• JOÃO LUÍS CARDOSO DE MORAES Federal University of São Carlos, Computer Science, São Carlos, Brazil
  • WANDERLEY LOPES DE SOUZA Federal University of São Carlos, Computer Science, São Carlos, Brazil
  • LUÍS FERREIRA PIRES University of Twente, Software Engineering Group, Enschede, The Netherlands
  • LUCIANA TRICAI CAVALINI Rio de Janeiro State University, Department of Health Information Technology, Brazil
  • ANTÔNIO FRANCISCO DO PRADO Federal University of São Carlos, Computer Science, São Carlos, Brazil


Pervasive Healthcare, Ubiquitous Computing, openEHR, Dual-level Modeling, Archetypes, Domain-Specific Language


Health information technology is the area of IT involving the design, development, creation, use and maintenance of information systems for the healthcare industry. Automated and interoperable healthcare information systems are expected to lower costs, improve efficiency and reduce error, while also providing better consumer care and service. Pervasive Healthcare focuses on the use of new technologies, tools, and services, to help patients play a more active role in the treatment of their conditions. Pervasive Healthcare environments demand a huge amount of information exchange, and specific technologies have been proposed to provide interoperability between the systems that comprise such environments. However, the complexity of these technologies makes it difficult to fully adopt them and to migrate Centered Healthcare Environments to Pervasive Healthcare Environments. Therefore, this paper proposes an approach to develop applications in the Pervasive Healthcare environment, through the use of dual-level modeling based on Archetypes. This approach was demonstrated and evaluated in a controlled experiment that we conducted in the cardiology department of a hospital located in the city of Marília (São Paulo, Brazil). An application was developed to evaluate this approach, and the results showed that the approach is suitable for facilitating the development of healthcare systems by offering generic and powerful capabilities.



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U. Varshney, Pervasive Healthcare Computing - EMR/EHR, Wireless and Health Monitoring, pp. 282, New York: Springer, 2009.

U. Hansmann et al., Pervasive Computing : The Mobile World, 2nd Edition ed.: Springer, 2003.

M. Weiser, “Some Computer Science Issues in Ubiquitous Computing,” Commun. ACM, vol. 36, no. 7, pp. 75-84, 1993.

E. Browne, openEHR Archetypes for HL7 CDA Documents, vol. 2012, Ocean Informatics, 2008.

F. P. Coyle, “XML, web services and the changing face of distributed computing,” Ubiquity, vol. 2002, no. April, pp. 2, 2002.

M. Alam et al., “Design and Implementation of HL7 V3 Standard-Based Service Aware System.” pp. 420-425.

R. H. Dolin et al., “HL7 Clinical Document Architecture, Release 2,” Journal of the American Medical Informatics Association, vol. 13, no. 1, pp. 30-39, Jan-Feb, 2006.

A. Ryan, P. Eklund, and B. Esler, “Toward the Interoperability of HL7 v3 and SNOMED CT: A Case Study Modeling Mobile Clinical Treatment,” Medinfo 2007: Proceedings of the 12th World Congress on Health (Medical) Informatics, Pts 1 and 2, vol. 129, pp. 626-630, 2007.

D. Bender, and K. Sartipi, “HL7 FHIR: An Agile and RESTful approach to healthcare information exchange.” pp. 326-331.

D. S. Channin, “Integrating the healthcare enterprise: A primer - Part 6: The fellowship of IHE: Year 4 additions and extensions,” Radiographics, vol. 22, no. 6, pp. 1555-1560, Nov-Dec, 2002.

J. Kriseman et al., “Harmonizing Content of Public Health Surveillance Systems: Lessons Learned from the ONC Standards and Interoperability (S&I) Public Health Reporting Initiative (PHRI)”, 2013 CSTE Annual Conference, 2013.

P. Schloeffel et al., “The relationship between CEN 13606, HL7, and openEHR,” in HIC 2006 Bridging the Digital Divide: Clinician, consumer and computer, 2006.

M. Mernik, J. Heering, and A. M. Sloane, “When and how to develop domain-specific languages,” ACM Comput. Surv., vol. 37, no. 4, pp. 316-344, 2005.

T. Beale, and S. Heard, Archetype Definition Language, openEHR Foundation, 2007.

R. Gronback, Eclipse Modeling Project: A Domain-Specific Language (DSL) Toolkit, 1st ed., 2009.

A. v. Deursen, P. Klint, and J. Visser, “Domain-specific languages: an annotated bibliography,” SIGPLAN Not., vol. 35, no. 6, pp. 26-36, 2000.

A. Rutle et al., “A metamodeling approach to behavioural modeling,” in Proceedings of the Fourth Workshop on Behaviour Modeling - Foundations and Applications, Kgs. Lyngby, Denmark, 2012.

C. Martinez-Costa et al., “A model-driven approach for representing clinical archetypes for Semantic Web environments,” Journal of Biomedical Informatics, vol. 42, no. 1, pp. 150-164, Feb, 2009.

D. T. Ross, “Structured Analysis (SA): A Language for Communicating Ideas,” Software Engineering, IEEE Transactions on, vol. SE-3, no. 1, pp. 16-34, 1977.

D. Steinberg et al., EMF: Eclipse Modeling Framework 2.0: Addison-Wesley Professional, 2009.

A. R. Hevner et al., “Design Science in Information Systems Research,” MIS Quarterly, vol. 28, no. 1, pp. 75-105, Mar, 2004.

F. D. Davis, “Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology,” MIS Q., vol. 13, no. 3, pp. 319-340, 1989.

P. Y. K. Chau, and P. J. H. Hu, “Investigating Healthcare Professionals' Decisions to Accept Telemedicine Technology: an Empirical Test of Competing Theories,” Information & Management, vol. 39, no. 4, pp. 297-311, Jan, 2002.

R. Likert, A Technique for the Measurement of Attitudes, New York: [s.n.], 1932.

J. C. Nunnally, “Psychometric Theory,” Current Contents/Social & Behavioral Sciences, no. 22, 1979.

J. Henseler, and W. W. Chin, “A Comparison of Approaches for the Analysis of Interaction Effects Between Latent Variables Using Partial Least Squares Path Modeling,” Structural Equation Modeling-a Multidisciplinary Journal, vol. 17, no. 1, pp. 82-109, 2010.

R. F. Goldin, “Review: Statistical Models-Theory and Practice,” The American Mathematical Monthly, vol. 117, no. 9, pp. 844-847, 2010.

F. D. Davis, and V. Venkatesh, “Toward Preprototype User Acceptance Testing of New Information Systems: Implications for Software Project Management,” IEEE Transactions on Engineering Management, vol. 51, no. 1, pp. 31-46, Feb, 2004.

B. Banfai et al., “Implementing an HL7 version 3 modeling tool from an Ecore model,” Studies in health technology and informatics, vol. 150, pp. 157-61, 2009.

G. Piho et al., “From archetypes-based domain model of clinical laboratory to LIMS software.” pp. 1179-1184.

M. Regio, and J. Greenfield, “Designing and Implementing an HL7 Software Factory,” 2005.

C. Ohr, and M. Václavík, “Using HL7 Processing Capabilities of the Open Ehealth Integration Platform in the Implementation of IHE Profiles.” p. 11, 2009.

R. D. M. Dias, T. W. Cook, and S. M. Freire, “Modeling healthcare authorization and claim submissions using the openEHR dual-model approach,” BMC Medical Informatics and Decision Making, vol. 11, Oct 12, 2011.

H. Kashfi, and O. Torgersson, “A migration to an openEHR-based clinical application,” Studies in health technology and informatics, vol. 150, pp. 152-6, 2009.