Digital Health and Artificial Intelligence: A Strategic Framework for India

Abstract

India is currently undergoing a paradigm shift in healthcare delivery, transitioning from a fragmented, provider-centric model to an integrated, data-driven ecosystem. This paper proposes a comprehensive strategic framework for the integration of Artificial Intelligence (AI) within India’s Digital Public Infrastructure (DPI). By leveraging the \"India Stack\" and the Ayushman Bharat Digital Mission (ABDM), the framework addresses unique domestic challenges: the rural-urban divide, physician shortages, and linguistic diversity. We outline a \"Six-Pillar Strategy\" encompassing infrastructure, governance, capacity building, and ethical AI deployment to ensure \"AI for All.\"

Introduction

The text presents a comprehensive strategic framework for integrating Artificial Intelligence (AI) with India’s Digital Public Infrastructure (DPI) to transform healthcare delivery at population scale. With over 1.4 billion people and vast diversity, India’s healthcare challenge is one of access, equity, and efficiency. By 2025–2026, AI has moved from pilot projects to a mission-critical national strategy under the vision of “AI for All.”

India’s transformation is anchored in the India Stack, comprising identity (Aadhaar/ABHA), payments (UPI), data exchange (DEPA), and application layers (ABDM/UHI). This open, federated, and consent-based architecture enables ethical data sharing, interoperability, and large-scale AI deployment without centralized data hoarding. The Ayushman Bharat Digital Mission (ABDM) operationalizes this infrastructure by standardizing registries, ensuring verified providers, and enabling federated health records that enhance privacy and cybersecurity.

The paper proposes a Six-Pillar Strategic Framework to operationalize AI in healthcare:

1. Robust Data Infrastructure & Interoperability through HL7 FHIR standards, federated data exchange, and consent managers.

2. AI for All (Inclusive Innovation) focusing on linguistic inclusivity via Bhashini, edge AI for rural areas, and AI as a digital public good.

3. Regulatory and Ethical Governance with graded liability, bias mitigation using Indian datasets, and DPDP Act compliance.

4. Clinical Validation and Sandboxing to ensure safety, evidence-based adoption, and post-market surveillance.

5. Human-Centric Capacity Building emphasizing AI as a support tool, curriculum reform, and ASHA worker empowerment.

6. Public–Private Synergy via UHI, incentives for digitization, and government-led grand challenges.

Empirical evidence from 2025–2026 highlights impactful use cases:

• AI-driven diabetic retinopathy screening achieving 94% accuracy and large-scale early detection.

• Maternal and child health risk prediction with 85% accuracy in detecting pre-eclampsia and improved antenatal care adherence.

• Predictive outbreak surveillance reducing detection time from 14 days to under 4 days.

• Generative AI for clinical documentation cutting paperwork time by 30% and increasing patient interaction.

Despite progress, challenges remain, including infrastructure gaps, legacy system interoperability, algorithmic bias, cybersecurity risks, evolving liability frameworks, and resistance due to low AI literacy and trust deficits. The paper concludes with strategic recommendations emphasizing outcome-based incentives, strengthened techno-legal governance, democratized access to AI infrastructure, and a shift from digital activity to measurable health impact.

Overall, the text positions AI not merely as a tool for efficiency, but as a core engine for health equity, social empowerment, and sustainable public healthcare transformation in India.

Conclusion

India stands at a \"technological crossroad.\" The strategic framework proposed centered on Digital Public Infrastructure (DPI), Inclusive Innovation, and Techno-Legal Governance offers a viable pathway for universal health coverage. By leveraging the \"late-mover advantage,\" India can bypass legacy pitfalls and emerge as the global \"Use Case Capital\" for AI in healthcare, proving that advanced technology can indeed be a force for the greater good.

References

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Copyright

Copyright © 2026 Dr. Bamang Apo. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.