Capitalization of digital healthcare: The cornerstone of emerging medical practices

Abstract

Background: The digital healthcare sector in India is rapidly transforming, driven by strategic government initiatives and technological advancements. In 2020, the market was valued at approximately $1.5 billion and is projected to grow at a compound annual growth rate of ~25% over the next five years.

Methodology: The study employed a descriptive and analytical approach, reviewing existing literature and data on the applications and implications of AI, mHealth, and GIS technologies in healthcare..

Result: The article highlighted the rapid growth of India's digital health market, driven by the adoption of telemedicine, mobile health, and electronic health records, alongside increased investments and internet penetration. Additionally, it also raised concerns about bias, transparency, and accountability in these technologies, urging the development of robust digital infrastructure, including Digital Health IDs, Health Facility Registries, and Healthcare Professionals Registries, as well as policy changes like the effective implementation of Personal Data Protection Bill and updates to the Information Technology Act.

Conclusion: India's healthcare market is at a critical juncture, where effective management of the ongoing digital transformation can vastly improve access and outcomes for millions. By tackling current challenges and embracing technological advancements, India could set a global standard in digital healthcare, ensuring equitable, high-quality care for all citizens, regardless of location or socio-economic status. The vision of a fully integrated digital healthcare system is not just possible but an impending reality that, with the right strategies and collaborations, could be realized within the next decade.

Keywords

Public health / Healthcare innovation / Market dynamics / Business models / Government initiatives / COVID-19 / QGIS / ArcGIS

References

[1] Gopichandran V , Ganeshkumar P , Dash S , Ramasamy A . Ethical challenges of digital health technologies: aadhaar, India. Bull World Health Organ. 2020; 98 (4): 277- 281.

[2] Al Dahdah M , Mishra RK . Digital health for all: The turn to digitized healthcare in India. Soc Sci Med. 2023; 319: 114968.

[3] Sarbadhikari SN . Digital health in India-As envisaged by the national health policy. BLDE Univer J Health Sci. 2017; 4 (1): 1- 6.

[4] Ramachandran A , Sarbadhikari SN . Digital health for the post-COVID-19 pandemic in India: emerging technologies for healthcare. In: 2021 8th International Conference on Computing for Sustainable Global Development (INDIACom). IEEE; 2021: 244- 249.

[5] Mason C , Lazenby S , Stuhldreher R , Kimball M , Bartlein R . Lessons learned from implementing digital health tools to address COVID-19 in LMICs. Front Public Health. 2022; 10: 859941.

[6] Tan TF , Thirunavukarasu AJ , Jin L , et al. Artificial intelligence and digital health in global eye health: opportunities and challenges. Lancet Global Health. 2023; 11: (9): e1432- e1443.

[7] Knawy A , Mckillop B , Abduljawad MM , et al. Successfully implementing digital health to ensure future global health security during pandemics: a consensus statement. JAMA Netw Open. 2022; 5 (2): e220214.

[8] Trocin C , Mikalef P , Papamitsiou Z , Conboy K . Responsible AI for digital health: a synthesis and a research agenda. Inf Syst Front. 2021. Published online.

[9] Gentili A , Failla G , Melnyk A , et al. The cost-effectiveness of digital health interventions: a systematic review of the literature. Front Public Health. 2022; 10: 787135.

[10] Grand View Research . Digital health market size, share & trends analysis report by technology (healthcare analytics, mHealth), by component (hardware, software, services), by application, by end-use, by region, and segment forecasts, 2024 -2030. www.grandviewresearch.com/industry-analysis/digital-health-market; 2024. Accessed August 26, 2024.

[11] Skyquest . Digital Health Market Size, Growth & Trends Report. Skyquestt.com; 2024. www.skyquestt.com/report/digital-health-market. Accessed August 26, 2024.

[12] Mullankandy S , Kazmi I , Islam T , Phia WJ . Emerging trends in AI-driven health tech: a comprehensive review and future prospects. European J Technol. 2024; 8 (2): 25- 40.

