In this article we argue that smart items and cloud computing can be powerful enablers of servitization as business trend. This is exemplified by an application scenario in healthcare that was developed in the context of the OpSIT-Project in Germany. We present a three-level architecture for a smart healthcare infrastructure. The approach is based on a service-oriented architecture and extends established architectural approaches developed previously at our group. More specifically, it integrates a role model, a layered cloud computing architecture, as well as a fog-computing-informed paradigm in order to provide a viable architecture for healthcare and elderly-care applications. The integration of established paradigms is beneficial with respect to providing adequate quality of service and governance (e.g., data privacy and compliance). It has been verified by expert interviews with healthcare specialists and IT professionals. To further demonstrate the validity of this architectural model, we provide an example use-case as a template for any kind of smart sensor-based healthcare infrastructure. Copyright © 2015 IFSA Publishing, S. L.