- India has a large, exceptionally talented and experienced IT manpower.
- India is at the point of radical departure from how government provided healthcare for a billion plus people. A NITI Aayog proposal describes a new plan, under which the public health infrastructure, which used to be built by the government and managed by the doctors and personnel employed by it, is moved to a public-private partnership model.
- Private doctors and private health facilities will now be the backbone of the national health service at the primary level. The government will reimburse the private healthcare entities based on the type and the volume of services rendered. Even at the secondary level, private hospitals of many different kinds will play a greater role in government health programs. With so many new entities, and both medical professionals and private businesses playing a role, the only way to make them part of a seamless network is by leveraging the IT sector to provide shared information infrastructure. Simply creating a new reimbursement model, without creating the required infrastructure, will lead to a nightmare in the future.
- The field of health information systems in India has not yet been run over by several EMR monopoly companies. Such companies not only have little incentive to support the standards but are prosperous in thwarting them too. Without standards, each system becomes an island and does not communicate or share information with the others.
- The national biometric ID project (UIDAI), or Aadhaar, provides an ideal solution to a problem faced by other countries, which is the lack of continuity of care due to the records of patients being fragmented across systems of different providers. In the US, for example, reconciling of records from different systems has always been a challenge since it is not always possible to definitively identify patients in different systems. ‘Aadhaar’ will allow the linking of all disparate records of an individual into one seamless record.
- There are many large sized open source projects which the National EMR project can draw upon. Even in healthcare there have been many projects which may offer valuable lessons to the National EMR project. Some open source projects in the past have floundered or failed because there was no sustained support for them from a company or a government organization. Given an assurance of viability, many developers will be keen to participate in such a project.
- The technology of web-accessed cloud-based systems has grown leaps and bounds in the last five years, while most current popular EMRs seem to be stuck with the technology from the early last decade. Any interaction with an EMR seems like one being transported back in time.
When I opposed Aadhaar in 2010 , I was called a BJP stooge. In 2016 I am still opposing Aadhaar for the same reasons and I am told I am a Congress die hard. No one wants to see why I oppose Aadhaar as it is too difficult. Plus Aadhaar is FREE so why not get one ? Ram Krishnaswamy
First they ignore you, then they laugh at you, then they fight you, then you win. -Mahatma Gandhi
In matters of conscience, the law of the majority has no place. Mahatma Gandhi
“The invasion of privacy is of no consequence because privacy is not a fundamental right and has no meaning under Article 21. The right to privacy is not a guaranteed under the constitution, because privacy is not a fundamental right.” Article 21 of the Indian constitution refers to the right to life and liberty -Attorney General Mukul Rohatgi
“There is merit in the complaints. You are unwittingly allowing snooping, harassment and commercial exploitation. The information about an individual obtained by the UIDAI while issuing an Aadhaar card shall not be used for any other purpose, save as above, except as may be directed by a court for the purpose of criminal investigation.” -A three judge bench headed by Justice J Chelameswar said in an interim order.
Legal scholar Usha Ramanathan describes UID as an inverse of sunshine laws like the Right to Information. While the RTI makes the state transparent to the citizen, the UID does the inverse: it makes the citizen transparent to the state, she says.
Good idea gone bad
I have written earlier that UID/Aadhaar was a poorly designed, unreliable and expensive solution to the really good idea of providing national identification for over a billion Indians. My petition contends that UID in its current form violates the right to privacy of a citizen, guaranteed under Article 21 of the Constitution. This is because sensitive biometric and demographic information of citizens are with enrolment agencies, registrars and sub-registrars who have no legal liability for any misuse of this data. This petition has opened up the larger discussion on privacy rights for Indians. The current Article 21 interpretation by the Supreme Court was done decades ago, before the advent of internet and today’s technology and all the new privacy challenges that have arisen as a consequence. Rajeev Chandrasekhar, MP Rajya Sabha
“What is Aadhaar? There is enormous confusion. That Aadhaar will identify people who are entitled for subsidy. No. Aadhaar doesn’t determine who is eligible and who isn’t,” Jairam Ramesh
But Aadhaar has been mythologised during the previous government by its creators into some technology super force that will transform governance in a miraculous manner. I even read an article recently that compared Aadhaar to some revolution and quoted a 1930s historian, Will Durant. Rajeev Chandrasekhar, Rajya Sabha MP
“I know you will say that it is not mandatory. But, it is compulsorily mandatorily voluntary,” Jairam Ramesh, Rajya Saba April 2017
Here is what the Parliament Standing Committee on Finance, which examined the draft N I A Bill said.
1. There is no feasibility study of the project]
2. The project was approved in haste
3. The system has far-reaching consequences for national security
4. The project is directionless with no clarity of purpose
5. It is built on unreliable and untested technology
6. The exercise becomes futile in case the project does not continue beyond the present number of 200 million enrolments
7. There is lack of coordination and difference of views between various departments and ministries of government on the project
What was said before the elections:
NPR & UID aiding Aliens – Narendra Modi
"I don't agree to Nandan Nilekeni and his madcap (UID) scheme which he is trying to promote," Senior BJP Leader Yashwant Sinha, Sept 2012
"All we have to show for the hundreds of thousands of crore spent on Aadhar is a Congress ticket for Nilekani" Yashwant Sinha.(27/02/2014)
TV Mohandas Pai, former chief financial officer and head of human resources, tweeted: "selling his soul for power; made his money in the company wedded to meritocracy." Money Life Article
Nilekani’s reporting structure is unprecedented in history; he reports directly to the Prime Minister, thus bypassing all checks and balances in government - Home Minister Chidambaram
To refer to Aadhaar as an anti corruption tool despite overwhelming evidence to the contrary is mystifying. That it is now officially a Rs.50,000 Crores solution searching for an explanation is also without any doubt. -- Statement by Rajeev Chandrasekhar, MP & Member, Standing Committee on Finance
Finance minister P Chidambaram’s statement, in an exit interview to this newspaper, that Aadhaar needs to be re-thought completely is probably the last nail in its coffin. :-) Financial Express
The Rural Development Ministry headed by Jairam Ramesh created a road Block and refused to make Aadhaar mandatory for making wage payment to people enrolled under the world’s largest social security scheme NRGA unless all residents are covered.