# Centralized vs. Decentralized Cloud Computing in Healthcare
## 5 Centralized Cloud Computing
However, the storage of patients' sensitive data in a system that utilizes Software as a Service (SaaS) technology involves security concerns. A solution for the management of patient data in rural healthcare systems via a private cloud model was proposed in [54]. The private cloud architecture stores and accesses patient data locally within the rural healthcare organization, eliminating the need for a centralized public cloud. This reduces network latency and improves the system's response time for accessing patient records. Hosting the private cloud eliminates the need to transmit data over long distances to a remote cloud, further enhancing response time. In order to ensure data security, the system proposed has two databases, one for patient files and the other for personal identification data. Health-related information resides within secure virtual machine, integrated into the consolidated private network architecture, which delivers processing capabilities, data storage solutions, and connectivity infrastructure for health information management. However, the building and maintenance of a private cloud infrastructure can be costly, especially for rural healthcare systems operating on limited budgets. The expense associated with hardware, software, and the skilled personnel required for a system's implementation and maintenance can pose significant barriers to the adoption of private cloud solutions by rural healthcare systems. Meanwhile, ref. [55] discussed the topic of scoliosis and its effects on patients, emphasizing the creation of a clinical data cloud system to improve pediatric patient care within the Shriners Children's Hospital system. The primary goals of the infrastructure development were to establish a consolidated data repository and enhance data interoperability. The infrastructure aims to consolidate and standardize diverse data from several locations and modalities, facilitating the retrieval and accessibility of data for clinical and research reasons. The authors employed the Fast Healthcare Interoperability Resources (FHIR) standard to include clinical data from several hospital sites [56]. This standard aims to enable fast data exchange and reduce latency in data access and retrieval. It also ensures secure data storage to protect the confidentiality of patient information. Their team engineered a SMART-on-FHIR application with a friendly graphical user interface (GUI). This platform enables the efficient retrieval of unified clinical information for users without technical expertise. The application incorporates role-based access controls to enforce selective entry protocols, restricting data visibility and interaction with the patient data. The clinical data infrastructure for pediatric patient care is efficacious for improving patient outcomes in actual clinical cases. However, creating SMART-on-FHIR apps is resource-intensive, as it involves time, money, and expertise. Moreover, patient data privacy concerns can be a barrier. The authors of [57] highlighted the absence of automation in healthcare management systems. The paper emphasized the significance of centralized and automated healthcare systems, specifically in relation to the COVID-19 pandemic. The authors proposed a frame work that collects patient details from wearable devices or testing centers and stores them in a central repository accessible to any hospital. This approach enables faster and more efficient handling of patient cases. The use of a doctors' forum in the framework enables quick decision making and treatment suggestions, improving the overall response time for patient care. Patient data are stored on the cloud as audio files to prevent unauthorized access. However, storing audio files in the cloud can be challenging, due to their larger size compared to text files. It is, therefore, essential to consider the impact on storage space to ensure seamless access to important files. Automation can decrease the necessity for manual tasks and human involvement, resulting in lower operational expenses. Similarly, ref.