The Ayushman Bharat Digital Mission aims to build a federated health data ecosystem. Discuss its architecture and the privacy-by-design challenges in scaling ABHA.

Introduction: The Ayushman Bharat Digital Mission (ABDM) was launched on 27 September 2021 by the Ministry of Health and Family Welfare; the National Health Authority dashboard records 76+ crore ABHA IDs and 4.5+ lakh health facilities linked to the Health Facility Registry by 2025.

Body: First, the architecture — ABHA (health ID), Healthcare Professional Registry (HPR), Health Facility Registry (HFR), and the Unified Health Interface (UHI) for service discovery; data is federated, with no central health locker. Second, privacy-by-design challenges — DPDP Act 2023 sets children's consent at 18 and requires explicit purpose limitation; private hospitals integrate slowly. Third, PMJAY claims integration with ABHA strengthens utilisation but raises sensitive-data exposure; the eSanjeevani telemedicine platform and Co-WIN precedent shape the design philosophy.

Way forward: Mandate ABHA-linked claims under PMJAY, enforce HMIS interoperability standards, and notify a health-data-fiduciary regime under DPDP Rules by 2027 under MoHFW.