This playable PPT presentation with audio describes the Cloud Healthcare Appliance Real-Time Solution as a Service information technology reference architecture for a cloud-based integrated development environment (IDE). This IDE is designed for use by healthcare provider subject matter experts (SMEs) with low cost and little/no need for IT system or staff resources. Healthcare SMEs can use CHARTSaaS to design, develop, deploy, operate and optimize apps that provide real-time cognitive support to them in the execution of clinical and administrative processes. CHARTSaaS-built apps are expected to have significant positive transformative impact on medical practice and healthcare delivery resulting in much-improved personal health maintenance, medical mistake mitigation, clinical case management, optimal case outcomes and accelerated knowledge accrual.