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Here, we outline the design, implementation, testing and evaluation phases of our bi-directional semantic and syntactic interoperability framework interconnecting traditional healthcare, industrial telemedicine and IoT wearable eHealth-domains. Specifically, our study demonstrates system interoperability among a hospital information system, an industrial telemedicine instrument and an eHealth smart wearable consumer electronic product through the Open Telemedicine Interoperability Hub (OTI-Hub) embedded in a hybrid Cloud architecture. The novelty of this study is the handling of Internet-ofThings smart healthcare devices and traditional healthcare devices through the same Cloud-based solution. This healthcare interoperability solution, service architecture and corresponding software engineering technique bridges technology barriers among the above-mentioned healthcare segments. Standard interoperability solutions exist and have already been described in related literature, but they are not applicable to the IoT healthcare devices and vice versa. Our study goes beyond isolated, individual interoperability solutions and seeks to bridge all major healthcare architecture frameworks including classical, telemedicine and eHealth IoT applications and appliances. This study presents the results of a two-year OTI-Hub Research Program. These experiments are manifestations of a trilateral cooperation among the

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The international healthcare systems interoperability is an unresolved technological area at the moment. This paper demonstrates the results of the software engineering research for simplex syntactic and semantic technical interoperability of hospital information systems, eHealth smart device technology and clinical telemedicine instruments through the recently developed Telemedicine Interoperability Hub. Several similar experiments exist. This research is unique in building a prototype interconnecting not only healthcare information systems with each other, but aiming to establish a general healthcare interoperability scheme including also the eHealth smart devices and telemedicine instruments. The aim of this research is to establish cloud-based data interchange capability with the newly developed information technology system interconnected with the emerging eHealth Internet of Things solutions and the classical hospital information system architecture. Notwithstanding the international information technology medical data exchange standards, like Health Level Seven, the adoption of an industry-wide open telemedicine syntactic and semantic interoperability standard is necessary. The research studied varying simplex, duplex, full-duplex, data package-and file-based information technology modalities establishing stable system interconnection among clinical instruments, healthcare systems and eHealth smart devices. This research is the manifestation of the trilateral cooperation of the

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