Abdul Mughees
The past few years have given Pakistan’s health sector something it has rarely had: digital innovation. From paperless Basic Health Units offering rural patients video consultations to telemedicine centres, Sehat Kahani and DoctHers, digital technologies are being used to expand access. The National Digital Health Framework 2022–2030 sets out a coherent long-term vision, while the National AI Policy extends that ambition into artificial intelligence, explicitly naming health among its priority sectors.
These are not small achievements. They reflect real investment, technical skill and a hard-won response to a health system long defined by scarcity: of doctors, budget and reach. Each initiative, on its own terms, deserves to be recognised as progress.
And yet, taken together, these achievements raise a question worth asking: What happens when a country adopts digital-health tools before building a standardised digital-health architecture? The tools must later be retrofitted, at the cost of expensive re-architecture, data-migration losses and delayed interoperability. Pakistan’s health system is an archipelago of disconnected digital systems in search of a foundational layer. Across health systems that innovate quickly at the point of care before investing in architecture, the same pattern recurs. Pakistan is not unique in this regard.
In practical terms, a patient examined by video at one of these centres today may have no accessible medical history tomorrow at a tertiary hospital in the same city. The record does not travel because there is no system for it to travel through. We have built a growing number of digital-health tools without first establishing the national infrastructure that would allow them to communicate through a shared patient identifier and common data-exchange standards. Other countries call this a health information exchange. Pakistan has yet to define one clearly.
The encouraging part of this diagnosis is that the solution is within reach, and countries facing similar constraints have already shown the way. Rwanda paired its expansion of universal health coverage with early investment in a national data-exchange backbone, allowing later tools such as telemedicine and drone-based supply delivery to plug into a system designed to receive them. Other countries with more decentralised systems have achieved connectivity through platforms that link patients, providers and payers through a single exchange. Neither path required abandoning existing investments; both added a connective layer beneath work already under way.
What Pakistan now requires, before the next digital service is implemented, is a clear decision on who will govern the national health-data infrastructure, including health records and data-exchange standards. Existing programmes would not need to be dismantled; they would simply need to be brought onto a shared standard. Paired with long-awaited health-data governance provisions, this would give the country’s considerable investment in digital health a technical foundation equal to its ambition.
None of this erases what has already been built. It simply completes it. Pakistan’s digital-health journey so far has generated genuine, visible momentum. The next chapter could be the one in which that momentum finally compounds.
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