By Manisha Dhulipala
As digital health technologies expand worldwide, they are redefining how people access healthcare, how health systems operate and how data flows through the medical ecosystem.
According to the World Health Organization (WHO), innovation is crucial for achieving universal health coverage (UHC) and for finding solutions through emerging technologies. Artificial intelligence (AI), big data and gene editing offer a wide array of opportunities that were previously unthinkable. From telemedicine platforms and wearable sensors to AI-driven diagnostics, the health sector is undergoing an unprecedented digital transformation.
However, this transformation raises a critical question: accountability.
At this year’s seventh edition of the Digital Citizen Summit (DCS) held in November 2025, organised by the Digital Empowerment Foundation (DEF) and Centre for Development Policy and Practice (CDPP), with the support of the Government of Telangana, one of CDPP’s key panels focused on this aspect – “healthcare policy in accordance with digital governance, regulations and accountability.”
Many of the panel discussion’s issues centred on emerging technologies, especially AI. Speakers – academicians, policymakers, and clinical practitioners – shared insights on technical limitations in clinical practice, legal and policy aspects of health data governance, adoption levels in hospitals and India’s future path towards responsible innovation.
As digital health platforms expand, the need for robust accountability mechanisms becomes increasingly crucial to ensure the ethical, equitable and transparent use of these technologies. The Centre for Health and Healthcare at the World Economic Forum (2025) states that by 2030, there will be a shortfall of approximately 11 million health workers due to rising population, increased demand and limited access to care. Harnessing the full potential of AI could be a game-changer – closing critical gaps and revolutionising healthcare delivery worldwide.
The health of its citizens is a sign of a thriving nation, and UHC is a vital measure of the success of its health systems. It promotes the inclusivity and well-being of its people. According to a review article in The Journal of Community Health Management (Kar & Ram, 2024), the 21st century has seen a growing focus on reshaping health systems around individuals, with the integration of data and digital technologies offering significant opportunities to advance the concept of digital governance in transforming health systems. Despite the challenges policymakers face, a tangible transformation is still underway.
From a global perspective, one speaker highlighted the European Union’s AI Act, which set a benchmark by classifying health-related AI systems as “high-risk mandating transparency, human oversight and post-market monitoring.” In contrast, the United States takes a fragmented yet evolving approach: the Food and Drug Administration (FDA) regulates certain AI/machine learning medical devices, the Health Insurance Portability and Accountability Act (HIPAA) governs patient data privacy; however, many digital health apps remain outside these frameworks.
Turning to India, the country’s framework, though underdevelopment, reflects a more holistic approach. Complementary initiatives – such as the proposed Digital Personal Data Protection (DPDP) Act and evolving regulations for telemedicine and e-pharmacy –signal a shift toward structured governance.
India’s healthcare and AI ecosystem is strengthened through a multi-pronged approach: Niti Aayog, aligned with the National Health Policy 2017, provides policy guidance and works with ministries, state governments and research institutions to ensure affordable, accessible healthcare. The Ayushman Bharat Digital Mission (2020) aims to build an integrated digital health infrastructure guided by the National Digital Health Blueprint (NDHB). In contrast, the DPDP Act (2023) aims to ensure privacy and lawful use of health data.
In addition, the Government of India (2025) has also designated AIIMS Delhi, PGIMER Chandigarh, and AIIMS Rishikesh as Centres of Excellence for AI in Health, promoting innovation and adoption of AI-driven solutions to transform healthcare delivery.
AI should be treated as a support tool, especially in diagnostics and imaging. An article in the Indian Journal of Ophthalmology, 2021, demonstrated that though India has made significant progress in laying down a strong framework through the NDHB and the National Health Stack for the future, there is a need to focus on the first important step of collection of “good quality” data point through the implementation of electronic medical records by the healthcare providers (Das, 2021).
There is significant potential to leverage big data effectively to generate insights that address the four major challenges in health care in India: availability, accessibility, affordability and acceptability.
India’s health datasets suffer major quality issues, and mandatory human oversight (“human-in-the-loop”) of AI-generated clinical outputs places an extra burden on medical professionals. Health data, a highly sensitive category of personal information, is without safeguards, risks surveillance, discrimination and misuse.
“Trust” forms the backbone of effective digital health transformation, whether in data altruism, diagnostics or health information exchanges. The panel discussion highlighted that transparency, clear consent pathways, institutional accountability and high-quality data practices will ensure trust and high-quality datasets.
The panel experts unanimously agreed that human expertise remains indispensable, especially in clinical contexts. There was concurrence that “regulations should ideally be contemplated as a bioethical mandate for AI production.”
One of the speakers remarked that “AI as a tool is not a replacement or a substitute, rather an assistant,” especially from a clinician’s perspective. When low-quality data is fed into the system, it inevitably results in the waste of natural and computational resources due to improper deployment.
AI cannot detect the patient’s nuanced symptoms. An example shared by one of the panellists was the radiology department at AIIMS, New Delhi, using AI to generate diagnostic reports, but also including disclaimers such as “preliminary only, not for diagnostic use” – underscoring the ethical need for transparency. Meanwhile, the Indian Council of Medical Research (ICMR) accelerates AI testing with authenticity and credibility (within three to six months) to avoid technological stagnation.
India’s health data sets suffer from inconsistent quality and data quality is under constant scrutiny, thereby shifting the burden back onto medical professionals. National data standards can ensure interoperability across systems and platforms. There was strong agreement that AI deployment requires structural oversight, and the existing mechanisms for auditing health AI systems are insufficient.
The digital transformation of healthcare is irreversible. As platforms reshape the way health services are delivered, the conversation must shift from technology adoption to technology accountability. Policymakers, companies, clinicians and citizens must work together to build a future where digital health is trustworthy, equitable and transparent.
(Manisha Dhulipala is a Senior Research Fellow at the Centre for Development Policy and Practice (CDPP) in Hyderabad. CDPP is an independent research organisation working to influence public policy with a focus on the development of vulnerable populations)
