Page 118 - ITU KALEIDOSCOPE, ATLANTA 2019

2019 ITU Kaleidoscope Academic Conference

2007-08 and till about 2016 about more than 1 lakh samples research laboratories working in the area of
of various food commodities have been analyzed [19]. Food- pesticides/contaminants/toxicology/pollution, nutrition and
borne diseases (FBDs) not only directly impact human health total diet studies/surveys, etc.). It is therefore of paramount
but also impede socioeconomic development by straining importance that countries like India implement an integrated
healthcare systems and harming national economies, tourism national health stack (NHS) built on the principles of
and trade [20]. Thus, information on pesticide residues in knowledge management systems (KMS) connecting all the
food, as well as food-borne diseases, should be integrated relevant sources. The proposed conceptual model (Figure 1)
with the HMIS. Similarly, information on air pollution, henceforth referred to as the national health stack (NHS) is a
waterpollution, soil pollution etc. being collected by various multilayered and multi-stakeholder model. The main
government authorities (pollution control boards) that has objectives of NHS (Figure1) would be to:
direct or indirect impact on human health should also be
available to PH authorities. However, data being collected by 1. facilitate inter-sectoral involvement and collaboration
these various authorities is “stove piped” into standalone of various stakeholders including government
databases that are not accessible within and across authorities and citizens (Figure 1: referred to as ‘Block1
government agencies. Non-standardized data collection, Data Providers’);
varied data formats, incompatible data IT systems, a sense of 2. develop an integrated KM platform using appropriate
ownership by the group that collects the data are the factors technologies (Figure 1, referred to as ‘Block2 KM
that further worsen the problem [21]. Platform’);
3. evolve policies, regulations and health standards, based
To surmount these issues, India has also renewed its focus on the (public) health predictions made by the related
on the implementation of the proposed ‘National Digital decision making/decision support bodies of the country
Health Blueprint’, the precursor of which can be traced back (Figure 1, referred to as ‘Block3 Decision makers and
to NITI Aayog’s vision document in 2018 laying out the R&D’);
strategy and approach for a national health stack [22]. In 4. spread social learning; NHS to also serve as a tool for
“India’s Trillion-Dollar Digital Opportunity” (pp 122), a spreading awareness on the creation and usage of this
report by the Ministry of Electronics and Information unified approach (Figure 1, Block3).
Technology, Government of India (GoI) [23], there are
examples of actions that are required for improving PH. The The aforementioned four layers (S. No. 1-4) form the basic
need to build an integrated health information platform to design structure of the proposed NHS. However, depending
create and provide access to electronic health records (EHR) on the implementation context of the respective countries,
for every Indian has been highlighted, which would be using more layers can be added to the NHS. Irrespective of the
open APIs. Emphasizing the need of public private number of layers or building blocks in each of these layers,
partnerships (PPP) in the health domain, suggests the the underlying system design principle weaving all of them
development of the PPP model for setting up digital remains the same. This principle is that all data/ information
infrastructure and training for health workers in primary flows emanating to/from each of these blocks/layers of NHS
health centers and other medical care facilities. The report have strong bidirectional feedback loops (Figure 1). Only
also highlights the need of finalization and implementation then the proposed NHS would be able to serve as a common
of the ‘Digital Information Security in Healthcare’ Act repository of data for multiple
(DISHA Act) to provide a framework for the sharing of agencies/authorities/stakeholders. The multisectoral data
health information digitally. The need to frame policy to would be collated, analyzed using advanced ICT techniques
mandate EHR adoption was also highlighted. To catalyze and presented as a ‘visualization layer’, pictorial, user-
implementation of these health aspirations of the nation, the friendly information presented to the decision makers for
Satyanarayana Committee (2018-19), setup by Government strategic planning. Collecting data from different authorities
of India, has been recently tasked with the purpose of will require inter-sectoral cooperation, interoperability and
suggesting a National Digital Health Blueprint so that adequate digital standards and ‘openness’ (to share). Such a
continuum of care could be provided to the citizens. national level KMS will essentially consist of the technology
layer viz.hardware (servers for storage of data, routers for
Thus, it is the right time to design and implement an communication, etc.), software (database for storage of
integrated, comprehensive and effective ICT-based system information, interfaces, etc.), Connectivity (telecom/data
with real-time linkages not only between various public connectivity and related protocols for connecting the various
health authorities but also other authorities that impact public databases and exchange of information) and the application
health. This can be achieved by adopting a holistic layer that would adequately employ a decision support
knowledge management system, as proposed below. system to run data analytics, open APIs etc. (Figure 1,
Block2). The output of these analyses will then be shared
4. PROPOSED CONCEPTUAL MODEL OF NHS: with the related stakeholders (Figure 1, Block3) such as
ICT-BASED KMS FOR PUBLIC HEALTH government, regulatory bodies, at various levels for policy
making, setting standards, regulation making, prospective
As already stated in section 1, PH is a multidisciplinary field planning and building synergies with government plans in an
that requires data/information from multiple sources integrated manner. This synergy can be assured only when
(disease surveillance, health systems, food testing as well as adequate adherence is done to international health standards

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