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In July 2018, The Government of India’s policy think tank NITI Aayog invited feedback on their blueprint for a “National Health Stack” – the tech spine required to support India’s recently-announced National Health Protection Scheme, extending coverage to 500 million people. In response, an interdisciplinary team of researchers and practitioners from across Harvard and India have published a paper, “Reimagining Health Data Exchange: An API-enabled Roadmap for India,” in the Journal of Medical Internet Research, building on 18 months of deliberations following an initial workshop in September 2016, sponsored by a grant from the Radcliffe Institute of Advanced Studies. 
This paper lays the foundational principles for a federated architecture for India’s digital health data flow, focusing on the data minimization, unique universal identification, substitutability, patient consent-driven exchange, and privacy by design. 
The paper will serve as a guidepost for the India Digital Health Net, a multi-faculty initiative at Harvard established with seed funding from the Harvard Provost Fund for Interfaculty Collaboration, with partners across the public and private sector in India. The IDHN team will build and test component prototypes for the proposed architecture, drawing from inter-disciplinary expertise across Harvard and MIT.