Ayushman Bharat Digital Mission (ABDM)

India’s Digital Health Revolution: A Confluence of Technology and Tradition

The ‘UPI Moment’ for Healthcare

Just as UPI revolutionized payments in India, the Ayushman Bharat Digital Mission (ABDM) is building a unified ‘digital highway’ to connect the nation’s fragmented healthcare system. Its goal is to make healthcare accessible, secure, and patient-centric for every citizen.

The Four Pillars of ABDM: A Foundation for Digital Health

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ABHA Health Account

A 14-digit unique health ID for every citizen, acting as a ‘digital health locker’ to securely store and link all medical records in one place.

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Health Facility Registry (HFR)

A verified national directory of all hospitals, clinics, and labs, helping citizens find trusted and certified healthcare providers.

🧑‍⚕️

Healthcare Professionals Registry (HPR)

A credible database of all qualified and certified doctors and health workers, ensuring quality care and protecting against fraudulent practitioners.

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Unified Health Interface (UHI)

An open network that enables booking appointments, tele-consultations, and other services from any health app to any hospital.

ABDM in Action: The Progress Dashboard

ABHA Accounts Created

711M+

Health Records Linked

459M+

Registered Facilities

354K+

Registered Professionals

537K+

Growth of the Digital Health Ecosystem

This chart shows the comparative growth of registered facilities, professionals, and linked health records under ABDM, highlighting the ecosystem’s expansion. Note the logarithmic scale to accommodate the vast range of numbers.

Holistic Vision: Technology Meets Tradition

Yoga: India’s Gift to the World

ABDM’s vision is not limited to curative health. It aligns with India’s ancient tradition of Yoga to create a holistic wellness model. International Day of Yoga, supported by a record 177 nations at the UN, is a testament to India’s global leadership in preventive health.

Support for International Day of Yoga at the UN

The Holistic Benefits of Yoga

Yoga is more than just physical exercise; it balances mind, body, and spirit. This chart illustrates the benefits of yoga across its different dimensions.

How It Works for a Citizen

ABDM simplifies access to healthcare services. The flowchart below shows a simple digital health journey for a citizen, ensuring a seamless and integrated experience.

1. Create ABHA

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2. Link Records

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3. Find Service (via UHI)

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4. Give Consent

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5. Get Better Care

The Road Ahead & Challenges

Building a digital system for 1.4 billion people is a monumental task. The mission’s success depends on effectively tackling these challenges.

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Data Privacy & Security

Ensuring the security of sensitive health data is the highest priority, managed through a decentralized architecture and a strong legal framework (DPDP Act, 2023).

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Digital Divide & Literacy

Bridging the digital gap between urban and rural areas is essential, addressed via multilingual interfaces and assisted modes.

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Private Sector Adoption

Onboarding all small and large private clinics is critical, encouraged through incentive schemes (DHIS) and ‘Microsites’.

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Part 1: Ayushman Bharat Digital Mission (ABDM) – The Digital Rejuvenation of India’s Healthcare

Chapter 1: Introduction – India’s Next Digital Superpower in Healthcare

Section 1.1: Prelude to a New Digital Revolution

Just as the Jan Dhan-Aadhaar-Mobile (JAM) trinity and the Unified Payments Interface (UPI) permanently transformed the landscape of financial inclusion and digital payments, respectively, the Government of India is now laying the foundation for an equally transformative digital revolution in the healthcare sector.[1, 2] This ambitious initiative, known as the Ayushman Bharat Digital Mission (ABDM), is poised to write the next chapter in India’s success story of Digital Public Infrastructure (DPI).[1, 3] This is not merely another government scheme; it is a ‘digital highway’ designed to transform India’s highly fragmented and scattered healthcare system into an integrated, coherent, and patient-centric ecosystem.[1, 3, 4]

India possesses a vast foundation of nearly 1.2 billion mobile subscribers, 800 million internet users, and 1.24 billion Aadhaar digital IDs.[1] Building upon this robust digital base, ABDM aims to weave together the country’s hospitals, clinics, laboratories, pharmacies, health professionals, and, most importantly, patients into a single digital thread. Its goal is to create an environment where health-related information can flow securely, seamlessly, and with the explicit consent of the patient, leading to unprecedented improvements in the efficiency, transparency, and accessibility of healthcare services.

