Karnataka leads in healthcare facility verification; Odisha, Delhi lag behind

By: Shantanu Bhattacharji

Experts caution that the inconsistent implementation of the Health Facility Registry reveals significant disparities in digital health readiness across India, threatening transparency, resource allocation, and overall healthcare service delivery.

The Health Facility Registry (HFR), part of the Ayushman Bharat Digital Mission (ABDM), is seeing mixed success as states differ sharply in their digital readiness. While frontrunners like Karnataka have fully integrated with the platform, others, including key states like Maharashtra and Uttar Pradesh, are struggling to catch up. This uneven adoption threatens to derail the broader vision of creating a unified digital health ecosystem. 

Karnataka: Full marks for readiness 

With 100 per cent verification of its 60,711 healthcare facilities, Karnataka is setting the gold standard for HFR implementation. Its seamless integration into the National Health Resource Repository (NHRR) speaks to strong administrative support and a well-executed strategy. This performance positions the state as a model for large states looking to accelerate their digital health transformation. 

Uttar Pradesh: Scale without depth 

Uttar Pradesh, the most populous state, has verified 59,438 facilities but achieved only 33.3 per cent. Despite high absolute numbers, its sheer scale (1,78,000 facilities in the NHRR) has diluted its digital penetration. The state’s struggle to implement digital reforms suggests a pressing need for tailored approaches to bridge the gap.

Maharashtra: Ambition meets reality 

With a verification rate of only 14.7 per cent, Maharashtra exemplifies the pitfalls of a large state with an unwieldy healthcare infrastructure. The disconnect between ambition and ground-level execution risks sidelining the state from the broader ABDM agenda. For a region with extensive health resources, the current pace is alarmingly inadequate. 

Rajasthan & Andhra: Mixed results 

Rajasthan and Andhra Pradesh, with verification rates of 50 per cent+ and 48.9 per cent, respectively, show decent progress but fall short of achieving full integration. Their moderate success highlights administrative traction but also points to the need for increased resources and focus to fully capitalize on digital health initiatives. 

Tripura and Chhattisgarh: Small states, big gains 

Smaller states such as Tripura (81.2 per cent) and Chhattisgarh (69.1 per cent) have turned their limited scale into an advantage, achieving high saturation rates. Their rapid adoption reflects efficient use of resources and should serve as a template for other states with compact healthcare systems. 

Delhi and Tamil Nadu: Digital laggards 

Despite their advanced healthcare ecosystems, Delhi (4.3 per cent) and Tamil Nadu (2.3 per cent) have barely scratched the surface of HFR adoption. The abysmal performance in these high-profile states signals either a lack of political will or administrative inertia. Their failure to digitise undermines broader efforts to build a cohesive national health database.

Experts are of the view that the uneven rollout of HFR reveals significant disparities in digital health readiness across India. High-performing states are reaping the benefits of comprehensive healthcare data, while laggards risk being left behind. Closing this digital gap will be essential for ensuring transparency, optimising resource allocation, and ultimately, delivering better healthcare services nationwide. 

The HFR is crucial for creating a comprehensive digital database of health facilities in India. However, slow saturation rates have resulted in significant delays in the rollout of this digital platform, leaving numerous public health facilities unregistered. 

Current Challenges: 

• Delayed Registrations: The slow pace of HFR registration is hindering the overall effectiveness of the system, with many public health facilities yet to be documented. 

• Impact on Healthcare: The lack of timely registration can impede access to healthcare services and transparency within the health ecosystem. 

NHA’s Response: 

• In August 2024, the National Health Authority (NHA), which oversees the implementation of the ABDM, initiated actions to address these challenges. 

• The NHA has urged state governments to accelerate the registration process for state-run public health facilities. This outreach emphasizes the urgency of resolving the bottlenecks that affect the efficiency of the healthcare system. 

More significantly, the NHA’s proactive approach is essential for ensuring that the digital health infrastructure is robust and comprehensive. Timely registration of health facilities will enhance service delivery, improve healthcare access, and promote better health outcomes across the country.  

The government is emphasising the need to expedite the verification process for registered health institutions in the HFR. As of October 2, a total of 338,177 facilities have been verified in the HFR, with a noteworthy ownership distribution: 56.94 per cent are government facilities, while 43.06 per cent are privately owned, according to the Business standard. This significant presence of public institutions highlights their vital role in India's healthcare ecosystem, but it also underscores the need for robust verification processes to build trust and accountability, which are essential for the effective implementation of digital health initiatives.