“Empowering Healthcare: The IT Backbone of PM-JAY”
To summarize the information you provided about the PM-JAY (Pradhan Mantri Jan Arogya Yojana) IT system, we can outline the key technology blocks, their functions, and the overall IT ecosystem supporting this health insurance initiative.
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Key Technology Blocks of PM-JAY
- PMJAY Dashboard
- Function: Provides a comprehensive view of datasets integrated into the PMJAY Data Warehouse, facilitating real-time reporting, performance evaluation, and utilization trend analysis.
- Hospital Empanelment System
- Function: Manages the registration and approval of hospitals for empanelment, with features for hospital quality assurance.
- Beneficiary Identification System (BIS)
- Function: Enables beneficiary searches through SECC (Socio-Economic Caste Census) and supports Aadhaar eKYC and non-Aadhaar KYC for authentication.
- Transaction Management System (TMS)
- Function: Captures inpatient data from admission to discharge and manages hospital claims and financial settlements, integrating with state-based and external systems through APIs.
- Citizen Portal (mera.pmjay.gov.in)
- Function: Allows citizens to verify eligibility by searching the beneficiary database, designed for mobile responsiveness to facilitate field-level access.
- Citizen Call Centre (14555)
- Function: A national toll-free helpline that provides multi-lingual assistance for beneficiaries regarding eligibility, hospital locations, and service feedback.
- National Health Stack
- Function: Serves as a design philosophy to enhance data capture for future improvements and inclusivity in the scheme, including the development of the National Health Claims Platform.
- PM-JAY Portal
- Function: Centralized platform for all information related to PM-JAY, enhancing back-office functions and sharing best practices, SOPs, policies, and guidelines.
- India Enterprise Architecture (IND-EA)
- Function: Principles to develop a future-ready enterprise architecture for PM-JAY and NHA (National Health Authority).
- Information Security & Data Privacy Policies
- Function: Enforces checklists for service providers and consumers to ensure security and privacy of beneficiaries’ personal data.
- National Portability
- Function: Enables benefits to be portable across locations, supporting real-time data integration and exchange.
- Grievance Management System
- Function: Allows for grievance registration and resolution by NHA/SHAs, ensuring anonymity and building trust among beneficiaries.
- Anti-Fraud Measures
- Function: Implements a ‘Man-Machine’ model to detect and investigate fraudulent transactions, supported by the National and State Anti-Fraud Units.
- Citizen Mobile App
- Function: Empowers beneficiaries to check their wallet balance, locate hospitals, and provide service feedback.
- Common Service Centre (CSC)
- Function: Acts as a service delivery partner, helping potential beneficiaries access information about eligibility and authentication in rural areas.
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PM-JAY IT Ecosystem
The PM-JAY IT ecosystem supports these key technology blocks, enabling efficient implementation and management of the health insurance scheme. It is designed to provide a seamless experience for both beneficiaries and service providers, ensuring quick access to health services and information.
Current IT Enablement Illustration
This section could include diagrams or visuals to represent the architecture, data flows, and interaction among the various components of the PM-JAY IT system.
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