Database Deployment Options: Managed Cloud, Bring Your Own CouchDB, Local-First and Remote-Only

💻 Local-first ☁️ Remote-only 🗄️ Bring your own CouchDB

Choose where your data lives and how each device connects

Perfect Hospital Management System supports managed cloud, private CouchDB-compatible infrastructure, and on-premise LAN deployments. You can also choose Local Database mode for offline continuity or Remote Database mode for direct access without a local operational database.

There are two separate decisions Deployment selects the CouchDB server and hosting location. Database Mode selects whether a device keeps a local database and synchronizes, or works directly against the remote database.

Where can the database be hosted?

Choose the arrangement that matches your organization's security policy, approved data region, connectivity, and operational requirements.

☁️

Managed cloud

SARU TECH can provide the CouchDB database with a paid licence. Each client uses a separate database on managed infrastructure.

Managed and secured by SARU TECH
Hosted in the USA by default
Simplest deployment for most practices

🗄️

Your own CouchDB

Bring a CouchDB-compatible database and control the provider, hosting location, backups, access rules, and infrastructure.

IBM Cloudant or another compatible service
Private cloud or hospital-managed server
On-premise or an approved data region

🖧

Hospital LAN

Host CouchDB inside the hospital's local area network for an internal on-premise deployment that does not depend on public internet.

Internal network access
Hospital-controlled infrastructure
Suitable for restricted or isolated sites

Private database requirement: the system needs a reachable CouchDB-compatible connection URL and valid credentials. The server must permit the required application traffic. Use HTTPS whenever traffic leaves a trusted private network.

Local Database or Remote Database?

The hosting choice and Database Mode can be combined. For example, a hospital can use its own IBM Cloudant instance with local-first synchronization, or use that same instance in remote-only mode.

Local Database

DEFAULT

Local PouchDBRemote CouchDB

Best for: unreliable internet, mobile teams, remote clinics, sensitive areas, and continuity during outages.

Operational data is stored in a local PouchDB database on the device.
With a licensed remote database, changes synchronize when connectivity is available.
Work can continue during an internet interruption and synchronize after the connection returns.
The Free plan remains local on one PC and does not provide remote synchronization.

Remote Database

PAID ONLY

DeviceRemote CouchDB

Best for: sites with guaranteed connectivity that do not want the application's operational database stored on the PC.

Data is read from and written directly to CouchDB.
No local PouchDB operational database or synchronization process is used.
The CouchDB server must be reachable at all times.
A valid, unexpired paid licence is required. Remote mode is unavailable on the Free plan.

Question	Local Database	Remote Database
Works through an internet interruption?	Yes, using the local database	No, CouchDB must remain reachable
Operational database stored on the device?	Yes	No local PouchDB database
Synchronization used?	Yes, when a remote database is licensed and configured	No, reads and writes are direct
Available on the Free plan?	Yes, for local use on one PC	No
Recommended connection?	Any connection; work can continue offline	Stable, continuous internet or private network connectivity

How to switch to Remote Database mode

Open General SettingsGo to Settings > General Settings.

Open Account & LicenseSelect the Account & License tab and find Database Mode.

Select Remote DatabaseChange Local Database (Default) to Remote Database. If the option is disabled, the account does not have a valid paid licence.

Save and allow the system to reloadSelect Save. The system records the choice, reconnects, and reloads in Remote Database mode.

Remote mode always needs a connection Do not enable Remote Database at a site with intermittent internet or an unreliable private network. If CouchDB cannot be reached, users cannot read or save operational records until connectivity returns.

To return to offline-capable operation, follow the same path, select Local Database (Default), and save. Coordinate the change with your administrator and confirm that the local database contains the records the team needs before depending on offline access.

Bring your own CouchDB with Alternative DB

A hospital or clinic can replace the SARU TECH-managed remote endpoint with its own CouchDB-compatible database. This is useful when the organization requires an approved provider, a private cloud, a particular data region, or hospital-managed infrastructure.

1. Prepare CouchDBProvision CouchDB, IBM Cloudant, or another compatible service in the approved location.

2. Secure accessCreate least-privilege credentials, enable encryption in transit, and restrict network access where possible.

3. Add Alternative DBIn General Settings > Account & License, enter the approved connection in Alternative DB and save.

4. Choose a modeUse Local Database for offline-first synchronization, or Remote Database for direct remote-only access.

Protect the connection URL and credentials These details grant access to clinical and business data. Do not place them in screenshots, public documents, or unencrypted messages. Use a secure handover process with SARU TECH support or your database administrator.

IBM Cloudant is one supported CouchDB-compatible option. See the IBM Cloudant product page for current service and region information. Provider plans, prices, and compliance options can change, so verify the current configuration before deployment.

Security and compliance checklist

Database location is only one part of a secure deployment. The SARU TECH data and security brief also identifies the following controls:

👤 Data separation and accessSeparate client databases, role-based permissions, authentication, and optional device or IP restrictions.

🔒 Encryption and monitoringProtect data in transit and at rest, secure credentials, and monitor user activity and access.

📝 AuditabilityKeep timestamps, audit trails, tracked changes, retention rules, and controlled deletion processes.

🔄 Backup and responseSchedule backups, test restoration, and document disaster recovery and breach response procedures.

HIPAA configuration matters When IBM Cloud is used for protected health information, the account owner must enable the appropriate HIPAA-supported settings, use HIPAA-enabled services or plans, and accept the applicable Business Associate Addendum when required. Your organization remains responsible for choosing and operating the correct compliant configuration.

Quick decision guide

Choose Local Database if offline continuity matters or connectivity may be interrupted.
Choose Remote Database if connectivity is guaranteed and you do not want a local operational database on the PC.
Choose managed cloud for the simplest managed setup.
Choose Alternative DB when you need control over the provider, region, private network, or server.
Choose LAN deployment for an internal on-premise environment that can operate without public internet.

Set up multiple devices on a LAN →Read the on-premise network connection guide. Review SARU TECH security →Learn more about data protection and security practices.