icegov2012 proceedings

3.2 Design Requirements
There are certain basic requirements that must be addressed in the
design of a rural healthcare information system.
3.2.1 Patient data collection
Whenever a patient visits a Primary Health Centre(PHC), the PHC
doctor performs certain preliminary investigation which may
involve pathological and clinical tests. Such data need to be
maintained in proper format to facilitate diagnosis and future
reference. Thus there is need for suitable methods to collect,
process and transmit patient data to specific locations. The
penetration of desk top/laptops computers in rural India can easily
address this concern.
3.2.2 Data transmission
If patient data need to be transmitted to other locations for further
analysis and for expert views then there must be facility for
secured transmission over a communication network. National
Informatics Centre (NIC), which is the largest public sector unit
of government of India has already extended network connectivity
to block levels and even to many of the rural areas in the form of
IT kiosks managed by NGOs. Therefore the NIC network is the
best way to be used for data transmission.
3.2.3 Storage and distribution of data
NIC has already started providing IaaS for data storage. Once data
is loaded to the cloud it can be accessed by authorized doctors and
other stakeholders.
3.2.4 Availability of medical equipment
Patient data is not enough but one would require sophisticated
medical equipment for diagnosis and data analysis. To create such
facilities in rural areas is a difficult proposition. But such facilities
are available either in the hospitals at the provincial level or in
national level or in designated national level medical research
institutes. Such centers can be integrated with the cloud
infrastructure to take advantage of the facilities. Thus, the system
should be flexible and extensible so that heterogeneous equipment
can be added to the system.
3.2.5 Scalability
The system should be scalable so that more and more rural
healthcare units can be integrated to make use of common
facilities.
3.2.6 Security and reliability
The system must guarantee confidentiality and integrity of patient
data. Only authorized doctors/persons should have access to data.
Whenever needed the required medical data must be available in
spite of operational problems.
3.3 Proof-of-Concept Design
The proposed high level design model is depicted in figure 2.
Patient data is collected at different PHCs and entered into a local
database. Data is then sent to a database server maintained at the
district/provincial level where it can be organized and suitably
indexed so that it can be accessed through user-friendly interfaces.
Specialist doctors available at the district/provincial level can
access the data for diagnosis and can guide the treatment to be
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administered to the patients. The data is then filtered and loaded to
the cloud services which can be later shared by experts and
authorized stakeholders for taking decision at a higher level. The
filtering process can involve aggregation of patient data (in case
tests have been conducted at different places) and preliminary
analysis, before the data can be loaded to the cloud. The stored
data can be delivered to authorized medical professionals/users
after proper authentication using suitable content delivery
services.
Expert analysis, Disease
control, Planning
Diagnosis by experts,
data analysis, filtering
(Provincial medical centers)
Further test inputs,
specialist views, data
indexing
Patient Data
(
collection at
Rural Health Centers
Figure 2. Rural Healthcare Information System
4. CLOUD SERVICE PROVISIONING
4.1 Cloud connectivity
The connectivity and configuration of the cloud based rural
healthcare Information system is based on the service provider
policy and location (i.e., cloud data center location). Internet is the
main communication link between the service provider and a rural
healthcare center. Users access cloud services using networked
client devices, such as desktop computers, laptops, tablets and
smartphones. Many of the cloud applications do not require
specific software on the client so that cloud applications can be
accessed through web browsers. A typical connectivity between
cloud data center and rural healthcare centers is depicted in figure
3.
4.2 Authenticated Access
As patient data is vital, access to such data requires proper
authentication. Only the concerned medical personnel should be
allowed to access patient data and for specific use. One must
enforce well-defined access policies to ensure that only authentic
doctors, nurses or other concerned users access the patient data.
This is achieved by deploying an authentication server which can
authenticate each and every access request to use the cloud
resources.