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The case focuses on the efforts taken by the government of the southern Indian state of Tamil Nadu to pilot the Population Health Registry (PHR) as part of offering preventive-care services to the state's 80 million residents. The case first touches upon Tamil Nadu's early initiatives beginning with the Tamil Nadu Health Systems Project (TNHSP), started in 2005 in collaboration with the World Bank, and the Health Management Information System (HMIS). The case then describes the approach taken by TN government and its partnership with Google to build a model, pilot and roll out the Population Health Registry (PHR) program, the program elements, challenges and the long-term plans. The case also touches upon issues like data privacy and interoperability of systems. What are the measures the government needs to put in place to ensure the success of the initiative, and how will it address issues like data privacy when collecting personal health information in future? It also remains to be seen whether the collaboration can become the first PPP in the healthcare sector in India to build such a large scale health management system. The case can be used in post-graduate and training programs on public policy planning and development and implementing large scale health interventions.