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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.

The purpose of this paper is to provide practitioners and researchers a more condensed and structured perspective on the adoption of information management systems by the health-care industry, given the spread and the increased amount of research concerning the topic.

This paper is a literature review. A Technology (What?) – Context and before adoption Analysis (When and Why?) – Implementation (How?) – Outcomes (What for?) framework is used to present the trends concerning information technology adoption in an accessible manner.

The main finding is that small or large health-care organizations should no longer focus on information systems’ adoption but should adopt a digital transformation paradigm. By considering this paradigm, management practices related to information technologies’ adoption projects should be complemented by practices related to the continuous organizational changes and readaptation of the organizational strategy, to benefit the advantages information systems can offer.

The main recommendation for health-care industry managers is to adopt specific practices to manage the digital transformation process of their organizations, as they should understand that it is no longer about adopting information technologies, but about managing the associated organizational change.

Instead of focusing on specific information systems’ adoption as other papers do, this paper provides a holistic understanding of the information technologies and management practices which are used in the field.

Cybersecurity in healthcare has become an urgent matter in recent years due to various malicious attacks on hospitals and other parts of the healthcare infrastructure. The purpose of this paper is to provide an outline of how core values of the health systems, such as the principles of biomedical ethics, are in a supportive or conflicting relation to cybersecurity.

This paper claims that it is possible to map the desiderata relevant to cybersecurity onto the four principles of medical ethics, i.e. beneficence, non-maleficence, autonomy and justice, and explore value conflicts in that way.

With respect to the question of how these principles should be balanced, there are reasons to think that the priority of autonomy relative to beneficence and non-maleficence in contemporary medical ethics could be extended to value conflicts in health-related cybersecurity.

However, the tension between autonomy and justice, which relates to the desideratum of usability of information and communication technology systems, cannot be ignored even if one assumes that respect for autonomy should take priority over other moral concerns.

In terms of value conflicts, most discussions in healthcare deal with the conflict of balancing efficiency and privacy given the sensible nature of health information. In this paper, the authors provide a broader and more detailed outline.

The aim of this paper is to identify some of the challenges that need to be addressed to accelerate the deployment and adoption of smart health technologies for ubiquitous healthcare access. The paper also explores how internet of things (IoT) and big data technologies can be combined with smart health to provide better healthcare solutions.

The authors reviewed the literature to identify the challenges which have slowed down the deployment and adoption of smart health.

The authors discussed how IoT and big data technologies can be integrated with smart health to address some of the challenges to improve health-care availability, access and costs.

The results of this paper will help health-care designers, professionals and researchers design better health-care information systems.

Medical research requires biological material and data collected through biobanks in reliable processes with quality assurance. Medical studies based on data with unknown or questionable quality are useless or even dangerous, as evidenced by recent examples of withdrawn studies. Medical data sets consist of highly sensitive personal data, which has to be protected carefully and is available for research only after the approval of ethics committees. The purpose of this research is to propose an architecture to support researchers to efficiently and effectively identify relevant collections of material and data with documented quality for their research projects while observing strict privacy rules.

Following a design science approach, this paper develops a conceptual model for capturing and relating metadata of medical data in biobanks to support medical research.

This study describes the landscape of biobanks as federated medical data lakes such as the collections of samples and their annotations in the European federation of biobanks (Biobanking and Biomolecular Resources Research Infrastructure – European Research Infrastructure Consortium, BBMRI-ERIC) and develops a conceptual model capturing schema information with quality annotation. This paper discusses the quality dimensions for data sets for medical research in-depth and proposes representations of both the metadata and data quality documentation with the aim to support researchers to effectively and efficiently identify suitable data sets for medical studies.

This novel conceptual model for metadata for medical data lakes has a unique focus on the high privacy requirements of the data sets contained in medical data lakes and also stands out in the detailed representation of data quality and metadata quality of medical data sets.

The purpose of this paper is to validate and measure the overall evaluation of electronic health record (EHR) and identify the factors that influence the health information systems (HIS) assessment in Brazil.

From February to May 2020, this study surveyed 262 doctors and nurses who work in hospitals and use the EHR in their workplace. This study validated the National Usability-focused HIS Scale (NuHISS) to measure usability in the Brazilian context.

The results showed adequate validity and reliability, validating the NuHISS in the Brazilian context. The survey showed that 38.9% of users rated the system as high quality. Technical quality, ease of use and benefits explained 43.5% of the user’s overall system evaluation.

This study validated the items that measure usability of health-care systems and identified that not all usability items impact the overall evaluation of the EHR.

NuHISS can be a valuable tool to measure HIS usability for doctors and nurses and monitor health systems’ long-term usability among health professionals. The results suggest dissatisfaction with the usability of HIS systems, specifically the EHR in hospital units. For this reason, those responsible for health systems must observe usability. This tool enables usability monitoring to highlight information system deficiencies for public managers. Furthermore, the government can create and develop actions to improve the existing tools to support health professionals.

From the scale validation, public managers could monitor and develop actions to foster the system’s usability, especially the system’s technical qualities – the factor that impacted the overall system evaluation.

To the best of the authors’ knowledge, this study is the first to validate the usability scale of EHR systems in Brazil. The results showed dissatisfaction with HIS and identified the factors that most influence the system evaluation.

The implementation of mobile health (mHealth) in developing countries seems to be stuck in a pattern of successive pilot studies that struggle for mainstream implementation. This study addresses the research question: what existing health-related structures, properties and practices are presented by rural areas of developing countries that might inhibit the implementation of mHealth initiatives?

This study was conducted using a socio-material approach, based on an exploratory case study in West Africa. Interviews and participant observation were used to gather data. A thematic analysis identified important social and material agencies, practices and imbrications which may limit the effectiveness of mHealth apps in the region.

Findings show that, while urban healthcare is highly structured, best practice-led, rural healthcare relies on peer-based knowledge sharing, and community support. This has implications for the enacted materiality of mobile technologies. While urban actors see mHealth as a tool for automation and the enforcement of responsible healthcare best practice, rural actors see mHealth as a tool for greater interconnectivity and independent, decentralised care.

This study has two significant limitations. First, the study focussed on a region where technology-enabled guideline-driven treatment is the main mHealth concern. Second, consistent with the exploratory nature of this study, the qualitative methodology and the single-case design, the study makes no claim to statistical generalisability.

To the authors' knowledge, this is the first study to adopt a socio-material view that considers existing structures and practices that may influence the widespread adoption and assimilation of a new mHealth app. This helps identify contextual challenges that are limiting the potential of mHealth to improve outcomes in rural areas of developing countries.