Digital Transformation of Healthcare Access: A Comparative Time Series Analysis of Online Versus Conventional OPD...

The Ayushman Bharat Digital Mission (ABDM) is transforming India's healthcare through digitization, including online outpatient department (OPD) registration using Ayushman Bharat Health Account (ABHA) identities (IDs). With an increase in the number of ABHA accounts, understanding time requirements and bottlenecks in these digital workflows is crucial for successful implementation.

To evaluate the efficiency of patient registration by measuring and comparing the time taken for each step in the online registration and conventional offline OPD registration.

To determine ARIMA (autoregressive integrated moving average) forecasting models to predict future registration and waiting times based on historical data patterns.

This cross-sectional study observed 40 patients (20 per registration method) using Time & Motion Study software. Data collection included four process steps: arrival, application download/token generation, waiting, and registration. Analysis used descriptive statistics, the Mann-Whitney U test, and ARIMA modeling.

Online ABHA registration averaged 4.15 minutes (SD = 1.28) versus 10.37 minutes (SD = 3.54) for offline registration, representing approximately 60% time savings. This difference was statistically significant (W = 16, p < 0.01). The main bottleneck was waiting time: nine minutes for offline versus one minute for online registration. ARIMA models predicted continued efficiency with a four-minute average time for online registration compared to 12 minutes for offline, with greater variability in the latter.

ABHA online registration demonstrates significantly improved efficiency and consistency over conventional methods, particularly in reducing waiting times. These findings support continued implementation of digital registration systems while highlighting the need for strategies to manage process variability in both systems.