ABDM vs Traditional Health IT Framework: Review

The digitalisation of healthcare has become a critical pillar for improving access, quality, and efficiency in health systems worldwide.

India’s healthcare IT system has historically been fragmented and institution-centric IT systems. India lacked a unified national architecture for health data; most digital systems were largely standalone and built to serve specific functions such as patient record management within a hospital or disease reporting, without being interoperable across the whole system.

While these systems helped automate internal workflows, they largely operated in silos, limiting data exchange and continuity of care.

Recognising these gaps, the Government of India launched the Ayushman Bharat Digital Mission (ABDM) in 2021 to create a national digital health ecosystem that enables seamless interoperability, patient-centric data governance, and continuity of care across public and private healthcare providers

The Ayushman Bharat Digital Mission (ABDM) represents a shift toward a citizen-centric, interoperable, and consent-based digital health ecosystem. In this article, we shall discover the shift from traditional, standalone, fragmented healthcare IT systems to a more citizen-centric, interoperable digital health ecosystem.

In this article, we shall explore how India’s healthcare digitisation has transitioned from fragmented, standalone IT systems to a unified national digital health architecture through the Ayushman Bharat Digital Mission.

Traditional Health IT Framework

Traditional Health IT frameworks refer to standalone digital systems implemented by healthcare providers, insurers, laboratories, or government agencies to support specific operational or clinical functions. These systems were primarily designed for internal efficiency rather than ecosystem-wide data sharing.

Core Components of Traditional Health IT

Hospital Information System (HIS)

The Hospital Information System (HIS) formed the backbone of traditional healthcare infrastructure in India. It supported the digitisation of core administrative and clinical workflows within healthcare facilities.

Electronic Medical Records (EMR) / Electronic Health Records (EHR)

EMR/EHR systems enabled the digitisation of patient clinical information that was traditionally maintained on paper records. These systems improved documentation and clinical workflow efficiency within healthcare facilities. While EMR/EHR systems enhanced internal clinical record-keeping, they were typically institution-specific and offered limited interoperability across healthcare providers.

Insurance & Claims Management Systems

Insurance and claims management systems were used by public and private payers to support healthcare financing and reimbursement processes, which included key functions such a verification of Patient eligibility and beneficiary verification, Claims submission, fraud detection, compliance monitoring, etc. These systems were payer-centric and had limited integration with clinical data platforms.

Disease Surveillance Platforms

Traditional health IT in India also comprised programme-specific digital platforms developed for public health surveillance and disease monitoring. These systems focused on population-level data collection and analysis rather than individual clinical care and largely operated as standalone platforms.

Key examples include the Integrated Disease Surveillance Programme (IDSP), launched in 2004, which was India’s flagship disease surveillance system for monitoring epidemic-prone diseases.

Health Management Information System (HMIS)

Health Management Information Systems (HMIS) were widely deployed in public healthcare settings, particularly under national and state health programmes. Health Management Information Systems (HMIS) were widely deployed in public healthcare settings, particularly under national and state health programmes.

Ayushman Bharat Digital Mission (ABDM)

The Ayushman Bharat Digital Mission is a national initiative aimed at building the foundational digital infrastructure required for an integrated and interoperable healthcare ecosystem in India. Rather than replacing existing hospital or insurance IT systems, ABDM acts as a unifying digital layer that connects diverse health systems through common standards, registries, and consent-based data exchange mechanisms.

Key Components

ABHA (Ayushman Bharat Health Account)

A unique, voluntary digital health identifier that allows individuals to link and access their health records across providers.

ABHA Application

The ABHA mobile application serves as a Personal Health Record (PHR), allowing individuals to store and access their health information in one place securely.

Healthcare Professional Registry (HPR)

A national registry of verified healthcare professionals across modern and traditional systems of medicine in India.

Health Facility Registry (HFR)

A comprehensive repository of public and private healthcare facilities enabling easier empanelment and licensing, and facilitating paperless, interoperable healthcare delivery.

Unified Health Interface (UHI)

UHI is an open, interoperable network similar to UPI in payments that enables seamless discovery, booking, delivery, and payment of digital health services across multiple platforms, with patient consent at its core.

Key Differences Between ABDM & Traditional Health IT

Even though both the Ayushman Bharat Digital Mission (ABDM) and traditional healthcare IT frameworks aim to leverage digital technologies to improve the efficiency, quality, and accessibility of healthcare services, there are certain key differences between them, which include

1. System Architecture and Design

ABDM is designed as a federated digital public infrastructure, where health data remains with the original data custodians and is exchanged securely when consent is provided. Traditional healthcare IT frameworks are siloed and institution-centric, with systems built mainly to serve individual hospitals, labs, or insurers rather than the broader healthcare ecosystem.

2. Interoperability and Standards

ABDM adopts open and standardised protocols such as HL7 FHIR, SNOMED CT, and ICD to enable seamless interoperability across healthcare providers. In contrast, traditional IT systems often rely on proprietary or mixed standards, resulting in limited interoperability and dependence on manual data sharing methods.

3. Patient Identity and Health Records

ABDM enables a single, unified digital health identity (ABHA) and supports longitudinal, portable health records that can be accessed across facilities. Traditional healthcare IT systems generate multiple facility-specific patient IDs, leading to fragmented, episode-based medical records

4. Consent and Data Governance

A core differentiator of ABDM is its digital, granular, and revocable consent mechanism, which places individuals at the centre of data-sharing decisions. Traditional IT frameworks generally operate on implicit or manual consent, with data ownership and access controlled by healthcare institutions.

5. Care Continuity and Patient Experience

ABDM supports the continuum of care by enabling coordinated care across providers and settings, offering patients unified digital access to their health information. Traditional Health IT results in fragmented care journeys, multiple portals, and largely manual care coordination.

6. Ecosystem Participation and Innovation

ABDM promotes an open public–private ecosystem, reducing vendor lock-in and enabling innovation by startups, technology providers, and healthcare institutions. Traditional healthcare IT frameworks often create high vendor dependency, limiting integration, flexibility, and system-wide innovation.

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