A Pub/Sub based Architecture to Support Public Healthcare Data Exchange Rakshit Wadhwa IIIT-Delhi New Delhi, India Email: rakshitw@iiitd.ac.in Apurv Mehra IIIT-Delhi New Delhi, India Email: apurv09064@iiitd.ac.in Pushpendra Singh IIIT-Delhi New Delhi, India Email: psingh@iiitd.ac.in Meenu Singh PGIMER-Chandigarh Chandigarh, India Email: meenusingh4@gmail.com Abstract—Data exchange plays an important role in public healthcare. Having timely access to right data can allow detection of the spread of a disease, assess effectiveness of government schemes, etc. In order to improve policies and provide awareness, various government healthcare schemes are run which generate a huge amount of data. This data is collected by number of field workers and is then transferred to central repositories for further analysis. While the data eventually reaches researchers and scientist for analysis, the delay (usually in months) hampers timely actions that can be taken. In this paper, we propose a Publish/Subscribe based Archi- tecture moderated through a web service that can enable an early exchange of healthcare data among different interested parties e.g. doctors, researchers, and policy makers. Our architecture handles the privacy and security requirements, and also pro- vides interoperability support for data exchange. We have also highlighted how the architecture deals with the key challenges involved in public health information exchange. I. I NTRODUCTION The future of healthcare is envisioned as a seamless interoperable network of systems communicating to provide improved health services to people [8]. Many researches have already pointed out value of information exchange in health information systems, both in terms of benefit to patients and economical benefits. A study done in 2005 estimated that fully standardized health information exchange can yield as much as $77.8 billion in the United States [11], since then the expanse and the collection of data has increased exponentially, hence increasing the need for information exchange. The major benefits of timely information exchange include reduced paper work and redundancy of information, better access to accurate clinical history of patients, better facilities for patients and efficient reporting of public health records that facilitates understanding various health statistics, early disease outbreak warning systems and better decision making at the policy level for improved service and quality of healthcare. In this paper we tackle the case of information exchange in public health infrastructure. The public health infrastructure in India has numerous sub centers such as community health centers, primary health cen- ters and hospitals. Apart from these there are more than 8.94 lakh ASHA workers [2] across the villages of the country. Our system aims to fit in all the places where aggregate information needs to be reported to hospitals, government agencies or research institutes for analysis and auditing purposes. Our system is designed to provide the much needed flexibility where users can consume information pertaining to different subjects or disseminate new information related to a subject. The main components of our architecture can be categorized as a publish/subscribe system, which directly aligns with the widely distributed environment of health information, and a web service, which provides a degree of control to answer to the privacy and security concerns of the health information in the public healthcare domain. In this paper, we describe an architecture for information exchange in the public healthcare domain. In section II we describe the challenges pertaining to health information exchange, in section III we describe the proposed system design that can cater to the requirements of public health information exchange. Section III-A describes the overall architecture, and section III-B describes each component of the architecture in detail. Section IV provides a real world scenario. In section V we outline the related work and further discusses about the proposed system. Finally, section VI concludes the paper. II. CHALLENGES Public healthcare has to deal with a high volume of data which is heterogeneous and distributed widely. A sudden shift to a common paradigm is not possible since too many existing healthcare units are involved which have different systems in place. Privacy and security of the information are also the primary concerns. Apart from the technical aspects, factors like incentives involved in the exchange of information play a crucial role. In this section we discuss these technical challenges in detail. 1) The distributed nature of healthcare systems results into wide scale heterogeneity. Many of the legacy systems did not incorporate any fixed standard nor do they have the flexibility to modify existing architecture to support them [2]. Hence, interoperability is the primary challenge for healtchare information exchange. In healthcare, interoperability is defined as the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged [6]. 2) Another important challenge in health information exchange is the need of a highly scalable architecture. The architecture should be able to handle high 978-1-4244-8953-4/11/$26.00 c  2015 IEEE