Section 1.2: The Mission’s Vision and Core Principles

The ultimate and overarching vision of the Ayushman Bharat Digital Mission is to assist in achieving the goal of “Universal Health Coverage” (UHC). This will be accomplished by creating a national digital health ecosystem that is efficient, accessible, inclusive, affordable, timely, and safe.[3] The mission is deeply inspired by the objectives of the National Health Policy (2017) and the National Digital Health Blueprint (2019), which emphasize a preventive approach to healthcare and the strategic use of digital technologies.[1, 5]

At the core of this vision is a significant paradigm shift: transforming healthcare from a “provider-centric” model to a “patient-centric” one. In the current system, a patient’s health data remains locked in disparate silos across various hospitals, clinics, and laboratories. The patient bears the burden of collecting and managing their own medical history and often has very little control over their own data. ABDM inverts this equation. Through its core components, such as the Ayushman Bharat Health Account (ABHA) and the Consent Manager, the mission makes the patient the true owner of their health data.[3, 6] The patient can now decide who can access their records, what information can be accessed, and for what duration. This transfer of power not only empowers the patient but also makes the entire healthcare system more transparent, accountable, and ultimately, more responsive to the patient’s needs.

The mission also stands firmly on the principle of “cooperative federalism,” with the central government, through the National Health Authority (NHA), working in tandem with states and union territories to realize this national vision.[3, 6]

Chapter 2: The Architecture of ABDM – The Four Pillars of the Digital Health Highway

The Ayushman Bharat Digital Mission is built upon a robust digital foundation comprising four main components or pillars. Together, these pillars create an interoperable and secure ecosystem that connects all stakeholders in healthcare.[7]

Section 2.1: ABHA (Ayushman Bharat Health Account) – Your Digital Health Identity

The Ayushman Bharat Health Account (ABHA), formerly known as the Health ID, is the citizen’s gateway to participating in the ABDM ecosystem. It is a 14-digit unique identification number available to every Indian citizen on a voluntary basis.[8, 9, 10] Citizens can easily create their ABHA number using their Aadhaar card or driving license, provided their mobile number is linked to the respective document.[4, 3, 11]

The primary function of ABHA is to act as a “digital health locker”.[4, 3, 11] It digitally stores and links all of a citizen’s health records—such as doctor’s prescriptions, diagnostic reports, hospital discharge summaries, and vaccination records—in a single place. This eliminates the physical hassle of carrying and managing thick files of medical reports. In emergency situations, this can be life-saving. With the patient’s consent, a doctor can instantly access critical information like allergies, pre-existing conditions, or ongoing medications, ensuring quicker and more accurate treatment.[3]

Along with the ABHA number, there is also an “ABHA Address,” also known as a Personal Health Record (PHR) Address. This is a simple, self-declared username (e.g., ‘yourname@abdm’), which functions like an email address. It allows users to sign into the Health Information Exchange and Consent Manager (HIE-CM) without revealing their actual 14-digit ABHA number, adding an extra layer of privacy.[12, 10, 13]

Section 2.2: HFR (Health Facility Registry) – A Verified Digital Address for Every Health Center

The Health Facility Registry (HFR) is a comprehensive and verified national repository of all health facilities in the country.[16, 17] This registry is not limited to large hospitals but also includes clinics, diagnostic laboratories, imaging centers, and pharmacies from both the public and private sectors. Notably, the HFR includes facilities from both modern (Allopathic) and traditional (AYUSH) systems of medicine, reflecting India’s integrated approach to health.[18]

For citizens, the HFR serves as a trusted online directory. They can search for certified and reliable health facilities in their area, helping them make informed decisions and protecting them from untrustworthy providers.[19, 2] For health facilities, registering on the HFR connects them to India’s growing digital health ecosystem, giving them visibility on a national platform and providing them access to various digital services like telemedicine and electronic health record management.[20] This also streamlines administrative processes like registration, license renewal, and empanelment with insurance companies, improving the ease of doing business.[20]

Section 2.3: HPR (Healthcare Professionals Registry) – A National Database of Certified Health Workers

The Healthcare Professionals Registry (HPR) is a centralized and trusted database of all qualified and certified health professionals in the country.[21, 22] It includes doctors, nurses, paramedics, and other allied health workers. Upon registering on the HPR, each health professional receives a unique Healthcare Professional ID (HP-ID), which serves as their digital identity within the ABDM ecosystem.[23]

Just like the HFR, the HPR is inclusive and encompasses not only practitioners of modern medicine but also certified practitioners of Ayurveda, Yoga, Unani, Siddha, and Homeopathy (AYUSH).[24, 25, 22] This step is a significant milestone towards integrating traditional Indian systems of medicine into the mainstream of national healthcare.

