On the path to UHC, digital healthcare transformation with Karnataka’s online referral framework

Abstract

Abstract Background Karnataka, a trailblazer in Universal Health Coverage (UHC) initiatives, has implemented various features under the Ayushman Bharat-PMJAY-Arogya Karnataka scheme to improve the access to health. This study provides a thorough exploration of Karnataka’s innovative Online Referral System (ORS) within the framework of achieving UHC. Methods The study analyses the performance of the ORS using cross-sectional data from June 2022 to November 2023, providing insights into the distribution of referrals, strategic purchasing from private healthcare providers, and the top medical procedures referred. The article delves into the unique features of Karnataka’s Online Referral System, implemented in 2019, which has streamlined the referral process and enhanced communication among healthcare providers. Results The findings underscore the positive impact of Karnataka’s ORS on healthcare efficiency, patient satisfaction, easy access to care and strategic purchasing from private healthcare providers. ORS demonstrates improved efficiency in referrals, mitigating the challenges associated with traditional manual process and is an important aspect in improving healthcare services. The system also provides insights on the specialities requiring more capacity building, the volume, completeness, and processing of referrals through the ORS. Conclusion Karnataka’s innovative ORS, presents a transformative solution for improving healthcare access, coordination, and outcomes, reinforcing Karnataka’s commitment to continuous innovation in healthcare delivery and progress towards Universal Health care. The system also offers valuable insights into specialties that require increased access, identifies gaps in the healthcare system, and outlines areas that need strengthening. The article concludes by advocating for the replication of Karnataka’s ORS model across India and suggests potential avenues for further research and improvement.