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The delivery of quality healthcare to all citizens at reasonable costs is an important challenge. With the increase in the aging population, the costs of managing chronic diseases increase. Today, healthcare services tend to shift from recovery to prevention. Remote healthcare monitoring is crucial for prevention and monitoring of chronic diseases since they require continuous and long-term monitoring. The advances in networking, mobile communications and medical device technologies offer a great potential to realize remote healthcare monitoring. However, seamless integration of multi-modal medical devices to the existing healthcare information systems is necessary for the automated use of medical device observations in related applications. The thesis addresses the automatic acquisition and use of multi-modal medical device observations in healthcare information systems. The interoperability of medical devices with healthcare information systems requires both physical connectivity and application level interoperability. Therefore, the thesis concentrates on both the medical device domain and the interoperability efforts on the existing healthcare information systems. It provides an interoperability solution based on ISO/IEEE 11073 and HL7 standards. This work is also realized the automatic acquisition and use of multi-modal medical device observations in an intelligent healthcare monitoring and decision support system which is developed as a part of the IST-027074 SAPHIRE project funded by the European Commission.