[13] Jayaraman PP , Forkan ARM , Morshed A , Haghighi PD , Kang YB . Healthcare 4.0: a review of frontiers in digital health. Wiley Interdiscip Rev Data Min Knowl Discov. 2020; 10 (2).

[14] Kasoju N , Remya NS , Sasi R , et al. Digital health: trends, opportunities and challenges in medical devices, pharma and bio-technology. CSI Transactions on ICT. 2023; 11 (1): 11- 30.

[15] Bajpai N , Wadhwa M . India's national digital health mission. In: ICT India Working Paper. 2020.

[16] Das S , Garg V , Joseph JJ . Advancements in e-governance initiatives: digitalizing healthcare in India. In: International Conference on Advances in IoT and Security with AI. Springer Nature; 2023: 287- 296.

[17] Insights . India digital health market analysis. www.insights10.com/report/indiadigital-health-market-analysis/?srsltid1/4AfmBOoom46C8AvQ5g0KTXtx5Mr 1ldbvofNZrCxDU45M6Q1RTXRORmneW; 2024. Accessed August 26, 2024.

[18] Digital health market . MarketsandMarkets; 2023. www.marketsandmarkets.com/Market-Reports/digital-health-market-45458752.html. Accessed August 26, 2024.

[19] Sarwal R , Prasad U , Gopal KM , et al. Investment Opportunities in India's Healthcare Sector. 2021. Published online.

[20] Iyawa GE , Herselman M , Botha A . Digital health innovation ecosystems: from systematic literature review to conceptual framework. Procedia Comput Sci. 2016; 100: 244- 252.

[21] Fong B , Fong ACM , Li CK . Telemedicine Technologies: Information Technologies in Medicine and Digital Health. John Wiley & Sons; 2020.

[22] Pillai APS . AIoMT-Assisted telemedicine: a case study of eSanjeevani telemedicine service in India. In: Handbook of Security and Privacy of AI-Enabled Healthcare Systems and Internet of Medical Things. CRC Press; 2023: 445- 464.

[23] Dastidar BG , Jani AR , Suri S , Nagaraja VH . Reimagining India's National Telemedicine Service to improve access to care. Lancet Reg Health Southeast Asia. 2024; 30 (100480): 100480.

[24] Centre for Development of Advanced Computing . Product information oneSanjeevani-national telemedicine service. C-DAC. www.cdac.in/index.aspx?id=product_details&productId=eSanjeevaniNational TelemedicineService. Accessed December 11, 2024.

[25] Nirupam B , Manisha W . National teleconsultation service in India: eSanjeevani OPD. Columbia.edu; 2021. csd.columbia.edu/sites/default/files/content/docs/ICT %20India/Papers/ICT_India_Working_Paper_53.pdf. Accessed December 11, 2024.

[26] Singh V , Sarbadhikari SN , Jacob AG , John O . Challenges in delivering primary care via telemedicine during COVID-19 pandemic in India: a review synthesis using systems approach. J Fam Med Prim Care. 2022; 11 (6): 2581- 2588.

[27] Fang F , Zhou Y , Ying S , Li Z . A study of the Ping an Health App based on user reviews with sentiment analysis. Int J Environ Res Publ Health. 2023; 20 (2): 1591.

[28] Iacobucci G . Babylon Health holds talks with "significant" number of NHS trusts. BMJ. 2020; 368: m266.

[29] Mishra US , Yadav S , Joe W . The ayushman Bharat digital mission of India: an assessment. Health Syst Reform. 2024; 10 (2): 2392290.

[30] Anderson JT , Bouchacourt LM , Sussman KL , Bright LF , Wilcox GB . Telehealth adoption during the COVID-19 pandemic: a social media textual and network analysis. Digit Health. 2022; 8: 20552076221090041.

[31] Rajkumar E , Gopi A , Joshi A , et al. Applications, benefits and challenges of telehealth in India during COVID-19 pandemic and beyond: a systematic review. BMC Health Serv Res. 2023; 23 (1). 7.

