In the last fifteen years, Bangladesh has made significant investments in digital healthcare systems. Various software programs, databases, online platforms, and digital services have been created. However, many of these projects have operated independently, leading to fragmented health information spread across different systems. Despite the abundance of data, their interoperability and usefulness have lagged behind.
This challenge is evident in the Bangladesh Core FHIR Implementation Guide from the Directorate General of Health Services (DGHS). Systems like DHIS2, hospital automation, and the Human Resources Information System (HRIS) have developed separately, using diverse data structures and standards. This diversity makes it challenging to exchange information. The main issue lies not in the lack of technology but in the absence of a robust institutional mechanism to unify various technologies and systems under a common framework.
Digitalization goes beyond creating more applications and websites. A sustainable digital health system requires secure information flow across platforms, the ability for new investments to build upon existing infrastructure, and systems that remain operational beyond individual project lifespans. Investing in disconnected systems with public funds not only proves inefficient but also hinders the development of a cohesive national digital health ecosystem.
The Bangladesh Digital Health Strategy 2023–2027 addresses crucial aspects such as digital infrastructure, electronic health records, telehealth, digital health identity, artificial intelligence, workforce capacity, data privacy, cybersecurity, and national health information exchange. Nonetheless, a vital institutional query remains: who will spearhead the transformation, coordinate diverse initiatives, establish common standards, and ensure accountability?
Looking at South Asian experiences, India’s Ayushman Bharat Digital Mission in 2021, led by the National Health Authority, presents a valuable model. Instead of mandating every healthcare facility to adopt a single software system, India prioritized creating shared digital infrastructure, standards, registries, and an interoperability framework. By introducing digital health IDs, registries of healthcare facilities and professionals, and consent-based health information exchange, India aims to facilitate collaboration among different systems. Bangladesh should heed this lesson by emphasizing institutional leadership and a unified digital architecture before proliferating applications.
Another pertinent example comes from Pakistan, which enacted the Digital Nation Pakistan Act, 2025, establishing the Pakistan Digital Authority (PDA) to oversee the nation’s broader digital transformation. The PDA’s responsibilities encompass data governance, citizen-centric digital services, interoperability, common standards, national digital planning, and government-wide coordination of digital initiatives. This approach views digital transformation as a national institutional obligation rather than a collection of disjointed ventures.
To advance digital health in Bangladesh, the country must adopt a similar institutional perspective. Digital health transcends merely digitizing hospitals; it involves managing data, privacy, cybersecurity, interoperability, standards, health information exchange, and utilizing data effectively for clinical care, public health, and policy. Addressing these responsibilities necessitates an authoritative institution with the expertise, mandate, and continuity to govern the entire digital health ecosystem.
Considering these points, Bangladesh should contemplate establishing an autonomous national digital health authority. This entity should not be a temporary project or a small IT unit but a legislatively mandated body staffed with professionals and granted administrative, financial, and technical independence. Drawing expertise from various sectors, the authority would define the national digital health architecture, manage digital health identity, establish national healthcare registries, set data and interoperability standards, facilitate secure information exchange, and ensure privacy, data protection, and cybersecurity. Additionally, it should devise a clear regulatory framework for public and private providers to develop and interconnect digital services.
Most importantly, the authority should oversee public investments in digital health. Before any public entity embarks on developing a new digital health system using public resources, it must justify the investment, assess existing systems, evaluate connectivity with current platforms, and plan for system operation post-project completion. A guiding principle should dictate public investment: no new standalone digital health system should receive funding unless it aligns with the national digital health architecture and is designed for interoperability.
This approach does not entail the government developing every application itself. Instead, the government should establish common infrastructure, standards, security protocols, and interoperability guidelines, allowing public and private entities freedom to innovate as needed. This strategy fosters innovation without fragmenting public investment across competing systems.
The ongoing initiative to create a national e-health platform presents Bangladesh with a significant chance to transition effectively. Before launching a new platform, a comprehensive national inventory should catalog all digital health systems, their investments, functionalities, utilization, areas of duplication, and integration potential. Based on this assessment, the government can establish the national digital health architecture and decide which systems to retain, integrate, upgrade, or phase out.
Digital health has become a fundamental component of the healthcare system’s long-term infrastructure. Bangladesh must shift from a project-oriented approach to an institution-centered strategy. A robust institution ensures continuity amidst changing governments, technologies, and partners, guaranteeing that current investments retain relevance in the future rather than becoming isolated digital assets. The decision for Bangladesh is not
