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Editorial 1 : Ayushman Bharat Digital Mission: Making healthcare accessible, the digital way

Context:

  • India has demonstrated its digital prowess by building digital public goods (DPG) — the digital identity system Aadhaar, the DPGs built on top of Aadhaar and the Unified Payments Interface.
  • While Aadhaar has become central to India’s public service delivery architecture, UPI has transformed how payments are made.
  • Our digital public infrastructure has reached the last mile, enabled by 1.2 billion wireless connections and 800 million internet users.
     

Role of Digital health system in better deliverance of health facilities:

  • India leveraged information and communications technologies (ICTs) during the pandemic.
  • Digital health solutions played a crucial role in bridging the gap in healthcare delivery as systems moved online to accommodate contactless care.
  • Some examples of DPGs developed during the pandemic include the Covid Vaccine Intelligence Network (CoWIN) and the Aarogya Setu application.
  • CoWIN propelled India to adopt a completely digital approach to its vaccination strategy.
  • Aarogya Setu provided real-time data on active cases and containment zones to help citizens assess risk in their areas.
  • Telemedicine platforms saw a steep increase in user acquisitions, as 85 per cent of physicians used teleconsultations during the pandemic, underscoring the need to better incorporate cutting-edge digital technologies into healthcare services.
  • Although the impact of the pandemic on health services put the spotlight on the benefits of digital innovation and technology-enabled solutions, private entities, health technology players, and the public sector have been driving digitisation in the sector for some time now.
  •  It has become clear that a comprehensive digital healthcare ecosystem is necessary to bring together existing siloed efforts and move toward proactive, holistic, and citizen-centric healthcare.

 

Steps taken by government to promote digital health:

  • Recognising this need, the government has created shared public goods for healthcare and developed a framework for a nationwide digital health system. This brought healthcare to a turning point in India.
  • The PM launched the Ayushman Bharat Digital Mission (ABDM) on September 27, 2021, under the aegis of the National Health Authority. Within a year of its launch, ABDM has established a robust framework to provide accessible, affordable, and equitable healthcare through digital highways.
  • The ABDM has implemented vital building blocks to unite all stakeholders in the digital healthcare ecosystem.
  • The Ayushman Bharat Health Account (ABHA) creates a standard identifier for patients across healthcare providers.
  • With the ABHA and its associated Personal Health Record (PHR) app, citizens can link, store, and share their health records to access healthcare services with autonomy and consent. With more than 300 million ABHAs and 50 million health records linked, the mission is growing at a massive rate.


The Health Facility Registry (HFR) and the Health Professional Registries (HPR):

  •  It  provide verified digital identities to large and small public and private health facilities and professionals.
  • This enables them to connect to a central digital ecosystem while serving as a single source for verified healthcare provider-related information.
  • HFR and HPR improve the discovery of healthcare facilities and help health professionals build an online presence and offer services more effectively.
  • The Drug Registry is a crucial building block designed to create a single, up-to-date, centralised repository of all approved drugs across all systems of medicine.

 

The Unified Health Interface (UHI) is another DPG at the cusp of market launch.

  •  It aims to strengthen the health sector by enabling all healthcare service providers and end-user applications to interact with each other on its network.
  • This will provide a seamless experience for service discovery, appointment booking, teleconsultations, ambulance access, and more.
  • The UHI is based on open network protocols and can address the current challenge of different digital solutions being unable to communicate with each other

 

Levering the advantages of available digital health platform:

  • To give UHI the necessary push, the government is repurposing Aarogya Setu and CoWIN. Aarogya Setu is being transformed into a general health and wellness application.
  • At the same time, CoWIN will be plugged with a lite Hospital Management Information System (HMIS) for small clinics, to bring digitisation to the masses.
  • Another use-case of ABDM is scan and share, which uses a QR code-based token system to manage queues at hospital counters. It uses the foundational elements of ABHA and PHR to streamline the outpatient registration process in large hospitals.


Conclusion:

  • The ABDM has proven to be a valuable asset and its adoption across states has been accelerated by the National Health Authority.
  • It aims to build the foundation for a sustainable digital public infrastructure for health, enabling India to achieve universal health coverage which embodies G20’s theme of “Vasudhaiva Kutumbakam” or “One Earth. One Family. One Future”.