[32] Marcelle ET , Nolting L , Hinshaw SP , Aguilera A . Effectiveness of a multimodal digital psychotherapy platform for adult depression: a naturalistic feasibility study. JMIR MHealth UHealth. 2019; 7 (1): e10948.

[33] Hull TD , Malgaroli M , Connolly E , Gopi PS , Feuerstein S , Simon NM . Two-way messaging therapy for depression and anxiety: longitudinal response trajectories. BMC Psychiatr. 2020; 20 (1). 297.

[34] Wiederhold BK . The rapid growth of telehealth therapy: what's next? Cyberpsychol, Behav Soc Netw. 2023; 26 (6): 391- 392.

[35] Minnaar A , Herbig FJ . Cyberattacks and the cybercrime threat of ransomware to hospitals and healthcare services during the COVID-19 pandemic. Acta Criminol: African J Criminol Victimol. 2021; 34 (3): 155- 185.

[36] Arnaert A , Sumbly P , da Costa D , Liu Y , Debe Z , Charbonneau S . Acceptance of the Apple Watch Series 6 for telemonitoring of older adults with chronic obstructive pulmonary disease: qualitative descriptive study part 1. JMIR Aging. 2023; 6: e41549.

[37] Akturk HK , Dowd R , Shankar K , Derdzinski M . Real-world evidence and glycemic improvement using Dexcom G6 features. Diabetes Technol Therapeut. 2021; 23(S1): S21- S26.

[38] Bidonde J , Fagerlund BC , Frønsdal KB , Lund UH , Robberstad B . FreeStyle Libre flash glucose self-monitoring system: a single-technology assessment. In: Knowledge Centre for the Health Services at the Norwegian Institute of Public Health (NIPH). 2017.

[39] Nguyen HH , Law IH , Rudokas MW , et al. Reveal LINQ versus Reveal XT implantable loop recorders: intra- and post-procedural comparison. J Pediatr. 2017; 187: 290- 294.

[40] Lo JC , Sehic E , Meijer SA . Measuring mental workload with low-cost and wearable sensors: insights into the accuracy, obtrusiveness, and research usability of three instruments. J Cogn Eng Decis Mak. 2017; 11 (4): 323- 336.

[41] Harfmann BD , Neph SE , Gardner MM , Plouffe AA , Vranish JR , Montoye AHK . Comparison of the Omron HeartGuide to the welch allyn ProBP 3400 blood pressure monitor. Blood Pres Monit. 2024; 29 (1): 45- 54.

[42] Heimark S , Bøtker-Rasmussen KG , Stepanov A , et al. Accuracy of non-invasive cuffless blood pressure in the intensive care unit: promises and challenges. Front Med. 2023; 10: 1154041.

[43] Mark N , Lyubin A , Gerasi R , et al. Comparison of the effects of motion and environment conditions on accuracy of handheld and finger-based pulse oximeters. Mil Med. 2021; 186(Suppl 1): 465- 472.

[44] Verdel N , Hjort K , Sperlich B , Holmberg HC , Supej M . Use of smart patches by athletes: a concise SWOT analysis. Front Physiol. 2023; 14: 1055173.

[45] Krigolson OE , Hammerstrom MR , Abimbola W , et al. Using Muse: rapid mobile assessment of brain performance. Front Neurosci. 2021; 15: 634147.

[46] Duvinage M , Castermans T , Petieau M , Hoellinger T , Cheron G , Dutoit T . Performance of the Emotiv epoc headset for P300-based applications. Biomed Eng Online. 2013; 12 (1): 56.

[47] Liao Y , Thompson C , Peterson S , Mandrola J , Beg MS . The future of wearable technologies and remote monitoring in health care. Am Soc Clin Oncol Educ Book. 2019; 39 (39): 115- 121.

[48] Bouzid Z , Al-Zaiti SS , Bond R , Sejdić E . Remote and wearable ECG devices with diagnostic abilities in adults: a state-of-the-science scoping review. Heart Rhythm. 2022; 19 (7): 1192- 1201.

[49] Sandy LG , Tuckson RV , Stevens SL . UnitedHealthcare experience illustrates how payers can enable patient engagement. Health Aff. 2013; 32 (8): 1440- 1445.

