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NDHM & What it means to be Integration Ready

5 minutes read

The healthcare industry in India has been steadily growing at a Compound Annual Growth Rate of around 22% since 2016 and is expected to reach USD 372 billion in 2022. 

NITI Aayog released a report titled ‘Investment Opportunities in India’s Healthcare Sector’ published by PIB which states that “The Indian Healthcare market is expected to reach $190 Bn by 2020; $372 Bn by 2022 at a CAGR of 39% The digital healthcare market in India was valued at INR 116.61 Bn in 2018, and is estimated to reach INR 485.43 Bn by 2024, expanding at a compound annual growth rate (CAGR) of ~27.41% during the 2019-2024 period.” 

The expansion of private hospitals to Tier-2 and Tier-3 cities is looking like an attractive investment opportunity in the hospital segment. With respect to the pharmaceutical industry, India is likely to boost domestic manufacturing, supported by recent Government schemes under the Aatmanirbhar Bharat initiative.

Wellness tourism, under the medical value travel diaspora, has given an impetus to the rise of alternative medicine and treatment prospects. Technology, by way of innovations in Artificial Intelligence (AI), wearable technologies, and the Internet of Things, also offer multiple avenues. 

The Indian healthcare system is fast-moving towards a wellness-driven model of care delivery from an otherwise historically siloed and episodic intervention approach. This streamlining of the healthcare system creates a wealth of new opportunities for healthcare enterprises and institutions. The hospital industry in India accounts for nearly 60% of the overall health ecosystem’s revenues. The addition of new frameworks for Health ID, PHR, telemedicine, and OPD insurance will create macro-level demand beyond local in-patient catchment zones.

Traditional modes of healthcare delivery are being phased out in favor of new and disruptive models. The COVID-19 pandemic and its subsequent waves have changed consumer demand and given a big push for the need for a digital healthcare ecosystem. 

Source: Mantra Labs Whitepaper, March 2021

The National Health Stack (NHS), a digital platform with the aim to create universal health records for all Indian citizens by 2022, aims to bring both central and state health verticals under the same umbrella. 

The action plan to fulfill the creation of the NHS is laid out in the National Digital Health

Blueprint (NDHB), which also outlines the vision for Universal Health Coverage, that’s been in the pipeline for India’s underprivileged. This is where the National Digital Health Mission (NDHM) comes into the picture, as the entity responsible for the successful implementation of the aforementioned Blueprint and subsequent Health Stack. 

The blueprint recommends two building blocks namely, Personal Health Identifier (PHI), and Health Master Directories & Registries, for handling the requirements of a unique identity (much akin to Aadhar) of persons, facilities, diseases, and devices. These building blocks that India is creating for its 1.4 billion citizens are said to be equipped with an interoperability option to seamlessly access digital records.

With rapid rates of digitalization and increasing demands from connected consumers, an integrated ecosystem will allow healthcare providers to deliver value-based care and outcomes in a real-world scenario. The NDHE can potentially create over US$200 billion in economic value for the health sector, over the next 10 years, according to BCG analysis. 

The National Digital Health Blueprint (NDHB) underlines key principles which include domain perspectives namely, Universal Health Coverage, Security & Privacy, Education & Empowerment, and Inclusiveness of citizens; and the technology perspective namely, Building Blocks, Interoperability, a set of Registries as single sources of truth, Open Standards and Open APIs.

Source: Mantra Labs Whitepaper, March 2021 

How integration-ready are we? 

Most hospitals in India continue to use paper-based medical records and verbal procedures to communicate among doctors and nurses for a patient’s treatment. This causes serious implications such as lack of transparency, lack of accountability, error-prone treatment, non-integrated patient health records, difficulty to understand the past medical history, poor collaboration within a team of doctors, a higher threat to infection, and a lack of progress towards adopting AI/ML-based technologies. As the consumer is being ushered into the ‘age of experiences‘, the onus is on digital healthcare enterprises to make them more relevant, emotional, and personalized.

Source: Mantra Labs Whitepaper, March 2021

An integration engine is not only an interface engine but also a healthcare integration platform that supports the day-to-day operations of a care delivery organization. From interfaces to workflow to operational decisions, integration engines assist in modernizing the healthcare system.

Source: Mantra Labs Whitepaper, March 2021 

By preparing for integration readiness, healthcare providers can access new patient demand pools from Tier-2 and Tier-3 cities, identify insights about the health consumer’s lifecycle needs, and leverage new technologies to draw in more value from these interactions than ever before.

As a result, hospitals will be able to drive improved margins from reduced administrative costs and gain higher utilization through increased demand. 

Healthcare experiences future will include insights harnessed from data and human expertise to bring sensory value to each interaction, in other words, the integration of IX or Intelligent Experiences.

Read our detailed Digital Health whitepaper to get more insights into NDHM and what it means to be integration-ready. 

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Conversational UI in Healthcare: Enhancing Patient Interaction with Chatbots

As healthcare becomes more patient-centric, the demand for efficient and personalized care continues to grow. One of the key technologies that have gained traction in this domain is Conversational UI (CUI) — a user interface where interactions occur through natural language, often with the help of chatbots. For developers, building a robust CUI in healthcare requires a balance of technical proficiency, understanding of the healthcare landscape, and empathy toward patient needs. Let’s explore how CUI can improve patient interactions through chatbots and what developers should consider during implementation.