Way forward:

  • With the implementation of digital solutions, the next step is to digitise and automate the insurance claim settlement process through the Health Claim Exchange platform.
  • This will make claim-related information verifiable, auditable, traceable and interoperable among various entities, enabling claim processing to become inexpensive, transparent and carried out in real time.
  • The government is also planning to expand its digital initiatives in the healthcare sector with Heal by India, making India’s healthcare professionals’ services available worldwide.
  • Additionally, a platform is being developed to automate the allocation of deceased organ and tissue donations, making the process faster and more transparent.

The Ayushman Bharat Digital Mission (ABDM)

It aims to develop the backbone necessary to support the integrated digital health infrastructure of the country. It will bridge the existing gap amongst different stakeholders of healthcare ecosystem through digital highways.

 

Vision: to create a national digital health ecosystem that supports universal health coverage in an efficient, accessible, inclusive, affordable, timely and safe manner, that provides a wide-range of data, information and infrastructure services, duly leveraging open, interoperable, standards-based digital systems, and ensures the security, confidentiality and privacy of health-related personal information.

 

Ayushman Bharat Digital Mission Components

1. ABHA Number:  It is important to standardize the process of identification of an individual across healthcare providers.

  • This is the only way to ensure that the created medical records are issued to the correct individual or accessed by Health Information User through appropriate consent.
  •  In order to issue the UHID, the system must collect certain basic details including demographic and location, family/relationship, and contact details. Ability to update contact information easily is the key.
  • The ABHA(Ayushman Bharat Health Account) Number will be used for the purposes of uniquely identifying persons, authenticating them, and threading their health records (only with the informed consent of the patient) across multiple systems and stakeholders.

 

2. Unified Health Interface (UHI) UHI is envisioned as an open protocol for various digital health services.

  • UHI Network will be an open network of End User Applications (EUAs) and participating Health Service Provider (HSP) applications.
  •  UHI will enable a wide variety of digital health services between patients and health service providers (HSPs) including appointment booking, teleconsultation, service discovery and others

 

3. ABHA Mobile App (PHR) :

  • A PHR is an electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.
  • The most salient feature of the PHR, and the one that distinguishes it from the EMR and EHR, is that the information it contains is under the control of the individual

 

4. Health Facility Registry (HFR)

  • It is a comprehensive repository of health facilities of the nation across different systems of medicine. It includes both public and private health facilities including hospitals, clinics, diagnostic laboratories and imaging centers, pharmacies, etc.
  • Enrolling in the Health Facility Registry will enable them to get connected to India's digital health ecosystem.

 

5. Healthcare Professionals Registry (HPR) - It is a comprehensive repository of all healthcare professionals involved in delivery of healthcare services across both modern and traditional systems of medicine. Enrolling in the Healthcare Professionals Registry will enable them to get connected to India’s digital health ecosystem.


Editorial 2: Union Cabinet approves Green Hydrogen Mission: A look at India’s push for the fuel

Recent Context:

  • Recently, Central The government has approved the National Green Hydrogen Mission with  outlay of Rs 19,744 crore which aims of making India a global hub for the production of green hydrogen.
  • A mission at the creation of export opportunities for green hydrogen and its derivatives; decarbonisation of the energy sector and use in mobility applications in a bid to lower the dependence on imported fossil fuels; and the development of indigenous manufacturing capacities.
  • The ultimate aim is to fuel key sectors of the economy using hydrogen that is made by splitting water through an electrical process called electrolysis, using a device called electrolyser that is powered entirely by renewable energy.

Hydrogen as a fuel

  • Hydrogen, the most common element in nature, exists only in combination with other elements, and has to be extracted from naturally occurring compounds like water (which is a combination of two hydrogen atoms and one oxygen atom). Hydrogen is a clean molecule, but the process of extracting it is energy intensive.
  • While hydrogen’s potential as a clean fuel source has a history of nearly 150 years, it was only after the oil price shocks of the 1970s that the possibility of hydrogen replacing fossil fuels came to be considered seriously.
  • The sources and processes by which hydrogen is derived are categorised by colour tabs.
  • Hydrogen produced from fossil fuels is called grey hydrogen, which constitutes the bulk of the hydrogen generated today. Hydrogen generated from fossil fuels with carbon capture and storage options is called blue hydrogen, while hydrogen generated using electrolysers powered by renewable power sources is called green hydrogen.

 

Production-based coding of hydrogen

Green hydrogen potential: green hydrogen has specific advantages.

  • One, it is a clean burning molecule that can decarbonise a range of sectors including iron and steel, chemicals, and transportation.
  •  Two, renewable energy that cannot be stored or used by the grid can be channeled to produce hydrogen.
  • Green hydrogen is not commercially viable at present. The current cost in India is around Rs 350-400 per kg; it is likely to become viable only at a production cost of under Rs 100/ kg. This is what the Hydrogen Energy Mission aims for.

