Sri Lanka urged to digitalise healthcare for efficiency and growth

Sri Lanka has long been admired for its free, universal public healthcare system and notably high literacy levels. Despite this success, the country’s health information infrastructure remains fragmented, insufficiently digitised, and prone to inaccuracies.

“As a result, disease coding accuracy in many hospitals remains below acceptable levels, leading to gaps in diagnostic records and inefficiencies in insurance claims processing. This results in the misallocation of scarce resources, higher costs for both citizens and the state, and missed opportunities to align with global digital health ecosystems,” says Dr. W. Ajith Raveendra De Mel, Chairman of the Insurance Regulatory Commission of Sri Lanka (IRCSL).

“As we look toward the next decade, it is clear that the sustainability of our healthcare system and the insurance sector that supports it depends on how effectively we modernise our data infrastructure and adopt international standards such as the International Classification of Diseases, 11th Revision (ICD-11).”

Globally, the healthcare landscape is undergoing rapid digital transformation. The World Health Organization’s ICD-11 provides a globally comparable framework for classifying diseases and causes of death, improving uniformity and accuracy in health reporting. For example, Estonia’s X-Road platform connects hospitals, insurers, pharmacies, and state systems, enabling instant encrypted data exchange. Nearly 99% of health data is digitised, allowing claims to be settled within minutes and fraud to be virtually eliminated.

Across Europe, countries are transitioning toward ICD-11 compliance and piloting its integration into national health information systems. Sri Lanka now stands at a pivotal moment to articulate a clear national vision to become South Asia’s first country to fully adopt ICD-11 nationwide and implement a unified electronic health record (EHR) system integrating modern medicine and Ayurveda by 2030.

“In this context, IRCSL has already initiated discussions with the Ministry of Health and relevant healthcare professionals to take the first steps toward this transformative vision,” Dr. De Mel said.

A digitally transformed health ecosystem built around ICD-11 and EHRs would enable faster, safer, and more accurate care. Citizens could carry a secure digital health ID containing their ICD-coded medical history and insurance entitlements, accessible anytime. This would support informed clinical decisions, minimise diagnostic errors, and ensure continuity of care across hospitals.

For policyholders, integration would allow insurers to verify diagnoses and process claims seamlessly, reducing delays and disputes. AI-driven analysis of anonymised health data could also accelerate medical innovation, clinical research, and preventive-care initiatives, positioning Sri Lanka as a “health-secure island nation” aligned with global digital health leaders.

Accurate ICD-11 coding would further enhance insurers’ risk assessment capabilities, enabling segmented and pre-underwritten health products tailored to different income groups. This would expand insurance coverage among low-income and informal-sector populations while encouraging preventive healthcare.

While acknowledging the Government’s broader digitalisation agenda and progress within the health sector, the IRCSL stresses the need for stronger political commitment and a coordinated, multi-stakeholder governance mechanism to ensure accountability and measurable progress.

By embracing ICD-11 and a nationwide EHR system integrated with insurance, Sri Lanka can revolutionise healthcare delivery, advance financial inclusion, and support long-term economic growth. The IRCSL stands ready to lead this transformation to ensure resilience, innovation, and sustainability across both healthcare and insurance systems.