Why Conversational UI is Gaining Popularity in Healthcare

From scheduling appointments to answering medical queries, healthcare chatbots have become vital tools for enhancing patient engagement and streamlining healthcare workflows. Conversational UIs enable these chatbots to interact with patients naturally, making them accessible even to non-tech-savvy users. By incorporating AI and NLP (Natural Language Processing), chatbots can now simulate human-like conversations, ensuring patients receive timely, relevant responses. 

Image credit: https://www.analytixlabs.co.in/blog/ai-chatbots-in-healthcare/ 

Key Areas Where Chatbots Are Revolutionizing Healthcare

  1. Appointment Scheduling and Reminders – Chatbots can automatically schedule appointments based on patient availability and send reminders before the visit, reducing no-show rates. For developers, this feature requires integration with hospital management systems (HMS) and calendar APIs. The challenge lies in ensuring secure and real-time data transfer while adhering to healthcare compliance standards like HIPAA.
  1. Medical Query Resolution– Chatbots equipped with NLP can answer common patient questions related to symptoms, medications, and treatment plans. This reduces the burden on healthcare providers, allowing them to focus on more critical tasks. Developers working on this feature need to consider integrating medical databases, such as SNOMED CT or ICD-10, for accurate and up-to-date information.
  1. Patient Monitoring and Follow-ups – Post-discharge, chatbots can monitor a patient’s condition by regularly asking for health updates (e.g., vital signs or medication adherence). Developers can integrate IoT devices, such as wearable health monitors, with chatbot platforms to collect real-time data, providing healthcare professionals with actionable insights.
  1. Mental Health Support – Chatbots have shown promise in offering mental health support by providing patients with an outlet to discuss their feelings and receive advice. Building these chatbots involves training them on therapeutic conversational frameworks like Cognitive Behavioral Therapy (CBT), ensuring they offer relevant advice while recognizing when a human intervention is required.

Key Considerations for Developers

1. Natural Language Processing (NLP) and AI Training

NLP plays a pivotal role in enabling chatbots to understand and process patient queries effectively. Developers must focus on the following:

Training Data: Start by gathering extensive datasets that include real-life medical queries and patient conversations. This ensures that the chatbot can recognize various intents and respond appropriately.

Multi-language Support: Healthcare is global, so building multi-lingual capabilities is critical. Using tools like Google’s BERT or Microsoft’s Turing-NLG models can help chatbots understand context in different languages.

Contextual Understanding: The chatbot must not just respond to individual queries but also maintain the context across the conversation. Developers can use contextual models that preserve the state of the conversation, ensuring personalized patient interactions.

2. Security and Compliance

Healthcare chatbots handle sensitive patient information, making security a top priority. Developers must ensure compliance with regulations such as HIPAA (Health Insurance Portability and Accountability Act) in the U.S. and GDPR (General Data Protection Regulation) in Europe. Key practices include:

  • Data Encryption: All communication between the chatbot and the server must be encrypted using protocols like TLS (Transport Layer Security).
  • Authentication Mechanisms: Implement two-factor authentication (2FA) to verify patient identity, especially for sensitive tasks like accessing medical records.
  • Anonymization: To avoid accidental data breaches, ensure that the chatbot anonymizes data where possible.

3. Seamless Integration with EHR Systems

For chatbots to be truly effective in healthcare, they must integrate seamlessly with Electronic Health Record (EHR) systems. This requires a deep understanding of healthcare APIs like FHIR (Fast Healthcare Interoperability Resources) or HL7. Developers should aim to:

  • Enable Real-time Updates: Ensure that chatbot interactions (e.g., new appointment schedules, and symptom checks) are instantly reflected in the patient’s EHR.
  • Avoid Data Silos: Ensure that all systems (EHR, chatbot, scheduling system) can communicate with each other, eliminating data silos that can lead to fragmented patient information.

4. Scalability and Performance Optimization

In healthcare, downtime can be critical. Developers need to ensure that chatbots are scalable and capable of handling thousands of patient interactions simultaneously. Using cloud-based platforms (AWS, Google Cloud) that offer auto-scaling capabilities can help. Additionally, performance optimization can be achieved by:

  • Caching Responses: Store frequently used responses (such as FAQs) in memory to speed up interaction times.
  • Load Balancing: Implement load balancers to distribute incoming queries across servers, ensuring no single server is overwhelmed.

Tools and Platforms for Building Healthcare Chatbots

Several tools and platforms can aid developers in building healthcare chatbots with conversational UIs:

  1. Dialogflow (Google): Offers pre-built healthcare intents and integrates with Google Cloud’s healthcare APIs.
  2. Microsoft Bot Framework: A scalable platform that integrates with Azure services and offers AI-driven insights.
  3. Rasa: An open-source NLP tool that provides flexibility in creating highly customized healthcare bots.

Conclusion

Conversational UI in healthcare is transforming patient care by offering real-time, scalable, and personalized interactions through chatbots. However, for developers, building these systems goes beyond programming chatbots — it involves understanding the unique challenges of healthcare, from regulatory compliance to seamless integration with hospital systems. By focusing on NLP capabilities, ensuring security and privacy, and integrating with existing healthcare infrastructure, developers can create chatbots that not only enhance patient interaction but also alleviate the burden on healthcare providers.

References

  1. NLP in Healthcare: Opportunities and Challenges
  2. HIPAA Compliance for Chatbots

About the Author:

Shristi is a creative professional with a passion for visual storytelling. She recently transitioned from the world of video and motion graphics to the exciting field of product design at Mantra Labs. When she’s not designing, she enjoys watching movies, traveling, and sharing her experiences through vlogs.

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