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The purpose of this paper is to investigate the way technology affects the provision of prehospital emergency care, upgrading the quality of services offered and significantly reducing the risk of premature termination of the patients.

The paper presents the development of the eEKAB, a pilot emergency medical information system that simulates the main services offered by the Greek National Instant Aid Centre (EKAB). The eEKAB was developed on an agile system methodology. From a technical perspective, the features and the technology were mainly chosen to provide reliable and user-friendly interfaces that will attract many users. eEKAB is based on three important pillars for offering health care to the patients: the “On-time Incident Reporting”, the “On-time Arrival at the Incident” and “Transfer to the Health Center”. According to the literature review, the emergency medical services (EMS) systems that combine all the features are very few.

It reduces the total time of the EMS procedures and it allows for an easier management of EMS, by providing a better allocation of human resources and a better geographical distribution of ambulances. The evaluation displayed that it is a very helpful application for the ambulance drivers as it reduces the ambulance response time to arrive in the patient's location and contributes significantly to the general performance of the prehospital medical care system. Also, the survey verified the importance of implementing eEKAB on a larger scale beyond the pilot usage. It is worth mentioning that the younger ambulance drivers had a more positive view for the purpose of the application.

The paper clearly identifies implications for further research. Regarding interoperability, the mobile app cooperates with the Operational Center of EKAB, while further collaboration could be achieved with other operational ambulance handling center, mainly, of the private sector. The system can evolve to include better communications among the EKAB departments. Particularly, the ambulance crew as well as the doctors should be informed with more incident features such as the emergency signal so that they know whether to open the siren, the patient's name, etc. The authors are currently working on implementing some features to provide effective medical health services to the patient in the ambulance.

eEKAB will have very significant implications in case of its enforcement, such as the reduction of the total time of EMS procedures with a corresponding reduction of the operating costs of an accident management system and an ambulance fleet handling system while in parallel informing in time the doctors/clinics. It will provide better distribution of ambulances as well as of total human resources. It will greatly assist ambulance drivers, while reducing ambulance response time to reach the patient's location. In other words, the authors will have a better performance of the whole prehospital care system.

Providing emergency care before the hospital is of great importance for upgrading the quality of health services provided at the accident site, thus significantly reducing the risk of premature death of patients. This in itself has a significant social implication.

The paper demonstrates a solid understanding in the field of the EMS systems and the corresponding medical services offered. It proposes the development of an effective, feasible and innovative EMS information system that will improve the existing emergency health care system in Greece (EKAB). An in depth literature review and presentation of the adopted new technologies and the respective architecture take place. An evaluation and statistical validation were conducted for proving the high applicability of eEKAB in case of real-life running.

Cloud computing originated in central data centers that are connected to the backbone of the Internet. The network transport to and from a distant data center incurs long latencies that hinder modern low-latency applications. In order to flexibly support the computing demands of users, cloud computing is evolving toward a continuum of cloud computing resources that are distributed between the end users and a distant data center. The purpose of this review paper is to concisely summarize the state-of-the-art in the evolving cloud computing field and to outline research imperatives.

The authors identify two main dimensions (or axes) of development of cloud computing: the trend toward flexibility of scaling computing resources, which the authors denote as Flex-Cloud, and the trend toward ubiquitous cloud computing, which the authors denote as Ubi-Cloud. Along these two axes of Flex-Cloud and Ubi-Cloud, the authors review the existing research and development and identify pressing open problems.

The authors find that extensive research and development efforts have addressed some Ubi-Cloud and Flex-Cloud challenges resulting in exciting advances to date. However, a wide array of research challenges remains open, thus providing a fertile field for future research and development.

This review paper is the first to define the concept of the Ubi-Flex-Cloud as the two-dimensional research and design space for cloud computing research and development. The Ubi-Flex-Cloud concept can serve as a foundation and reference framework for planning and positioning future cloud computing research and development efforts.