 

The Mission will result in the following likely outcomes by 2030:

  • Development of green hydrogen production capacity of at least 5 MMT (Million Metric Tonne) per annum with an associated renewable energy capacity addition of about 125 GW in the country
  • Over Rs. Eight lakh crores in total investments
  • Creation of over Six lakh jobs
  • Cumulative reduction in fossil fuel imports over Rs. One lakh crore
  • Abatement of nearly 50 MMT of annual greenhouse gas emission
  • The initial outlay for the Mission will be  Rs.19,744 crore, including an outlay of Rs.17,490 crore for the SIGHT  programme, Rs.1,466 crore for pilot projects, Rs.400 crore for R&D, and Rs. 388 crore towards other Mission components.  
  • The implicit subsidy support and a government-backed R&D push,
  • A major part of this is a proposed Strategic Interventions for Green Hydrogen Transition Programme (SIGHT), under which two financial incentive mechanisms — targeting domestic manufacturing of electrolysers and the production of green hydrogen — will be promoted to achieve a reduction in fossil fuel imports and abatement of annual greenhouse gas emissions by 2030
    •  the plan is to target lower costs of renewable power generation and to bring down the costs of electrolysers to make the production of green hydrogen cost-competitive.
  •  Green hydrogen could eventually potentially replace fossil fuels and fossil fuel-based feedstocks in fertiliser production, petroleum refining, steel production, and transport applications.
  • The United States and European Union have already pledged incentives worth several billions of dollars for green hydrogen projects.

 

Auto sector, fuel cells

  • Hydrogen is an energy carrier, not a source of energy. Hydrogen fuel must be transformed into electricity by a device called a fuel cell stack before it can be used to power a car or truck.
  • A fuel cell converts chemical energy into electrical energy using oxidising agents through an oxidation-reduction reaction.
  • Fuel cell-based vehicles most commonly combine hydrogen and oxygen to produce electricity to power the electric motor on board. Since fuel cell vehicles use electricity to run, they are considered electric vehicles (EVs).
  • Inside each fuel cell, hydrogen is drawn from an onboard pressurised tank and made to react with a catalyst, usually made from platinum.
    • As the hydrogen passes through the catalyst, it is stripped of its electrons, which are forced to move along an external circuit, producing an electrical current.
    •  This current is used by the electric motor to power the vehicle, with the only byproduct being water vapour.
  • Hydrogen fuel cell cars have a near-zero carbon footprint. Hydrogen is about 2-3 times as efficient as burning petrol, because an electric chemical reaction is much more efficient than combustion. The Toyota Mirai and the Honda Clarity cars are powered by fuel cells.

 

Hydrogen Use cases in India

  • India’s electricity grid is predominantly coal-based and will continue to be so, thus negating collateral benefits from a major EV push, as coal will have to be burnt to generate the electricity that will power these vehicles.
  • In several countries that are pushing EVs, much of the electricity is generated from renewables — in Norway for example, 99 per cent is hydroelectric power.
  • Hydrogen vehicles can be especially effective in long-haul trucking and other hard-to-electrify sectors such as shipping and long-haul air travel.
  • Using heavy batteries in these applications would be counterproductive, especially for countries such as India, where the electricity grid is predominantly coal-fired.
  • Besides auto, there is a concerted attempt to leverage green hydrogen in sectors such as petroleum refining and steel. In April 2022, state-owned Oil India Limited commissioned India’s first 99.99 per cent pure green hydrogen plant in Jorhat, Assam.
  • In the proposed Mission, the steel sector has been made a stakeholder, and it has been proposed to set up pilot plants with part funding from the government to explore the feasibility of using green hydrogen in Direct Reduced Iron (DRI) production by partly replacing natural gas with hydrogen in gas-based DRI plants.
    • Based on the success of the pilot projects, the gas-based DRI units are to be encouraged for large-scale adoption of the process.

 

Conclusion:

  • The government initiative of national mission of green hydrogen is in right direction towards Renewable based energy generation as which will help in  achieving India’s INDC targets under Paris climate deal.
  • Along with it, It will also have significant advantages such as – Reducing the dependence on imported fossil fuels which will reduce India’s import bill also reduce CAD,
  • It is a step towards Decarbonisation which will lead to GHGs reduction and also creations of job in new area of economy.
     

Process and advantages of Using green Hydrogen: