This article discusses the ambitious project of the National Health Portal being implemented by the Union Ministry of Health & Family Welfare. Written by Rajendra Pratap Gupta

1. 78 I June 2013
Policies & Regulations: National Health Portal
T
he National Health Portal
(NHP) that was established a
few years ago (2010-2011) was
set up to put information on
standardisation and protocols in the public
domain. The effort was also to ensure that
the medical records of the NHP project
looked at a long-term view of creating a
portal that, in the words of Sam Pitroda,
‘will be a game changer in healthcare.’As of
April 2013, the work continues to be
moving at a snails pace and the expected
date of launch (August 2013) seems
unrealistic.
Reality: When it comes to
information on health-related issues
1. Information overload confuses the
patient or the information seeker.
2. Lack of credibility of information that
is available for India/from India.
3. Inconsistency of information.
4. Literacy rate in India as per 2011 census
is 74.04 per cent.
5. About 30 per cent (330 million) Indians
belong to the poor category, where
healthcare affordability and accessibility
is a serious cause of concern.
6.Broadband connections at the end of January
2013, according to TRAI, were 15.01
million.Ruralwirelesssubscribersareabout2
million.According to 2011 census,about 20
per cent of urban households and 5 per cent
of rural households now own a computer or
laptop. About 1 per cent rural India owns a
laptop or computer with a net connection.
In terms of information communication
mediums, television is far ahead of others.
Then comes print. According to the Deloitte
Media Democracy Survey, almost 64 per cent
respondentsidentifiedtelevisionastheprimary
influencer and about 63 per cent mentioned
newspapers as the next influencer. Mobile as
a medium ranks third According to TRAI,
the tele density has reached 74.24 per cent.
However, according to GSMA, taking into
account the multiple SIM cards and actual
number of active users, there are about 380
million actual users -- about 26 per cent of
the total population. Reports are indicating
that Indian broadband users are switching to
mobile internet. Clearly, mobile will be the
game changer for the healthcare industry and
the national health portal should be available
as an app on all mobile phones Next is Radio.
Indian Readership Survey (IRS) report says
that, the share of radio listenership on mobile
The National Health Portal (NHP) was ideated in 2010 and in June 2011, the Health Ministry announced
that NHP, recommended by the National Knowledge Commission, would make optimum use of technology
for establishing a database of medical records of all citizens and other health-related issues. Has this plan
lived up to the expectations?
Time for a reality check
Health Portal Home Page
Year 1-4 & Beyond Main Links Sub-Links
Healthy
Lifestyle
Healthy Living A-Z List Ayurveda
Unani
Schemes
Siddha
Homeopathy
Interactive
Tutorials
Yoga &
Naturopathy
Healthcare
Provider Locator
User-Specific
Information
Careers
E-Learning
NEWS for
Healthcare
Professional
National Health
Programmes
State Health
Programmes
Disaster
Management
Forums
News
Forums for
Students and
Professionals
National
Standards
International
Standards
Governance
& Protocols
Redressal
Mechanism
First Aid
Public Health
Alerts
Food & Nutrition
Women’s Health
Pregnancy
Child Health
Teen Health
Sexual Health
Healthy Aging
Psychosocial Health
Occupational Health
Travel Health
Health
Conditions
Alternative
Medicine
Directory
Services
Regulatory
Issues
MiscellaneousProfessional
Enhancement

2. National Health Portal
81June 2013 I
phones has increased from 20 per cent in
2009 to about 30 per cent in 2011-12. Future
growth in listenership is expected to come
from increased penetration of FM radio in
smallercities.AccordingtoPrasarBharati,over
99.19 per cent of the population have access
to this cheap medium of communication.
Against only six radio stations in 1947, today
the number has increased to 326. The All
India Radio (AIR) broadcasts program in 23
languages and 146 dialects.
Now, let us relate the above-mentioned
realities with the project site map as
mentioned in the initial project document.
It talks about health content, AYUSH
content, regulatory information, disaster
management and directory services.
(Question: Do we actually need all this?)
Site map
If we connect the intent behind the NHP,
its objectives and outcomes, the site map
and the reality on ground with the need
of the hour, following must be taken into
consideration:
The NHP is not clear whom it wants
to serve? Healthcare professionals, rural
population,poor,urban elite etc,or all of them?
