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Technical Standards of the Personal Health Records (PHR) component of the National Health Stack

We have an exciting announcement for you all today!

We are publishing a draft of the technical standards of the Personal Health Records (PHR) component of the National Health Stack (NHS)!

As a refresher, these standards govern the consented sharing of health information between Health Information Providers (HIPs) – like hospitals, pathology labs, and clinics –  and Health Information Users (HIUs) like pharmacies, medical consultants, doctors, and so on. The user’s consent to share their health data is issued via a new entity called a Health Data Consent Manager (HDCM). 

This is a big deal. The problem today is that the electronic health records listed in one app or ecosystem are not easily portable to other systems. There is no common standard that can be used to discover, share, and authenticate data between different networks or ecosystems. This means that the electronic medical records generated by users end up being confined to many different isolated silos, which can result in frustrating and complex experiences for patients wishing to manage data lying across different providers. 

With the PHR system, a user is able to generate a longitudinal view of their health data across providers. The interoperability and security of the PHR architecture allows users to securely discover, share, and manage their health data in a safe, convenient, and universally acceptable manner. For instance, a user could use a HDCM to discover their account at one hospital or diagnostic lab, and then select certain electronic reports to share with a doctor from another hospital or clinic. The flow of data would be safe, and the user would have granular control over who can access their data and for how long. Here is a small demo of the PHR system in action. 

The standards document released today offers a high level description of the architecture and flows that make this possible. You can find version 0.5 of the document embedded below.

Health Information Flows Technical Standards – V 0.5 from ProductNation/iSPIRT.

All the exciting progress we are making on this new digital public infrastructure for healthcare is all thanks to you, the community. We are grateful for your support and look forward to engaging with you further!

The blogpost is co-authored by our volunteers Aaryaman Vir, Saurabh Panjwani and Graphics by Dharmesh BA.

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NHS Open House Discussion #4: Doctor Registry, Enrollment APIs And PHR

On 13th June, iSPIRT hosted the fourth open house discussion on the National Health Stack (NHS). For anybody unfamiliar with the NHS, here are some introductory blog posts and videos.

In the session, our volunteer Vikram Srinivasan deep dived into the Enrollment APIs of the electronic doctor registry. These APIs are called when a new doctor is being added to the registry, or when a doctor’s information is being uploaded. 

Vikram also spoke about the attestation APIs, which come into play when an attesting institution (such as a state medical council, medical college, or hospital) confirms some data about a doctor. This is crucially important for building trust in the registry and preventing the proliferation of false profiles. With the release of these enrolment and attestation APIs, all the APIs pertaining to the electronic doctor registry are now available here.

After Vikram’s presentation, he and our other volunteer Siddharth Shetty answered some technical questions submitted by the community. Here are some of the questions they fielded:

  • Doctors have multiple identities (from different medical councils), how are these unique IDs handled by the electronic registry?
  • Can anybody access the doctor information in the registry, including phone numbers and photographs of doctors?
  • Who can healthcare companies partner with in the Health Stack Ecosystem?
  • How does the federated network architecture of the PHR system deal with downtimes, incorrect data, and other failure? Is this architecture scalable for a system with 1000s of participants?

As always, these were great questions. You can watch Sid and Vikram answer these questions and walk through their presentations below. Please keep the questions coming by sending them in through this form: https://bit.ly/NHS-QAForm.

If you would like to get involved with Health Stack, we encourage you to watch the recordings of the previous Health Stack open house discussions before reaching out.

Furthermore, if you are interested in the Health Stack and wish to build on top of it or contribute to the working groups being formed, you should reach out to [email protected]

Please note: The fifth open house on PHR Implementation was previously planned for 27th June. This has been postponed to 11:30 am on 4th July due to unavoidable circumstances.

To confirm your participation, continue to register on this form.

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iSPIRT NHS Open House Session #2: PHR and Doctor Registry

iSPIRT hosted the second open house session on the National Health Stack (NHS). 

In this session, our health stack volunteers dived deeper into the Personal Health Record (PHR) system and also covered the concept of the Electronic Doctor Registry.

In the first part of the session, our volunteer Siddharth Shetty answered technical questions pertaining to the PHR system. These questions, which were all submitted by the community, covered topics ranging from blockchains and zero-knowledge proofs to assisted consent flow for low tech-savvy users. A link to a recording of the session can be found at the end of this post.

In the second half of the session, our volunteer Kiran Anandampillai explained the concept of the doctor registry. The electronic registry system is a mechanism for managing master data about different entities in the healthcare ecosystem. Although some of these entities do appear in existing databases, these legacy systems are often incomplete, outdated, and seldom accessible via APIs. In contrast, the registries in the NHS are intended to capture trusted, non-repudiable data and enable self-maintainability. These registries will also have open APIs and will allow for secure authentication and data sharing. 

In the context of doctors, the electronic doctor registry can be used to:

  • Prove their identity and credentials as doctors
  • Electronically sign documents such as prescriptions, insurance claims, operating theatre notes, and more
  • Streamline workflows such as joining or telehealth application or registering for CME points (Continuing Medical Education points necessary for renewing a doctor’s license)

A recording of the entire session, including a breakdown of the design principles, APIs, and timelines behind the doctor registry, can be found below.

Inquisitive readers are also encouraged to submit their technical questions around the NHS to [email protected].

We will be answering those questions at the start of next week’s open house session, which will begin at 11:30 am on Saturday, 6th June. An invite to that session will be sent out to all participants who sign up at this link: https:// www.bit.ly/NHS-OHD

Although these sessions have so far been focusing on technical features of the NHS, the business and design aspects are also crucially important and will be covered in short order.

The blog post is authored by our volunteer Aaryaman Vir and he can be reached at [email protected].