Version #1.0 (Draft)
Priyanka Yadav, Krishan Bhardwaj, Arun Kumbhat, Dr Pankaj
Gupta, Department of Digital Health
Single Source of Truth for Governance and
Health Resource Planning
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What is a Registry? .............................................................................................................................4
How a Registry is different from a Directory?......................................................................................4
What is a National Health Facility Registry? .......................................................................................4
Advantages of a harmonized facility registry using NHRR, NIN and ROHINI.................................8
Annexure-I: Recommended MDDS based data elements for National Facility Registry ....................9
Annexure-II: National Health Facility Registry- Technical Architecture and approach......................12
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We would like to thank National Health System Resource Centre (NHSRC), IQVIA,
Insurance Information Bureau &IRDA, who have contributed towards completion of this
concept paper. The research that went into this paper would not have been possible without
their valuable inputs & publications through the different experiences that they brought on
the table. Their respective insights had led to important findings and helped us formulate
recommendations on National Facility Registry.
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What is a Registry?
A registry is an organized system or database that collects, stores uniformed data or information
about an entity like patient, person , or facility etc and is kept updated at all times to act as “Single
Source of Truth” for the entity in question. The data facilitated by the registry can be accessed as
service by information technology applications or by the government for planning initiatives and
How a Registry is different from a Directory?
A registry is an official record keeping database which not only identifies an entity uniquely but also
proves its existence in the ecosystem in question. E.g.: ADHAAR- A person must be listed in
AADHAAR registry to be able to verify his/her identification as an Indian Citizen with authentic
Directory on the other hand does not required to be an official or comprehensive, but mere a
collection of data without uniquely identifying entities listed in it and do not serve as “single source of
truth”. Example- A telephone directory.
What is a National Health Facility Registry?
A National Health Facility Registry is a centrally maintained registry that stores and facilitates uniform
minimum required data or information about both public and private health facilities in the country. It is
a building block that is essential to enable nationwide health information exchange. It will do so by
identifying each health facility uniquely and creating a unique Identifier for every registered facility.
This unique identifier then becomes available to be utilized by states and IT systems as a pointer or
primary key to store more facility related data in directories maintained at state/district level, providing
comprehensive data on all private and public health establishments
Indian healthcare has been trying to overcome the problem of interoperability and siloed systems to
enable continuum of care. This requires a standard driven health information exchange (HIE), and to
enable a HIE, it is essential to uniquely identify each stakeholder and resource (Patient, Provider,
facility, health worker) involved in an episode of care.
Also, from a quality of care and governance perspective a facility registry becomes very critical for
resource planning to create a reliable, unified registry of country’s healthcare infrastructure &
associated resources through associated state or national level repositories like NHRR to show their
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distribution pattern of health facilities and services areas across the country. This assumes even
greater significance in emergencies like Pandemics and disasters.
Several initiatives have been made by the Indian Government in the past to enable a centrally
maintained facility registry for India.
Key initiatives undertaken in India for facility registry includes:
• National Identification Number (NIN) project that was undertaken by National Health
System Resource Centre (NHSRC) in 2016 where data pertaining to approximately
1,11,990 health facilities was cleaned and validated by 25 states including longitude-Latitude
details. A 10-digit unique National Identification Number (NIN) was allocated to the identified
public health facilities. A NIN portal was also developed for missing facilities or new facility
registrations and states were provided trainings on the same to keep the NIN facility data
• National Health Resource Repository (NHRR) project by Ministry of Health and Family
Welfare (MoHFW)- In NHRRa Healthcare establishment Census was conducted which
included on ground physical survey to enlist all the health facilities as well as resources.
NHRR database has listed approximately 8.5 lakhs+ facilities and provides around 7000+
attributes withspatialinformation maintained by the technology partner ISRO.
• ROHINI (Registry of Hospitals in Network of Insurance)– Dubbed as the AADHAAR of
Hospitals by Insurance Information Bureau of India (IIB)- ROHINI is a PAN India registry of
hospitals/day care centers that are empanelled with health insurance payers/Third Party
Administrators(TPAs) for service delivery to the beneficiaries. It has approximately 35,000
facilities listed so far. Each registered facility is allotted a 13-digit Global unique GS1 identifier,
along with geo coding of facility address. ROHINI also has self service portal for
registration/inactivation /deletion or amendment of registered facilities. All network hospitals
and hospitals involved in cashless reimbursement claims or those that wish to provide this
facility, are registered on ROHINI.
All the initiatives as mentioned above had common goals, one to act as single source of truth and
second to become single point of reference for facility information as per their identified scope.
