India’s ABDM Links Over 104 Crore Health Records Using NRCeS FHIR R4 Standards

The Ayushman Bharat Digital Mission (ABDM) is India’s national programme for digital health infrastructure, run by the National Health Authority. Its core components include the Ayushman Bharat Health Account (ABHA), a health identifier for individuals, the Health Facility Registry (HFR) and the Healthcare Professionals Registry (HPR). Health records remain with the facilities that create them and are exchanged with the individual’s consent.

A Press Information Bureau backgrounder dated 6 July 2026 reports that more than 104 crore health records have been linked to more than 93 crore ABHA accounts. Other coverage from July 2026 cites more than 93.95 crore ABHA numbers as of 10 July 2026. The backgrounder also reports payments under the Digital Health Incentive Scheme, which rewards facilities and software providers for creating interoperable digital records, with totals given as of 18 June 2026.

Access to the network is granted only after healthcare professionals and facilities are verified through the HPR and HFR. The National Health Authority’s gateway handles authentication of individuals through ABHA credentials.

ABDM uses HL7 FHIR R4 for the exchange of health information, customised for the Indian context by the National Resource Centre for EHR Standards (NRCeS). Descriptions of the ABDM architecture identify three elements: a federated health data architecture, the electronic consent framework of the Ministry of Electronics and Information Technology, and FHIR standards for the exchange of health information.

The FHIR Implementation Guide for ABDM, maintained by NRCeS, defines the minimum conformance requirements for accessing health data to achieve continuity of care in the Indian context. It is based on the ABDM Health Data Interchange Specifications 1.0 and is updated periodically. The guide provides FHIR profiles and examples for the types of health records exchanged through ABDM.

NRCeS also published, in September 2024, an Implementation Guide for Adoption of FHIR in ABDM and NHCX. NHCX is the National Health Claims Exchange, which uses FHIR for the exchange of health insurance claims information. The companion guide explains how organisations should adopt the FHIR profiles across both care records and claims.

The NRCeS guide is under active revision. One NRCeS page lists version 7.0.0 as a draft dated 15 July 2026, while another describes version 6.5.0 as the current published version. Implementers should check the NRCeS version directory to confirm which version is the current official release before building or updating integrations, and should plan for changes when version 7.0.0 is finalised.

The sources reviewed did not identify a notification by the Ministry of Health and Family Welfare or the National Health Authority that makes the ABDM standards mandatory for all healthcare providers. Some third-party publications describe mandatory compliance deadlines for particular categories of organisation in 2026 to 2028, but these could not be confirmed against government sources. Participation in ABDM and in incentive schemes depends on using the ABDM specifications, which in practice makes the NRCeS profiles the reference standard for organisations that integrate with the national network.

For software vendors and hospitals, conformance with the NRCeS FHIR profiles is the condition for exchanging records through ABDM. Vendors should test against the current version and follow the release of version 7.0.0. For organisations outside India, the use of FHIR R4 means that skills and tools developed for FHIR-based systems in other countries are relevant, although Indian profiles, terminologies and consent processes differ from those in the US or the EU.

The scale of ABDM also matters for evidence planning. With more than 93 crore ABHA accounts reported in July 2026, a growing share of care in India is being recorded in a form that can be linked to an individual identifier and exchanged in a standard format. Organisations planning studies, registries or post-marketing activities in India should follow how ABDM develops, including any future rules on access to linked records, while recognising that uptake has varied between states and that the existence of a digital record does not by itself make the data available for research.

For researchers and sponsors, ABDM is primarily a care-delivery and consent-based exchange network rather than a research data platform. Any use of ABDM-linked records for research would need to respect the consent framework and applicable Indian data protection requirements, and the sources reviewed did not identify a specific framework for secondary use of ABDM data for research comparable to the EU’s European Health Data Space.