For citizens, the HPR is a powerful tool to ensure they are receiving treatment from a qualified and certified professional, significantly reducing the risks associated with “quack doctors” and unqualified practitioners.[24, 25] For health professionals, the HPR provides a verified online presence, enhances their credibility, and enables them to participate in telemedicine and other digital health services, thereby expanding their reach beyond geographical boundaries.[22]

Section 2.4: UHI (Unified Health Interface) – The UPI of Healthcare

The Unified Health Interface (UHI) is arguably the most revolutionary and transformative component of the Ayushman Bharat Digital Mission. It is often compared to the Unified Payments Interface (UPI) in the financial sector, and this comparison is apt. Just as UPI allows any payment app to seamlessly send money from any bank account to any other bank account, UHI aims to bring similar interoperability to healthcare.[26, 27]

UHI is not a technology platform but a network of open protocols and standardized Application Programming Interfaces (APIs), built on standards like Fast Healthcare Interoperability Resources (FHIR).[26, 19, 28, 29] It operates as a decentralized, peer-to-peer network, representing a fundamental shift from a “platform-centric” to a “network-centric” model.[26, 30, 31] In this network, there are two main types of applications: End User Applications (EUAs), which are the apps used by patients, and Health Service Provider Applications (HSPAs), which are used by hospitals, doctors, and laboratories.[32]

Through UHI, a user can discover, book, utilize, and pay for health services from any HSPA using any EUA of their choice. This means a patient can use one app to book appointments with doctors in different hospitals, receive tele-consultations, schedule diagnostic tests, or book an ambulance, regardless of the different software systems those providers are using.[30, 33, 34]

This is more than just a technical convenience; it is a democratizing force in the healthcare market. Currently, many large hospitals and health-tech companies operate in their own “closed ecosystems,” which “lock-in” patients to their platforms. UHI eliminates this lock-in.[26] It provides a level playing field for small startups and new app developers to compete with large, established players, as any UHI-compliant app can connect to any provider on the network. This increased competition will foster innovation, bring transparency in pricing, and ultimately lead to better services and more choices for patients, creating a more vibrant and dynamic healthcare market.[26, 33, 34]

Chapter 3: Implementation, Progress, and Ground Impact

Since its nationwide launch on September 27, 2021, the Ayushman Bharat Digital Mission has made significant progress in building and adopting the digital health ecosystem.[4, 1] This progress is not only reflected in the statistics but is also visible through successful innovations and strategic initiatives at the ground level.

Section 3.1: The Journey of ABDM So Far – Progress in Numbers

To understand the scale of ABDM and its rapid adoption, it is essential to look at the latest available data. These numbers reflect the mission’s extensive reach and its growing penetration among various healthcare stakeholders. To provide a solid basis for evaluating the mission’s progress, the following table compiles the latest data from official government sources like the Press Information Bureau (PIB).

Table 1: Current Status of ABDM (Data as of December 10, 2024)

| Metric | Number (as of Dec 10, 2024) | Source |

| :— | :— | :— |

| ABHA Accounts Created | 71.16 Crore (711.6 million) | [14, 15] |

| Health Records Linked to ABHA | 45.99 Crore (459.9 million) | [14, 15] |

| Health Facilities Registered on HFR | 3.54 Lakh (354,000) | [14, 15] |

| Healthcare Professionals Registered on HPR | 5.37 Lakh (537,000) | [14, 15] |

These figures paint an impressive picture. The creation of over 71 crore ABHA accounts indicates that a significant portion of the country’s population is now part of the digital health ecosystem. Similarly, the registration of lakhs of health facilities and professionals signals a robust and growing network. The digital linking of over 45 crore health records is a significant step towards the mission’s core objective of creating a longitudinal health record.

Section 3.2: Successful Innovations – The ‘Scan & Share’ Revolution

Perhaps the most visible and impactful innovation of ABDM is the ‘Scan & Share’ service. This is a simple yet powerful QR-code-based Out-Patient Department (OPD) registration system that has transformed the patient experience in hospitals across the country.[35]

Traditionally, patients had to wait in long queues for OPD registration, often taking 30 to 40 minutes or more. With ‘Scan & Share,’ patients can now scan the QR code displayed at the hospital counter with their phone (using the ABHA app, Aarogya Setu, or any other ABDM-enabled app) and instantly share their demographic information. This process reduces the registration time to just 5 to 10 minutes, saving millions of man-hours.[35] Leading institutions like the All India Institute of Medical Sciences (AIIMS), New Delhi, have been pioneers in the successful implementation of this system, where over 1.8 million tokens have been generated.[36]

Section 3.3: Strategies for Engaging the Private Sector

The success of ABDM cannot depend solely on public sector participation, as a large portion of healthcare services in India is provided by the private sector. Acknowledging this reality, the National Health Authority (NHA) has implemented several targeted strategies to encourage the participation of the private sector, especially small and medium-scale providers.