Since a lot of effort has gone into each of these initiatives, they should be brought together and
harmonized to enable a National Facility Registry that can identify both public and private health
facilities uniquely. The data collected under each mentioned initiative can be consumed or exposed
as service to get/retrieve additional data about a facility using the same National Unique Facility
Identifier that can be allotted by the National facility registry and act as a primary key to stitch the
different databases together.
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1. Identify Minimum required data elements for Centrally maintained Registry
A central or nationally maintained registry that can be self-sustainable and easy to maintain should
not have a long list of data elements or attributes. It should consist of only a set of minimum required
data elements that helps to identify the facility uniquely and can be kept updated at all times. The
recommended data elements should follow Metadata and Data standards for India (MDDS) which
is a standard notified by Ministry of Electronics and Information Technology (MeITY). It is essential
to use data standards to collect and store information in a registry, so that if states want to maintain
their own facility directories/state registry/database they can use the same standard MDDS
elements to define the local registry structure and will be able to push data seamlessly to the
National facility registry.
The recommended minimum viable data elements are listed in the Annexure.
2. Map NHRR-NIN-ROHINI Facilities& State verification and updation
Facilities listed in all the three mentioned databases can be mapped using Machine Logic/AI and
manual interventions by making use of the key attributes like name, address and longitude-latitude
Following steps are recommended to harmonize and enable a National Health Facility Registry
1. Map ROHINI, NIN and NHRR facilities.
The facility data from NHRR, NIN and ROHINI data sources will be harmonized by employing
Fuzzy logic-based matching of facility data from each of these different sources. Facility
data (NHRR, NIN and ROHINI) shall be matched by deploying fuzzy algorithms like Soundex
or levenshtein distance matching etc. The unique minimum required attributes as described in
appendix 1 shall be loaded in the facility registry database.
2. Develop standard definitions for attributes using MDDS elements as provided in the
3. Identify & publish mismatches and duplicates in the standard definition template and
suggests standard process of verification with district and health state departments.
4. State can filter facilities district wise and get the data verified through the respective district
5. Districts can update information in excel format and request corrections if any to the state.
6. State after verification and validation can push the cleaned facility data to the centre.
3. Convert the clean, verified data using a technology partner like NIC into a registry.
The first step towards digitalizing the National Facility Registry after receiving clean and validated
data is to load the cleaned facility data into the National Facility Registry. The facility registry shall
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store the source ID of each system (NHRR ID, NIN ID and ROHINI ID) against the set of data
attributes loaded from each of these three data sources to facilitate the facility data set retrieval
from registry based on different identifiers (e.g. based on ROHINI ID or NHRR ID) and thus it shall
not disrupt the design of existing systems which are using this data.
The loading process of facility data into facility registry shall ensure the uniqueness and
deduplication of facility data by using validation/data deduplication engine. A National unique
facility Identifier shall be generated for each facility populated in the facility registry (the algorithm
to generate the unique facility identifier should be decided by the authority implementing the
design of facility registry), The facility unique Identifier will be a 10 digit unique Integer value and
should not contain any data attribute based logic in the design of identifier code due to volatile
nature of the facility data attributes as that may change in future e.g. if facility identifier contains
the logic built based on the location of facility e.g. state and district code, the same may change
due to administrative change of the location of facility due to addition or deletion of state or district
by the respective state government in future. It is recommended that facility identifier should be a
running serial number generated based on a selected algorithm like generation of AADHAR
NUMBER which generate a unique number which is unique across the lifetime.
4. Develop a central portal with standard operating procedures on deletion, updation or
addition of facilities.
➢ Portal for enrolling new public and private facilities into National Facility Registry.
➢ Public Portal for access to National Facility Registry data as part of e-governance.
5. Develop a roadmap for training & updation of National Facility database by
6. Maintenance of National Health Facility Registry
For maintenance of Facility data in Facility Registry. openAPI/web service standards can be
used to add/update or delete facility data. After Initial load of facility in facility registry any new
facility shall be added in the Registry by use of openAPIs/webservices. The updation of facility
registry shall follow the design principles for registries as laid out in National Health Stack
document and will ensure the single source of truth and non repudiablity of facility data in
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Advantages of a harmonized facility registry using NHRR,
NIN and ROHINI
• The National Facility Registry will be a single source of truth for all the clinical establishments
or healthcare facilities in India and can be a single point of reference for health infrastructure
• The Facility registry will always also help the Government to plan emergency responses and
predict healthcare expenditure by making operational status of facilities available.
