title: The MADE Reference Information Model for Interoperable Pervasive Telemedicine Systems.
abstract: OBJECTIVE
  The main objective is to develop and validate a reference information model (RIM) to support semantic interoperability of pervasive telemedicine systems. The RIM is one component within a larger, computer-interpretable "MADE language" developed by the authors in the context of the MobiGuide project. To validate our RIM, we applied it to a clinical guideline for patients with gestational diabetes mellitus (GDM).
  
  
  METHODS
  The RIM is derived from a generic data flow model of disease management which comprises a network of four types of concurrent processes: Monitoring (M), Analysis (A), Decision (D) and Effectuation (E). This resulting MADE RIM, which was specified using the formal Vienna Development Method (VDM), includes six main, high-level data types representing measurements, observations, abstractions, action plans, action instructions and control instructions.
  
  
  RESULTS
  The authors applied the MADE RIM to the complete GDM guideline and derived from it a domain information model (DIM) comprising 61 archetypes, specifically 1 measurement, 8 observation, 10 abstraction, 18 action plan, 3 action instruction and 21 control instruction archetypes. It was observed that there are six generic patterns for transforming different guideline elements into MADE archetypes, although a direct mapping does not exist in some cases. Most notable examples are notifications to the patient and/or clinician as well as decision conditions which pertain to specific stages in the therapy.
  
  
  CONCLUSIONS
  The results provide evidence that the MADE RIM is suitable for modelling clinical data in the design of pervasive telemedicine systems. Together with the other components of the MADE language, the MADE RIM supports development of pervasive telemedicine systems that are interoperable and independent of particular clinical applications.
authors.affiliation: Nick L. S. Fung, Biomedical Signals and Systems Group, University of Twente, P. O. Box 217, 7500 AE Enschede, The Netherlands, E-mail: l.s.n.fung@utwente.nl.
authors.forename: Nick L S
authors.initials: NL
authors.lastname: Fung
authors.forename: Valerie M
authors.initials: VM
authors.lastname: Jones
authors.forename: Hermie J
authors.initials: HJ
authors.lastname: Hermens
mesh_terms: D008962:Models, Theoretical; D012015:Reference Standards; D017216:Telemedicine / Q000379:methods*
keywords: Telemedicine; pervasive healthcare; reference information model; semantic interoperability