# Centralized vs. Decentralized Cloud Computing in Healthcare
## 5 Centralized Cloud Computing  
Centralized cloud computing has gained prominence in contemporary information technology landscapes, due to its ability to transform the way in which organizations handle and deliver computing resources and services [17]. This model concentrates computing power, storage, and other resources in a central data center, or group of data centers. Users and organizations can configure their computing resources over the Internet, according to their needs. This centralized model offers flexibility to users and organizations alike, enabling them to streamline their operations and achieve their goals more efficiently [48]. Data centers play a crucial role in centralized cloud computing as they help businesses to save cost and to optimize resource management utilizing resources efficiently. Users can manage computing resources like virtual machines, storage, and applications directly, which is a flexible and scalable approach that can improve operational efficiency. Cloud systems can adjust resources quickly to adapt to changing demands, making it easier for organizations to respond to business requirements [49]. Several previous studies employed centralized cloud computing in their model. For instance, ref. [50] proposed a framework for analyzing big data in healthcare. A centralized cloud hosts patient information and provides healthcare services. The EHR component integrates patient records from pharmacies, hospitals, and laboratories with a data analytical component for identifying new patterns. A Care Delivery Organization (CDO) component represents healthcare organizations in various locations, sharing data using \begin{table}
\begin{tabular}{c c c c} \hline \hline \multirow{2}{*}{**Steps**} & \multirow{2}{*}{**Libraries**} & \
\begin{tabular}{c} **Total Number of** \\ **Studies per Library** \\ \end{tabular} &
\begin{tabular}{c} **Total Number of** \\ **Studies Selected** \\ \end{tabular} \\ \hline \multirow{4}{*}{First: Manual Search on Libraries} & MDPI & 64 & 324 \\  & Springer & 81 & \\  & Elsevier & 49 & \\  & IEEE & 73 & \\  & ACM & 57 & \\ \hline \multirow{4}{*}{Second: Analysis of Titles and Duplicate} & MDPI & 31 & 183 \\  & Springer & 47 & \\  & Elsevier & 33 & \\  & IEEE & 50 & \\  & ACM & 22 & \\ \hline \multirow{4}{*}{Third: Analysis of Abstract} & MDPI & 19 & 98 \\  & Springer & 21 & \\  & Elsevier & 15 & \\  & IEEE & 31 & \\  & ACM & 12 & \\ \hline \multirow{4}{*}{Fourth: Full-Text Analysis} & MDPI & 9 & 53 \\  & Springer & 11 & \\ \cline{1-1}  & Elsevier & 9 & \\ \cline{1-1}  & IEEE & 23 & \\ \cline{1-1}  & ACM & 4 & \\ \hline \hline \end{tabular}
\end{table} 
Table 1: The cumulative count of research selected at each phase. the HL7 protocol [51]. The framework employs a centralized cloud shared with different CDOs nationwide. The framework outlined in the paper leverages mobile cloud computing to enhance access to patient data and optimize system response times. By consolidating patient records in a cloud-based EHR system, healthcare providers can eliminate the need to maintain individual EMR systems, potentially reducing overall costs. However, the paper does not provide much detail on data transmission security, but it does mention the use of security measures like encryption algorithms and authentication techniques used to safeguard the inviolability and restricted access of health-related data. Meanwhile, ref. [52] introduced a new cloud-based model for sharing medical data across healthcare units in Indonesia. The software developed can be used by various entities, like medical centers, physicians, and patients. All the patient data are stored in one centralized cloud-based EMR. By hosting the EMR application in the cloud, the system benefits from scalable resources for faster response times and dynamic resource scaling. It eliminates large upfront costs, offers a pay-per-use model, and ensures patient privacy and compliance through the use of ICD-10 [53] and HL7. protocols for secure data exchange, centralized data storage and security measures.