title: Architecture Design of Healthcare Software-as-a-Service Platform for Cloud-Based Clinical Decision Support Service.
abstract: OBJECTIVE
  To design a cloud computing-based Healthcare Software-as-a-Service (SaaS) Platform (HSP) for delivering healthcare information services with low cost, high clinical value, and high usability.
  
  
  METHODS
  We analyzed the architecture requirements of an HSP, including the interface, business services, cloud SaaS, quality attributes, privacy and security, and multi-lingual capacity. For cloud-based SaaS services, we focused on Clinical Decision Service (CDS) content services, basic functional services, and mobile services. Microsoft's Azure cloud computing for Infrastructure-as-a-Service (IaaS) and Platform-as-a-Service (PaaS) was used.
  
  
  RESULTS
  The functional and software views of an HSP were designed in a layered architecture. External systems can be interfaced with the HSP using SOAP and REST/JSON. The multi-tenancy model of the HSP was designed as a shared database, with a separate schema for each tenant through a single application, although healthcare data can be physically located on a cloud or in a hospital, depending on regulations. The CDS services were categorized into rule-based services for medications, alert registration services, and knowledge services.
  
  
  CONCLUSIONS
  We expect that cloud-based HSPs will allow small and mid-sized hospitals, in addition to large-sized hospitals, to adopt information infrastructures and health information technology with low system operation and maintenance costs.
authors.affiliation: R&D Institute, ezCaretech Co. Ltd., Seoul, Korea.
authors.forename: Sungyoung
authors.initials: S
authors.lastname: Oh
authors.affiliation: R&D Institute, ezCaretech Co. Ltd., Seoul, Korea.
authors.forename: Jieun
authors.initials: J
authors.lastname: Cha
authors.affiliation: R&D Institute, ezCaretech Co. Ltd., Seoul, Korea.
authors.forename: Myungkyu
authors.initials: M
authors.lastname: Ji
authors.affiliation: R&D Institute, ezCaretech Co. Ltd., Seoul, Korea.
authors.forename: Hyekyung
authors.initials: H
authors.lastname: Kang
authors.affiliation: Center for Medical Informatics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Seok
authors.initials: S
authors.lastname: Kim
authors.affiliation: Center for Medical Informatics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Eunyoung
authors.initials: E
authors.lastname: Heo
authors.affiliation: Health Promotion Center & Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jong Soo
authors.initials: JS
authors.lastname: Han
authors.affiliation: OnSecurity Co. Ltd., Seoul, Korea.
authors.forename: Hyunggoo
authors.initials: H
authors.lastname: Kang
authors.affiliation: R&D Institute, ezCaretech Co. Ltd., Seoul, Korea.
authors.forename: Hoseok
authors.initials: H
authors.lastname: Chae
authors.affiliation: Center for Medical Informatics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Hee
authors.initials: H
authors.lastname: Hwang
authors.affiliation: Center for Medical Informatics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Sooyoung
authors.initials: S
authors.lastname: Yoo
keywords: Clinical Decision Support Systems; Computer Systems; Electronic Health Records; Medical Order Entry Systems