India’s shift to a unified digital health architecture began as a pilot on 15 August 2020 under the National Digital Health Mission (NDHM). A year later, on 27 September 2021, the programme was launched nationally as the Ayushman Bharat Digital Mission (ABDM), moving from proof-of-concept to a nationwide backbone for secure, portable health data.

The policy intent was to make an individual’s records easily accessible at all times, standardize how providers and facilities are identified, and enable safe, interoperable exchange of data across public and private systems.

At the centre is the Ayushman Bharat Health Account (ABHA), a voluntary, 14-digit unique health identifier that links prescriptions, diagnostics, discharge summaries, and other records across institutions. Since its inception, adoption has been rapid. By 5 August 2025, official figures show 79.91 crore ABHAs were created, alongside 67.19 crore health records already linked,  portraying clear evidence that the ABHA is becoming the basic unit of India’s health data ecosystem rather than a parallel silo.

Three technical choices give the mission its practical force. The Health Facility Registry (HFR) and Healthcare Professionals Registry (HPR) ensure that systems “speak the same language” when they reference a hospital, lab, clinic, doctor, or nurse. Second, an API-first design and common standards let any compliant software exchange data without locking providers into a single vendor. Then, a central digital infrastructure and monitoring layer support real-time visibility. These elements, now complemented by public building blocks such as the Unified Health Interface (UHI) and the National Health Claims Exchange (NHCX), allow the ecosystem to scale without sacrificing transparency.

As of 5 August 2025, the HFR had 4.18 lakh registered health facilities, and the HPR had 6.79 lakh registered professionals. By February 2025, 1.59 lakh facilities were using ABDM-enabled software, an indicator that digitization is moving from registration to real use. The National Health Authority’s public updates track these numbers at the district level.

But why does this matter for service delivery? Consider everyday practice. A physician who can see a patient’s recent lab panel and discharge summary avoids repeating tests, trims the diagnostic arc, and makes better-timed referrals. Public health teams can spot unusual pneumonia clusters or a rise in a particular illness without waiting for monthly report updates. And for hospitals and startups, a national interoperable infrastructure lowers transaction costs. Also, add-ons like Scan & Share, a QR-based OPD registration feature now live in ABDM-empanelled facilities; patients scan a facility QR code and consent to share demographics from their ABHA app, cutting queues and manual data entry.

The roll-out has not been frictionless. Connectivity gaps persist in parts of rural India; many smaller hospitals still run on paper or outdated software, slowing full integration. Training is another practical hurdle as frontline staff need simple workflows, local-language interfaces, and reliable power and bandwidth.

Notably, the program has avoided a hard mandate in favor of modular, standards-based adoption. Registries are open for states and private networks to onboard at their own pace; vendors become “ABDM-enabled” by meeting minimum conformance rather than ripping out existing systems. It is also important to situate ABDM within the wider Ayushman Bharat ecosystem. The digital infras are slowly converging with financing (PM-JAY) and infrastructure (PM-ABHIM). As PM-JAY crosses 42 crore Ayushman cards issued, standardized claims frameworks via NHCX and historical records of patients via ABHA can together reduce fraud, speed payments, and sharpen purchasing for impact.

Five years on from the pilot, the direction is unmistakable. India has moved beyond one-off health IT projects to systems design at a national scale: unique identifiers that people control, shared registries everyone trusts, and open standards that keep the market competitive. If governance keeps pace with scale and if states continue to invest in last-mile capacity, the result will be more than digital convenience. It will be a durable, extensible public digital good that strengthens routine care, public health, and health innovation for the decade ahead.

References

• Press Information Bureau – Update on ABDM
• Ministry of Health and Family Welfare – Ayushman Bharat Digital Mission (ABDM)
• Press Information Bureau – NHA launches online public dashboard for ABDM
• Ministry of Health & Family Welfare
• National Health Authority – Healthcare Professionals Registry (HPR) portal
• Ayushman Bharat portal
• National Healthcare Providers Registry- ABDM
• National Health Claims Exchange

Raj Kashyap Das – Knowledge & Insights Coordinator, Sambodhi