Privacy by Design in Indian Healthcare: Moving Beyond Compliance to Responsibility

Sameer Ahirrao -

Healthcare data is one of the most sensitive categories of personal information. In India’s rapidly digitizing healthcare ecosystem with electronic health records (EHRs), telemedicine, health apps, and wearable devices the stakes are high. A single breach can harm not just the patient’s privacy but also their dignity, finances, and trust in the system.

Privacy by Design is a proactive framework where privacy and data protection are built into business processes, technology, and culture from the outset , not retrofitted after a system is deployed. It is based on seven foundational principles:-

1. Proactive, not reactive

2. Privacy as the default

3. Privacy embedded into design

4. Full functionality

5. End-to-end security

6. Visibility and transparency

7. Respect for user privacy

Why PbD Matters in Healthcare

Healthcare organizations in India face unique challenges:

  • Volume & Sensitivity of Data: Medical histories, diagnoses, prescriptions, genetic data.
  • Multiple Data Sources: Hospitals, labs, pharmacies, wearable devices, telemedicine platforms.
  • High Breach Impact: A single leak can cause stigma, identity theft, or insurance fraud.
  • Complex Ecosystem: Involves doctors, nurses, insurers, government bodies, and third-party service providers.

Without PbD, compliance is reactive, you only fix issues after something goes wrong. PbD flips this-privacy becomes a core design principle.

Privacy by Design under India’s DPDPA, ABDM & DISHA

The Digital Personal Data Protection Act 2023 represents India's most significant step toward establishing a privacy-centric data governance regime. The DPDPA applies only to digital personal data, distinguishing it from broader international frameworks like GDPR, while maintaining fundamental privacy protection principles.

The DPDPA 2023 doesn’t explicitly list "Privacy by Design" as a principle like GDPR, but it implicitly requires it through:

  • Purpose Limitation (process only for the stated purpose)
  • Data Minimization (collect only what is necessary)
  • Consent & Notice requirements (clear, informed, specific)
  • Security Safeguards (reasonable measures to prevent breaches)
  • Data Principal Rights (access, correction, deletion, grievance redressal)

The Act mandates data fiduciaries to implement appropriate technical and organizational measures for data security and protection from the outset of any data processing activity. The central government may under the DPDPA designate Significant Data Fiduciaries and require it to follow the additional responsibilities, that include- Conduct Data Protection Impact Assessments (DPIAs); Appoint a Data Protection Officer (DPO); Carry out periodic audits.

PbD is the practical approach to meeting these requirements consistently. The Act's framework requires businesses to build privacy safeguards into their systems architecture rather than treating privacy as an afterthought.

India's healthcare sector exemplifies the practical implementation of Privacy by Design through the Ayushman Bharat Digital Mission (ABDM) and the proposed Digital Information Security in Healthcare Act (DISHA). 'Privacy by Design' is identified as one of the key guiding principles of ABDM, ensuring that patient data protection is fundamental to the digital health ecosystem's architecture while DISHA aims to standardize and regulate the processes related to collection, storing, transmission and use of digital health data while ensuring reliability, data privacy, confidentiality and security.

The ABDM's federated architecture demonstrates Privacy by Design in practice. In alignment with the DPDP Act, the federated architecture ensures security, confidentiality, and secured sharing of patient-related health information. Rather than centralizing all health data, the system maintains distributed control while enabling interoperability through consent-based mechanisms.

ABDM's Health Data Management Policy also serves as "a guidance document to set out the minimum standard for data privacy protection" for all ecosystem participants, representing a comprehensive approach to implementing Privacy by Design across healthcare stakeholders. This policy framework ensures that privacy considerations are embedded throughout the healthcare data lifecycle.

How to Implement Privacy by Design in Healthcare

1) Map and Classify Health Data- Maintain a ROPA (Record of Processing Activities) to log what data is collected, why, and where it flows and tag sensitive personal data like biometric, genetic, and health details.

2) Consent as a Built-in Mechanism- Use explicit and informed consent for collecting health data and, implement consent dashboards for patients to modify or withdraw consent easily.

3) Data Minimization and Purpose Limitation- Only collect the minimum necessary data for a specific medical purpose also, avoid storing unnecessary identifiers like Aadhaar unless legally required.

4) Secure Data Across its Lifecycle- Encrypt health data in transit and at rest.Use role-based access control so only authorized medical staff can view records. Automatically delete or anonymize data after retention periods expire.

5) Vendor and Third-Party Compliance- Ensure data processors like lab service providers or cloud storage vendors follow DPDPA safeguards and include data protection clauses in contracts.

6) Transparency and Patient Rights- Clearly explain to patients how their data will be used and who will have access also provide quick channels to respond to access, correction, and erasure requests.

7) Regular Audits and DPIAs- Conduct privacy audits to find gaps in compliance. And actively use DPIAs before deploying new systems like AI diagnostics or new patient portals.

As India’s National Digital Health Mission (NDHM) and Ayushman Bharat Digital Mission (ABDM) expand, healthcare data processing will only grow. By adopting Privacy by Design now, healthcare providers won’t just comply with DPDPA but they will earn patient trust, reduce breach risks, and set a gold standard for ethical data handling.

The integration of Privacy by Design principles in India's digital infrastructure extends beyond regulatory compliance to encompass technical innovation. The emphasis on federated architectures, consent management systems, and data minimization techniques reflects a maturing understanding of privacy-preserving technologies. These approaches enable India to harness the benefits of digital transformation while maintaining citizen trust and constitutional privacy rights.

Privacy by Design is not just a legal safeguard, it’s a moral obligation in healthcare. In India’s compliance landscape, it’s the smartest way to ensure you meet both the letter and the spirit of the DPDPA.

Final Takeway

Learn how Ardent Privacy’s TurtleShield Platform enables healthcare organizations to embed Privacy by Design into daily operations. From automated data discovery and consent management to breach monitoring and compliance with India’s DPDPA, ABDM, and DISHA, TurtleShield helps you protect patient trust while simplifying compliance.