McMaster Service-Based eHealth Integration Environment (MacSeie) allows interoperability between two health care systems. The first system is a clinical decision support system from the COMPETE III Group known as Vascular Tracker (VT). VT uses algorithms that use the patients medical history, current medications, allergies, and vascular risk to generate messages which contain specific targets as well as recommendations. For health care providers and patients VT identifies which vascular risk factors are on target and which ones require additional attention. The health care providers use the recommendations to help in the treatment of patients with diabetes, hypertension, dyslipidemia, and cardiovascular disease. The second legacy system is an electronic medical record (EMR). This EMR system contains the medical information of patients who are currently rehabilitating from cardiovascular disease. These patients require a method to keep track of their cardiovascular risk factors to ensure that the risk factors are on target, and if not, alert the physician so that action can be taken. EMR and VT systems are web-based therefore are accessible through a web browser.