Healthc Inform Res.  2015 Apr;21(2):102-110. 10.4258/hir.2015.21.2.102.

Architecture Design of Healthcare Software-as-a-Service Platform for Cloud-Based Clinical Decision Support Service

• Oh S
• Cha J
• Ji M
• Kang H
• Kim S
• Heo E
• Han JS
• Kang H
• Chae H
• Hwang H
• Yoo S

• KMID: 2284613
• DOI: http://doi.org/10.4258/hir.2015.21.2.102

Abstract

OBJECTIVES
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.

Keyword

Clinical Decision Support Systems; Electronic Health Records; Computer Systems; Medical Order Entry Systems

MeSH Terms

Commerce
Computer Systems
Decision Support Systems, Clinical
Delivery of Health Care*
Electronic Health Records
Information Services
Medical Informatics
Medical Order Entry Systems
Privacy
Soaps
Social Control, Formal
Soaps

Figure

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  Figure 1 Overview of cloud computing-based Healthcare Software-as-a-Service (SaaS). CDS: Clinical Decision Support, OSS: operational support service, BSS: business support service.

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  Figure 2 Overview of a cloud-based Clinical Decision Support Service (CDSS).

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  Figure 3 Architecture of the Healthcare SaaS Platform (HSP): functional view.

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  Figure 4 Architecture of the Healthcare SaaS Platform (HSP): software view.

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  Figure 5 Healthcare SaaS Platform (HSP) multi-tenancy model, depending on the storage location of the healthcare data: (A) cloud storage or (B) hospital storage.

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  Figure 6 Normal EHR (A) vs. cloud-based EHR (B). EHR: Electronic Health Record, SaaS: Software-as-a-Service, CP: computing platform, EMR: Electronic Medical Record, CDSS: Clinical Decision Support Service, CPOE: computerized provider order entry.

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  Figure 7 Cloud configuration using Microsoft's Azure cloud computing platform and the Healthcare SaaS Platform (HSP).

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