[50] Chishtie J , Sapiro N , Wiebe N , et al. Use of Epic electronic health record system for health care research: scoping review. J Med Internet Res. 2023; 25: e51003.

[51] Tsega S , Vijayaraghavan M , Chronister M , et al. COVID-19 and the electronic health record: tool design and evolution at the US pandemic epicenter. ACI Open. 2022; 6 (2): e85- e93.

[52] Han HR , Gleason KT , Sun CA , et al. Using patient portals to improve patient outcomes: systematic review. JMIR Hum Factors. 2019; 6 (4): e15038.

[53] Ramsey A , Lanzo E , Huston-Paterson H , Tomaszewski K , Trent M . Increasing patient portal usage: preliminary outcomes from the MyChart Genius project. J Adolesc Health. 2018; 62 (1): 29- 35.

[54] Mckinstry CJ . The HIPAA privacy rule: flawed privacy exposed when compared with the European Union's general data protection regulation. J Health Care Finance. 2018; 45 (1): 1- 32.

[55] Ettaloui N , Arezki S , Gadi T . An overview of blockchain-based electronic health records and compliance with GDPR and HIPAA. Data and Metadata. 2023; 2: 166.

[56] Powles J , Hodson H . Google DeepMind and healthcare in an age of algorithms. Health Technol. 2017; 7 (4): 351- 367.

[57] Milam ME , Koo CW . The current status and future of FDA-approved artificial intelligence tools in chest radiology in the United States. Clin Radiol. 2023; 78 (2): 115- 122.

[58] Suehnholz SP , Kundra R , Roshal M , et al. Annotation of somatic genomic variants in hematologic diseases using OncoKB, a precision oncology knowledgebase. Blood. 2019; 134 (Supplement_1): 2148.

[59] Shausan A , Nazarathy Y , Dyda A . Emerging data inputs for infectious diseases surveillance and decision making. Front Digit Health. 2023; 5: 1131731.

[60] Choubey SK , Naman H . A review on use of data science for visualization and prediction of the COVID-19 pandemic and early diagnosis of COVID-19 using machine learning models. In: Studies in Big Data. Singapore: Springer; 2020: 241- 265.

[61] Goirand M , Austin E , Clay-Williams R . Implementing ethics in healthcare AI-based applications: a scoping review. Sci Eng Ethics. 2021; 27 (5): 61.

[62] Moore CM . The challenges of health inequities and AI. Intell Based Med. 2022; 6 (100067): 100067.

[63] Hoffman S , Podgurski A . Artificial Intelligence and Discrimination in Health Care. vol. 19. Yale J Health Pol'y L & Ethics; 2019.

[64] Chan J . Exploring digital health care: eHealth, mHealth, and librarian opportunities. J Med Libr Assoc. 2021; 109 (3): 376- 381.

[65] Quevedo Rodríguez A , Wägner AM . Mobile phone applications for diabetes management: a systematic review. Endocrinol Diabetes Nutr. 2019; 66 (5): 330- 337.

[66] Murphy J , McSharry J , Hynes L , Molloy GJ . A smartphone app to support adherence to inhaled corticosteroids in young adults with asthma: multi-methods feasibility study. JMIR Form Res. 2021; 5 (9): e28784.

[67] Oliver D . David oliver: lessons from the Babylon health saga. BMJ. 2019; 365: l2387.

[68] Lee-Cruz L , Lenormand M , Cappelle J , et al. Mapping of Ebola virus spillover: Suitability and seasonal variability at the landscape scale. PLoS Negl Trop Dis. 2021; 15 (8): e0009683.

[69] Sharma M , Kunduparambil S , Abhay RK . Spatiotemporal Patterns of COVID-19: A District-Level Analysis of Kerala, India, 2020-2021. CRC Press; 2023.

[70] Boulos K , Peng MN , Vopham G . An overview of GeoAI applications in health and healthcare. Int J Health Geogr. 2019; 18 (1).