Digital Health Incentive Scheme (DHIS): The DHIS provides financial incentives to private sector hospitals, clinics, and diagnostic laboratories for adopting ABDM-compliant digital solutions and creating ABHA-linked health records.[4, 11, 37] This scheme directly addresses the cost barrier associated with adopting digital systems, which is a major concern for smaller providers.

Microsites: Microsites are another innovative approach. These are specific geographical areas (like a part of a city or a small town) where a focused campaign is run to onboard all small and medium private healthcare providers in that area into the ABDM ecosystem.[4, 35, 51, 37] In these microsites, an Interfacing Agency (IFA) assists providers with the onboarding process, helps them choose ABDM-compliant software, and trains them. This “handholding” approach helps overcome the technical and awareness barriers that smaller providers often face.[52] Surpassing the initial target of 100 microsites, over 100 microsites are now operational, demonstrating the success of this model in boosting private sector participation.[4, 35, 37]

These initiatives reflect the government’s pragmatic strategy. It recognizes that engaging the private sector requires a combination of incentives and handholding rather than a top-down mandate.

Chapter 4: Challenges and the Path to Solutions

Building an integrated digital health ecosystem for 1.4 billion people is a monumental task and is not without its challenges. The success of ABDM depends on the ability to recognize and effectively address these hurdles.

Section 4.1: The Digital Divide and Literacy

The significant “digital divide” in India is one of the biggest challenges to ABDM’s inclusive goal. There are vast disparities in internet connectivity, access to smartphones, and digital literacy between urban and rural areas.

To tackle this challenge, ABDM has adopted a multi-pronged approach.

• Multilingual Interfaces: The ABHA portal and related applications have been made available in several regional languages to overcome language barriers.
• Assisted Mode: Most importantly, the mission provides assisted and offline modes for those who do not have smartphones or internet connectivity. Citizens can visit health facilities where health workers or ASHA workers can assist them in creating an ABHA account and accessing health records.[42, 35, 12, 43] This ensures that a lack of digital literacy does not become a barrier to accessing the mission’s benefits.

Section 4.2: Data Privacy and Security – A Non-Negotiable Priority

Health data is arguably an individual’s most sensitive personal data. Therefore, ensuring its privacy, security, and confidentiality is a non-negotiable priority for ABDM.

ABDM is built on the core principle of “Privacy by Design.” Its decentralized or “federated” architecture means that no health data is stored centrally. Instead, the data remains where it was created—in the system of the respective hospital or laboratory.[11, 44, 45] The ABDM platform only acts as a gateway that facilitates the exchange of data based on the patient’s explicit consent.

This consent framework is another critical pillar of ABDM’s security. Through the Health Information Exchange and Consent Manager (HIE-CM), patients have complete control over their data. No doctor or health facility can access their records without the patient’s permission.[11, 12, 45]

This technical framework is further strengthened by the Digital Personal Data Protection (DPDP) Act, 2023.[4, 11, 46, 47] This comprehensive law governs the processing of digital personal data in India and provides a strong legal foundation for ABDM. It designates healthcare providers as ‘Data Fiduciaries,’ who are legally responsible for protecting patient data.

Section 4.3: Barriers to Adoption by Healthcare Providers

Widespread adoption of ABDM by healthcare providers is crucial for its success. However, many providers, especially small and medium-scale private establishments, face barriers to joining the digital ecosystem, such as the cost of digital infrastructure and technical complexity.[48, 49, 50]

To address these challenges, the government has taken proactive steps like the Digital Health Incentive Scheme (DHIS) and the Microsites initiative, as discussed earlier. These programs are designed to reduce the financial burden and provide the necessary technical and procedural support to smaller providers.

Part 2: Yoga – India’s Priceless Health Gift to the World

While the Ayushman Bharat Digital Mission represents the future of healthcare, India’s story of health and wellness is deeply rooted in its ancient past. Yoga, a 5,000-year-old tradition, is a shining example of this heritage. It is not just a physical exercise but a holistic science of life that offers a powerful preventive and complementary approach to modern healthcare.

Chapter 5: Yoga – Not Just Postures, A Complete Science of Life

Section 5.1: The Philosophical Foundation of Yoga

The term “Yoga” is derived from the Sanskrit root ‘Yuj,’ which means ‘to unite’ or ‘to integrate’. At its core, Yoga is a philosophy and practice of integrating individual consciousness with universal consciousness. It is not limited to the asanas (physical postures) performed on a mat but is a holistic way of life.

