Interoperability in Healthcare
Advances in technology have made digital collection of health related information easy but data still largely remain siloed in the boundaries of the various applications.
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 hospitals, 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. COVID-19 like pandemics have surfaced glaring loopholes in our global health infrastructure, once of the major one being lack of information exchange between various health entities in a timely manner.
I have worked on the following major interoperability scenarios :-
Information exchange hospitals and central authorities
Information exchange between central authorities
A Pub/Sub based Architecture to Support Public Healthcare Data Exchange
The first work is about leveraging a Publish/Subscribe based Architecture 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. The architecture handles the privacy and security requirements, and also provides interoperability support for data exchange.
A Live Interoperability Model for Health Information Systems
There exist diverse health information systems today, each addressing a specific need in the healthcare domain e.g. Hospital Information System collecting clinical, patient and administrative data; Health Management and Information Systems (HMIS) collecting health indicators across an area (such as mortality, births and vaccination) and systems for Telemedicine to provide access to healthcare for areas that are not easily accessible. Integrating the information collected across such diverse systems can be technically challenging, primarily due to the different data models and work flows being adopted to address specific requirements catered by such systems. However, such integration can provide significant benefits such as single point of access, detailed and real-time analysis and reduction in duplication of information.
The second work captures experience of integrating OpenMRS based hospital information systems and DHIS2 based HMIS deployed across the state of Himachal Pradesh (HP), India. OpenMRS based system is now deployed across 20 hospitals in the state while the DHIS2 based system is used for data collection from multiple reports under NRHM program. We used WHO backed interface for statistical data and metadata exchange in healthcare called SDMX-HD for data communication across the systems.
Publications & Resources
R. Wadhwa, A. Mehra, P. Singh and M. Singh, "A pub/sub based architecture to support public healthcare data exchange," 2015 7th International Conference on Communication Systems and Networks (COMSNETS), 2015, pp. 1-6, doi: 10.1109/COMSNETS.2015.7098706. [link]
Mehra, A., & Singh, A. (2014). Interoperability model for health information systems and associated benefits challenges and approach (Doctoral dissertation, IIIT Delhi). [Link]
GitHub Repository to OpenMRS - DHIS2 interoperability module - https://github.com/hispindia/dhisreport