[71] Johnston FH , Wheeler AJ , Williamson GJ , et al. Using smartphone technology to reduce health impacts from atmospheric environmental hazards. Environ Res Lett. 2018; 13 (4): 044019.

[72] Wang F . Why public health needs GIS: a methodological overview. Spatial Sci. 2020; 26 (1): 1- 12.

[73] Munthali EC , Chikumba PA , Gondwe KC . Application of GIS in health human resource deployment to health facilities: a case of blantyre. MJASI. 2018; 2 (1): 53- 56.

[74] Tracxn-Global . HealthTech Global Market Evaluation. Tracxn.com; 2024. platform.tracxn.com/a/s/practicearea/5409d072e4b0831de3527d69/t/overview. Accessed August 26, 2024.

[75] Fortune Business Insights . Digital Health Market Size (2023-2030). Fortunebusinessinsights.com; 2024. www.fortunebusinessinsights.com/industryreports/digital-health-market-100227. Accessed August 26, 2024.

[76] Tracxn-India . HealthTech India-feed geo report. platform.tracxn.com/a/d/report/0O1BmiMVq05wvsU8yQal66kKWbPe4JEnhu6tNofBhXs/healthtechindiafeedgeo report; 2024. Accessed August 26, 2024.

[77] Nishithdesai . Digital health in India. Nishithdesai.com; 2024. www.nishithdesai.com/fileadmin/user_upload/pdfs/Research_Papers/Digital_Health_in_India.pdf. Accessed August 26, 2024.

[78] Faizullabhoy M , Wani G . Digital Health Market-by Technology[Telehealthcare {telecare, mHealth (Wearables, Apps (Medical, Fitness))}, Health Analytics], by Component (Hardware, Software, Services), by Region, Competitive Landscape, Pricing Analysis-Global Forecast to 2032. Global Market Insights Inc; 2023.

[79] CMI . India digital health market size, trends, share 2033-CMI. Custom marketinsights. www.custommarketinsights.com/report/india-digital-healthmarket/; 2024. Accessed August 26, 2024.

[80] Sharma A . Digital health in the aftermath of COVID-19. Gov. www.indembassyisrael.gov.in/pdf/Invest_India_Digital_Health_2_V4.pdf; 2023. Accessed August 26, 2024.

[81] IMARC . India Digital Health Market. Imarcgroup.com; 2024. www.imarcgroup.com/india-digital-health-market. Accessed August 26, 2024.

[82] Kapoor S . Digital health ecosystem in India: present status, challenges, and way forward. D Patil J Health Sci. 2022; 10 (4): 202.

[83] Rani S , Sachar M . Technological transformation and digital India. Int J Res Pharm Sci. 2022; 13 (2): 370- 377.

[84] Muthappan S , Elumalai R , Shanmugasundaram N , et al. AYUSH digital initiatives: harnessing the power of digital technology for India's traditional medical systems. J Ayurveda Integr Med. 2022; 13 (2): 100498.

[85] Sharma RS , Rohatgi A , Jain S , Singh D . The ayushman Bharat digital mission(ABDM): making of India's digital health story. CSI Trans ICT. 2023. Published online.

[86] Ram T . Ayush grid: digital health platform. Int J Ayurveda Res. 2023; 4 (2): 61.

[87] Paliwal S , Parveen S , Singh O , Alam MA , Ahmed J . The role of ayushman Bharat health account (abha) in telehealth: a new frontier of smart healthcare delivery in India. In: Proceedings of the Future Technologies Conference. Springer. 2023: 388- 406.

[88] Raj GM , Dananjayan S , Agarwal N . Inception of the Indian digital health mission: connecting… the… dots. Health Care Science. 2023; 2 (5): 345- 351.

[89] Kumar S , Jaswal M , Soman A , Thakur R . Shaping holistic health care: national Institution for Transforming India (NITI) Aayog's pioneering contributions in the Ayush sector. Int J Ayurveda Res. 2023; 4 (3): 137- 145.

[90] Jain S , Arora S , Chauhan A , Agarwal A , Saikia B , Singh M . Super-specialty medical teleconsultations to remote areas of Ladakh, India via E-sanjeevani under hub-andspoke model: a pilot study. Telehealth Med Today. 2024; 9 (2).

