lab 5

Data flow

Health Information Users (HIUs)

Lab 3LIMS 2

CM Registry

Bridge Registry

User

Consent & Healthcare Data Flows Architecture

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Open APIs - Personal Health Records

https://projecteka.github.io/content/documentation.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

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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