• Harmonizing the different initiatives like NHRR, NIN and ROHINI will help in collating
authentic data for facilities which are already recorded under respective initiatives while the
initiatives coexist in harmony and expose the data as a service.
• A repository like NHRR and state repositories if linked with the National Facility Registry can
provide more information about a facility’s resources like Doctors, Nurses, equipment etc
which will help a state to plan optimized utilization of available resources.
A harmonized National facility registry can be one shot solution, which can support the Government to
manage and optimize healthcare infrastructure & resources effectively and predict the unmet needs to
design an effective risk mitigation plans in advance to combat a future pandemic. It can identify key
areas of improvement by upgrading existing health facilities or establishing new health facilities
keeping in view the population density, geographic nature, health condition, distance
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Annexure-I: Recommended MDDS based data elements for
National Facility Registry
Element Label Format Size Value set
05.008.0001 Unique Facility
Integer 10 To be generated by the National
Registry (Primary Key)
05.008.0025 Facility Global
Bits 16 Mach
Varchar 50 Can use this field to map NHRR,
ROHINI or NIN or state registry ID
05.008.0033 Facility Name Varchar 60
05.008.0002 Facility Type Code Integer 2 CD05.002 (district hospital, sub centre
Char 1 CD05.120
Premises Identifier Varchar 60 House Number./DoorNumber/House
l Building Number./Plot Number
lBuilding Name/ Building Identifier
Sub Locality-1 Varchar 50 Block Name/Number or any other
l Street Number /Name/Mohalla/
Sector Number/any other qualifier
Locality Varchar 50 Area Number/Area Name/Suburb/Sub
district in case of Village/any other
G02.01 Land Region code Integer 2 Integer
State - 2
District - 3
Sub-District - 5
Village - 6
Town - 6
G02.02-01 State Name Varchar 50 e-governance/census list
G02.01 District Code Integer 3 CD02.03A unique code allocated by
of RGI at National level
G02.02-01 District Name Varchar 50
G02.01 Taluka LRC Integer 5 CD02.04, A unique code allocated by
RGI at National level, for
unit, Sub-District (Taluka) for
Taluka Name Varchar
G02.01 Village LRC Integer 6 A unique code allocated by Office of
RGI at National level
G02.02-01 Village Name Varchar 50
G02.01 Town LRC Integer 2 CD02.06, A unique code allocated by
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RGI at National level
Town Name Varchar 50
State Integer 2 CD02.02
G02.02-01 Pin Integer 6
Longitude Varchar 20
Latitude Varchar 20
Altitude Varchar 20
05.008.0012 Facility Population
Access to Facility
Integer 1 Flag indicating whether the access to
the facility is difficult or easy In case of
Hilly/Desert areas it is difficult
05.008.0008 Facility Region
Integer 1 Flag to indicate whether facility is rural/
Integer 2 The status of the facility will indicate its
operational status, such as
“Operational”, “Closed”, or “Under
Integer 2 Code representing the owner of the
facility, the data element can take
Value List are
3. Central -ESI
4. Central - CGHS
5. Central - HRD
6. Central - other ministries
7. Central - Railways
8. Central - Military
9. State Government
10. Private - for profit
11. Private - not for profit
05.008.0007 Facility Owning
Integer 1 Code represents the relationship
between owners and owned by facility.
1. Complete Ownership
2. Management Control
Integer 10 CD05.001, Unique Facility
of facility that has ownership authority
over the owned by facility
Varchar 60 Autofill
Integer 10 UID of a person will be used as
Identifier if person is owner of the
owned by facility
05.008.0010 Facility Specialty
Integer 3 Good to have
05.008.0018 Number of Beds Integer 4 Good to have
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G00.08 VND Char 5 Defines Version number of the data
record to be used for tracing history of
G00.01 DOUD Date (dd/
10 Date of last Update for ownership
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Annexure-II: National Health Facility Registry- Technical
Architecture and approach
The system architecture will have the following components:
• National Facility Registry (Master Facility Registry)- Registry database with checks and
balances needed for facility database.
• Lookup Registry: Where data would be synced through APIs/ Web Services with the legacy
systems to flag inconsistencies based on the protocols. Appropriate changes to be made in
NIN registry as per protocols.
• Integration engine- to integrate information systems through APIs/Web Services for using
National Facility Registry data into their system.
• Validation/deduplication engine- Facility Register Portal will be strengthened with the
protocols for deduplication and facility data validation.
Facility Database RCH
Primary Systems- Data Input (Sync) into Facility Registry
Facility Registry Platform Data
Management with de-