[91] Kaladharan S , Dhanya M , Drisya R , Raj MB . Intention to use eSanjeevani-OPD app: an empirical investigation using health belief model. In: 2023 Advanced Computing and Communication Technologies for High Performance Applications (ACCTHPA). IEEE. 2023.

[92] Chakravarthi I . Digital health and the national digital health mission-leveraging. In: "Universal Health Care" for technology and capital? RUPE India; 2024. Published online https://rupe-india.org/aspects-no-81-82/digital-health-and-the-national-digital-health-mission/. Accessed August 26, 2024.

[93] Patnaik S , Patnaik AN . E-health for all-is India ready? Nat J Commun Med. 2015; 6 (4): 633- 638.

[94] Sharma RK , Thapar University , Prashar R . Feasibility of eHealth implementation in India learning from global experience. Asia Pac J Health Manag. 2006; 14 (3): 12- 23.

[95] Bhatia R , Taneja U . Factors affecting Indian consumers' intention to use eHealth services. J Health Manag. 2019; 21 (2): 258- 278.

[96] Chellaiyan VG , Nirupama AY , Taneja N . Telemedicine in India: where do we stand? J Fam Med Prim Care. 2019; 8 (6): 1872- 1876.

[97] Agarwal D , Roy N , Panwar V , Basil A , Agarwal PM . Bringing health care closer to people-A review of various telemedicine models under the national health mission in India. Indian J Community Med. 2020; 45 (3): 274- 277.

[98] Parsekar SS , Pundir P , Bevilacqua V . Reproductive, maternal, Newborn, child and adolescent health and related behaviour change communication strategies in Bangladesh, Nepal and India: a narrative review. Clin Epidemiol Glob Health. 2020; 8 (1): 280- 286.

[99] Malhotra C , Kotwal V , Basu A . Designing national health stack for public health: role of ICT-based knowledge management system. In: 2019 ITU Kaleidoscope: ICT for Health: Networks, Standards and Innovation (ITU K). IEEE; 2019.

[100] Nirula SR , Naik M , Gupta SR . NHS vs Modicare: the Indian Healthcare v2.0. Are we ready to build the healthier India that we envisage? J Fam Med Prim Care. 2019; 8 (6): 1835- 1837.

[101] Wadhwa M . Revamping of public health surveillance system in India. In: ICT India Working Paper. 2021.

[102] Jha U , Mohan R . Health management information system: a journey towards public health data ecosystem in India. Dynamics of Health Care Services. 2022. Published online.

[103] Paropkari A . Study on public awareness of mHealth apps introduced by the government of India. Indian J Public Health Res Dev. 2019; 10 (5): 707- 5506.2019.01094.5.

[104] Mohan D , Bashingwa JJH , Scott K , et al. Optimising the reach of mobile health messaging programmes: an analysis of system generated data for the Kilkari programme across 13 states in India. BMJ Glob Health. 2022; 6 (suppl 5): e009395.

[105] Mohan D , Scott K , Shah N , et al. Can health information through mobile phones close the divide in health behaviours among the marginalised? An equity analysis of Kilkari in Madhya Pradesh, India. BMJ Glob Health. 2021; 6 (suppl 5): e005512.

[106] Sharma A , Shinde A , Kar A . Prevalence in the utilization of text message services under the mother and child tracking system of India: a cross sectional study from Pune district, Maharashtra, India. Int J Community Med Public Health. 2016: 2319- 2324. Published online.

[107] Saha S , Pandya A , Raval D , Saxena D . Cost-effectiveness of mHealth intervention(TeCHO+) for improving maternal and child health indicators in Gujarat, India. Indian J Community Med. 2022; 47 (4): 549- 554.

[108] Dehury RK , Samal J , Raza A , Cautinho S , Behera MR , Dehury P . Can the National Health Policy 2017 strengthen the national health system and improve the health of the Indian populace? J Health Manag. 2023; 25 (2): 232- 239.

