Scalable and Interoperable Platform for Precision Medicine: Cloud-based Hospital Information Systems.

are managed via hospital information systems (HISs), which are sophisticated, integrated information platforms [1]. The effectiveness of a system and the quality of its information are associated with user satisfaction [2,3]. Therefore, many hospitals are investing significant financial resources into building next-generation HISs in order to create and utilize high-quality biomedical data. HISs have also been recently acknowledged as a vital component in the digitalization and intellectualization of hospitals. However, because of the high level of difficulty in domain expertise, HIS renewal projects are large-scale IT initiatives that frequently fail [4]. Korea University Medical Center (KUMC) began developing “P-HIS 1.0,” a cloud-based hospital information system, in 2017, and became the first institution in Korea to operate an HIS using cloud infrastructure on March 29, 2021. Since then, it has obtained approximately 18 months of experience in operating the system. This period was not just a time interval, but a community-wide effort to provide future medical care and a challenge to adapt to the changing environment of the biomedical industry. The leaders who introduced these changes emphasized the scalability and interoperability of the HIS as a platform for the future medical industry. The data flowing through the system are extracted as standardized terms, transformed into common modules, and loaded into an integrated database. The biomedical data are used for clinical services and for research and development to achieve precision medicine. To effectively regulate incursions from external networks to internal networks, the cloud architecture incorporated an intrusion prevention system (IPS). The security capacity was further enhanced by deploying several anti-distributed denial-of-service (DDoS), IPS, and firewall security devices. In addition to general user access, a virtual personal network (VPN) system with enhanced security is installed for those in charge and users who need access to systems and servers from outside, and all information is encrypted through externally enhanced security access to maintain operational continuity. In other words, general users and hospital personnel use the network separately. Scalability can be defined as the capacity of an HIS to match the increasing number of environmental requirements comprehensively and allow the integration of systemic growth [5]. Interoperability implies the capacity of different software applications and information technology systems to communicate and share data consistently, effectively, and accurately, as well as to properly use the shared data [6]. The utilization of a tremendous amount of biomedical data is only possible on a platform equipped with scalability and interoperability. The construction and operation of the platform are close to the realm of art based on the essential characteristics of its data, medical services, and technical design. KUMC’s information technology leaders understand Scalable and Interoperable Platform for Precision Medicine: Cloud-based Hospital Information Systems