What NHP can actually deliver with
the above-mentioned complicated site
map, which will be extremely difficult to
navigate for 95 per cent of the population?
Should NHP be just a web portal for
electronic health records and protocols,
which are meant for clinicians or educated
urban elite, or it should provide clinically
validated primary care information and
OTC-based treatment and automated
electronically guided referrals for the
entire population, linking it to the nearest
ASHA worker,PHC,Jan Aushadhi stores,
hospitals, and diagnostic labs, mapped
with geographic information system across
the nation?
Primary suggestions
1. First and foremost, we need an
introductory video of how to use the
NHP, and this video must be not more
than a minute. Let us not assume that
all the people know how to use Internet
(more so, a health website )
2. The NHP needs to be mNHP (Mobile
version is a must). A tie up with COAI
& TRAI could help in pre-loading this
mNHP app in every mobile phone sold
in India.
3. Instead of the complicated site map,
which will put off majority of users
& fail in its objective, it might be
good to consider a simple, intuitive,
user friendly and interactive interface.
So if I log in from a remote class IV
town, using the IP/ network location,
the NHP should give me an option
of opening a webpage indexed to my
town in my local language (so that I
could access the local resources that I
might need and in the language that
I can understand).
4. Next important thing I should be asked
(pictorial or audio visual is better), is that
whether I am looking for a disease-related
information, doctor, diagnosis, medicine
(substitute, price, drug interactions, side
effects or availability) etc. If I click on
disease-related information, I must be
guided to something like this in the
local language,
If I click on the body part, I should
be taken to the ailment and suggestions
provided based on an interactive interface.
Say, pain in stomach could further prompt,
did you take (a) meal outside, (b) consume
alcohol, (c) did pain happen before, (d) did
you take medicine etc. If someone has taken
a medicine, s/he could just feed his contact
number which could be automatically
forwarded to a national health helpline (local
network of ASHA or primary health worker
or healthcare service provider) for further
consultation or suggest a locally available
emergency care or healthcare provider
(private or public). Alternatively, a user
might like to check for medical information
or availability of a particular medicine.
Also, the user must be given an option to
chose a line of treatment, be it AYUSH or
allopathic system.NHP must be able to give
the information needed that is actionable.
Needless to say,that the clinical information
on the website must be something that
can be relied upon and not outsourced to
organisations that have a conflict of interest.
Points to consider
We must keep in mind that Indians, or for
that matter anywhere in the world,we surf the
web either out of curiosity or need,and when
it comes to health,it is a need-based search.
Also,we must be clear which segment of
the population the NHP wishes to serve?
Will it be end users, or doctors, nurses,
pharmacists, ASHA workers etc. and,
would it be just the tablet wielding urban
eliteorpeopleresidingintheremotestparts
of the country,or all of them? If we make it
too wide (currently, the project document
makes it look vague and intellectual) and
the NHP comes up as mentioned in the
document, it will be too cluttered and
will end up being another government
website available. Clearly, the NHP could
provide links for healthcare professionals
but, as a NHP, it must clearly demarcate
its sections without being over crowded.
It should also give an option of uploading
the health records,which are secure,ensure
privacy and ease of use anytime/anywhere.
May be, a good idea would be to provide
EHR-enabled patient portals, which are
interoperable and can be connected to any
healthcare providers
Also, it might be a good idea to develop
newsletters,health tips and alerts on various
health topics and send it periodically
to users who opt for them through
email or SMS. Also, Facebook, Twitter,
Doordarshan and AIR could be used for
promoting NHP and keeping the users
engaged. Since NHP is being managed
by NIHFW, it would be good idea to link
government medical colleges and its staff by
giving a login ID to individual government
doctors for answering the questions on the
chat forums, which come from the public
via live chats (this could happen at phase
II).The chat section needs to be supervised
at the NHP HQ. The difference that the
NHP can make to the lives of Indians is
phenomenal, but one needs to map the
needs with the user’s psyche, and fulfill
it with advice that is credible, actionable
and acceptable.
(office@rajendragupta.in)
Rajendra Pratap Gupta
International Healthcare Expert,
President,DMAI