This paper briefly presents the architectural considerations, and details of the technical implementation of an integrated prehospital health emergency management system. Subsequently, the paper focuses on a critical review of the experiences gained through the deployment and use of the system with the objective of analyzing the factors influencing IT adoption in healthcare. In doing so, the “Fit between Individuals, Task and Technology” (FITT) framework has been adopted and used in the retrospective analysis of our case study in an attempt to better analyze the socio-organizational-technical factors that influence IT adoption.

In an age where medical collaboration is the key to effective healthcare delivery and continuity of care, the location of experts and the management of their time are affecting the wide deployment of eHealth services. In this setting, the use of instant messaging and presence technologies provides a possible solution. A collaboration platform based on instant messaging and presence technology has been employed to implement flexible and adaptable eHealth services. The platform is characterized by the use of medical device components that currently support real-time and/ or store-and-forward access to spirometry examinations, medical imaging, vital signs, ECG, and auscultation data. Other important features of the platform are eHealth service profiles that entail electronic document templates conforming to HL7's clinical document architecture (CDA), the electronic signing of clinical objects using smart cards, and the use of Object Management Group's (OMG) person identification service (PIDS) to interoperate with clinical information systems.So far, eHealth services profiles have been designed for cardiology and respiratory problems. The storage of clinical data in actively shared episode folders and the flexible messaging services that provide users with feedback, feedthrough, awareness, and notification irrespective of their location, have been immediately embraced by the healthcare community. In the immediate future, eHealth service profiles are expected to be further refined based on user feedback and usage data to support service evolution and thus, lead to even more effective service provision in healthcare.

In the context of HYGEIAnet, the regional health network of Crete, numerous information systems have been developed to support the management of patient related data. In all these systems the digital acquisition and storage of clinical examinations and various vital signs play a major role in the provision of continuity of care to each patient in the region through the Integrated Electronic Health Record (IEHR).In such environment, Personal Digital Assistants (PDAs) can be of great value to doctors on the move. The long-term goal is to extend the access to e-Health and m-Health services and to the citizen's multimedia IEHR through the use of such devices. PDAs have already been used worldwide for the display and editing of textual information, while their graphic capabilities are also continuously improving. The development of new software components for the display of specific multimedia clinical information on PDAs should speed up our long-term goal.As a first step, a multi-vendor ECG viewer for PDAs has been developed and successfully evaluated by cardiologists and general practitioners.

To meet the need for detailed diagnostic data in the follow-up of cardiac patients residing in remote areas we have developed an extensible platform that allows the plug-in operation and remote control of multi-vendor medical devices, including an electrocardiograph and an electronic stethoscope. The doctor has remote control of all the medical devices installed at the patient's site. Following satisfactory internal tests using a local area network with a bandwidth of 100 Mbps, we set out to test the platform in a 'real world' situation to assess its practical use. The real-time transmission was satisfactory over a dedicated channel of 128 kbps. However, problems occurred when the channel was shared, in which case the speed, latency and capacity of the network were the bottleneck. These early results suggest that a real-time tele-visit over a regional network is feasible and could help to bring health care closer to the patient, provided that suflcient bandwidth is secured.

Describes the architectural considerations of HYGEIAnet (the Regional Health Telematics Network of Crete), the R&D issues involved in the design, development and implementation of a modular and configurable Home Care Platform that supports different health and social care domains, and the results of the clinical pilots to evaluate the platform and the service. In addition, the R&D issues that must be addressed in order to transform and extend the aforementioned platform for the support of personal health management services are presented.

Several R&D issues need to be resolved in tomorrow's eHealth care platforms to support personal health management services as well as mobility of patients and health professionals, by seamlessly integrating these services with smart surroundings that use self-configuring devices, intelligent agent technology and tools for ambient awareness and decision support. Such services, when interoperating with a life-long electronic health record of a citizen, can become the cornerstone for supporting continuity of care and cost effective health care for all. This paper discusses the architectural considerations and the R&D issues addressed in the design, development and implementation of the Ambient Intelligent platform for Cardiology (AmICa), a modular and flexible ambient intelligent eHealth platform for remote multiparametric monitoring of patients, able to be adapted to different care provision modes and daily life situations.