This philosophy was systematically codified by Maharshi Patanjali in his ‘Yoga Sutras,’ which describe “Ashtanga Yoga” or the eight limbs of Yoga: Yama (moral restraints), Niyama (personal observances), Asana (physical postures), Pranayama (breath control), Pratyahara (withdrawal of the senses), Dharana (concentration), Dhyana (meditation), and Samadhi (self-realization). This eight-fold path provides a comprehensive framework that addresses not only physical health but also mental, emotional, and spiritual well-being.

Section 5.2: The Scientifically Proven Health Benefits of Yoga

In recent decades, modern science has begun to validate the countless health benefits that yogis have experienced for centuries. Research conducted by prestigious medical institutions and organizations like the World Health Organization (WHO) has established a strong evidence base for the benefits of yoga.

• Physical Benefits: Yoga improves muscle strength, balance, and flexibility. It helps in managing non-communicable diseases (NCDs) like hypertension and diabetes and provides relief from chronic pain, such as back pain.
• Mental Benefits: The meditation and breathing practices of yoga reduce stress, anxiety, and symptoms of depression. They help activate the body’s relaxation response, promoting a sense of calm and improving sleep quality.
• Immune System: Research suggests that regular yoga practice can help strengthen the body’s immune system.

India’s Ministry of AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy) plays a significant role in promoting these benefits and standardizing yoga practices.

Section 5.3: Yoga in Preventive and Holistic Health

ABDM and Yoga represent two complementary aspects of India’s healthcare approach. While ABDM primarily focuses on curative and managerial healthcare, yoga serves as a powerful preventive and promotive health measure. The philosophy of yoga is about maintaining health and preventing disease in the first place. The integration of AYUSH facilities and professionals into ABDM registries like HFR and HPR is a concrete acknowledgment of this complementary relationship.[39, 40, 17, 41]

Chapter 6: International Day of Yoga – India’s Cultural Diplomacy on the Global Stage

Recognizing the universal benefits of yoga, India undertook a diplomatic initiative to share it with the world, resulting in the establishment of the International Day of Yoga.

Section 6.1: The Birth of a Global Movement

This global movement began on September 27, 2014, when the Prime Minister of India, Shri Narendra Modi, proposed designating June 21 as the International Day of Yoga at the UN General Assembly. This proposal received unprecedented support from a record 177 member states. On December 11, 2014, the UN unanimously adopted Resolution 69/131, declaring June 21 as the International Day of Yoga.

Section 6.2: The Significance of June 21

The date of June 21 was chosen for its symbolic significance. It is the Summer Solstice, the longest day of the year in the Northern Hemisphere. This day holds special importance in the yogic tradition, as it is considered the day when Adiyogi (Shiva), the first yogi, began imparting the knowledge of yoga to humanity.

Section 6.3: India’s Leadership and Global Celebrations

Since its inauguration in 2015, India has led the International Day of Yoga (IDY) celebrations worldwide. The first IDY celebration in New Delhi set two Guinness World Records. Since then, IDY has become a global phenomenon, with millions participating every year under a specific theme, such as “Yoga for Self and Society” in 2024.

Part 3: Synthesis and Future Direction

Chapter 7: Conclusion – The Dual Vision of a Healthy India, Healthy World

The Ayushman Bharat Digital Mission and Yoga represent India’s unique and holistic approach to health and wellness in the 21st century.

Section 7.1: The Confluence of Technology and Tradition

The confluence of ABDM and Yoga reflects India’s ability to integrate its technological prowess with its deep cultural roots. ABDM provides the state-of-the-art framework for healthcare delivery, while Yoga provides the source of preventive and holistic well-being. This integration is concretely embedded in the architecture of ABDM through the inclusion of AYUSH facilities and practitioners in its registries. This creates a healthcare system that is truly integrated and patient-centric.

Section 7.2: India Towards Global Health Leadership

The success of UPI has shown the world how India can build large-scale digital public infrastructure. Similarly, ABDM has the potential to become a model for the world, especially for developing countries. At the same time, through the global celebration of the International Day of Yoga, India has established itself as a leader in global health and wellness.

Ultimately, ABDM and Yoga together present a powerful and visionary approach. They demonstrate that India is not only committed to improving healthcare for its 1.4 billion citizens but is also offering a new paradigm to the world—a paradigm that harmonizes the technology of the future with the wisdom of the past. This is a bold step towards achieving the broader goal of a “Healthy India, Healthy World.”

Refrences

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