[109] Jain D . Regulation of digital healthcare in India: ethical and legal challenges. Healthcare (Basel). 2023; 11 (6).

[110] Puhan B , Gupta S . Digital health rules and regulations: an overview. CSI Trans ICT. 2023. Published online.

[111] Pai MMM , Ganiga R , Pai RM , Sinha RK . Standard electronic health record (EHR) framework for Indian healthcare system. Health Serv Outcome Res Methodol. 2021; 21 (3): 339- 362.

[112] Dash SP . The impact of IoT in healthcare: global technological change & the roadmap to a networked architecture in India. J Indian Inst Sci. 2020; 100 (4): 773- 785.

[113] Dinakaran D , Basavarajappa C , Manjunatha N , Kumar CN , Math SB . Telemedicine practice guidelines and Telepsychiatry operational guidelines, India-A commentary. Indian J Psychol Med. 2020; 42 (5 Suppl): 1S- 3S.

[114] Venkatesh U , Aravind GP , Velmurugan AA . Telemedicine practice guidelines in India: global implications in the wake of the COVID-19 pandemic. World Med Health Pol. 2022; 14 (3): 589- 599.

[115] Aneja J , Arora S . Telemedicine and ethics: opportunities in India. Indian J Med Ethics. 2021; VI (4): 314- 320.

[116] Noor F . Digi-health: technology and healthcare dynamics. In: IoT and Cloud Computing-Based Healthcare Information Systems. Apple Academic Press; 2023: 1- 12.

[117] Goel RK , Vishnoi S . Strengthening and sustaining health-related outcomes through digital health interventions. J Eng Sci Technol Rev. 2023; 16 (2).

[118] Das AV , Kammari P , Vadapalli R , Basu S . Big data and the eyeSmart electronic medical record system-An 8-year experience from a three-tier eye care network in India. Indian J Ophthalmol. 2020; 68 (3): 427- 432.

[119] Sharma R , Kshetri N . Digital healthcare: historical development, applications, and future research directions. Int J Inf Manag. 2020; 53 (102105): 102105.

[120] Kanwar V , Chaudhary S , Sharma AK . Challenges in implementing digital health services in rural India. Intern Soc Telemed eHealth. 2023; 11: 1- 5.

[121] Krishnan Ganapathy MN . Artificial intelligence and healthcare regulatory and legal concerns. Telehealth Med Today. 2021; 6 (2).

[122] Ledford H . Millions of black people affected by racial bias in health-care algorithms. Nature. 2019; 574 (7780): 608- 609.

[123] Ferryman K , Cesare N , Creary M , Nsoesie EO . Racism is an ethical issue for healthcare artificial intelligence. Cell Rep Med. 2024; 5 (6): 101617.

[124] Digital health and interoperabilty . www.cognizant.com. Accessed December 11, 2024. www.cognizant.com/ch/de/insights/blog/articles/interoperability-ofdigital-health-data1.

[125] Kouroubali A , Katehakis DG . Policy and strategy for interoperability of digital health in Europe. Stud Health Technol Inf. 2022; 290: 897- 901.

[126] PRS . The Digital Personal Data Protection Bill, 2023. PRS Legislative Research; 2023. prsindia.org/billtrack/digital-personal-data-protection-bill-2023. Accessed August 26, 2024.

[127] Dhagarra D , Goswami M , Kumar G . Impact of trust and privacy concerns on technology acceptance in healthcare: an Indian perspective. Int J Med Inf. 2020; 141 (104164): 104164.

[128] Ganapathy K , Das S , Reddy S , et al. Digital health care in public private partnership mode. Telemed J e Health. 2021; 27 (12): 1363- 1371.

[129] BHASKAR, bharath startup community. Gov. www.startupindia.gov.in/bhaskar. Accessed September 22, 2024

[130] Anand N . One startup per district: digital portal BHASKAR launched to push growth. Business-standard.com. Autumn. 2024;9. www.business-standard.com/industry/news/one-startup-per-district-digital-portal-bhaskar-launched-topushgrowth-124091900831_1.html. Accessed September 22, 2024.

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