Evaluative Research of Technologies for Prehospital Communication and Coordination: a Systematic Review.

Various technologies have been designed and developed to support communication and coordination between the field and hospital during a medical emergency. The usability issues and human factors entailed in these new technologies are important to their application and effectiveness, suggesting the need to examine this information in a systematic review. The systematic review aims to synthesize the user-centered evaluative research of prehospital communication technologies. We conducted a systematic literature search in four databases (Medline, Cochrane, Embase, and Web of Science) for articles published between the years 2000 and 2019. We included articles that evaluated the technologies developed for supporting prehospital communication and collaboration, and were published in English. A total of 918 articles were retrieved and screened, with 17 articles included for in-depth analysis. Two authors conducted independent screens and reviews of the articles using a list of inclusion/exclusion criteria and defined factors. The types of technology of reviewed articles included ambulance-based telemedicine, wearable, handheld, and Internet of Things (IoT) devices. Even though these technologies have demonstrated high levels of user acceptance, the reviewed studies noted a variety of challenges faced by emergency care providers, which were grouped into three categories-technical, usability, and organizational challenges. Our review also highlighted the paucity of evaluative research of prehospital communication technologies and the lack of user engagement throughout system design process. Based on the results, we discuss the importance of adopting user-centered design approaches and accounting for three social-technical factors in designing technologies for time-critical medical settings, including cognitive and physical stressor, workflow, and context. This systematic review presents an overview of key evaluative research of prehospital communication technologies. The paucity of evaluative research in prehospital communication technology and challenges faced in adopting advanced technological solutions in emergency care highlight the need to adopt user-centered design and take into account socio-technical issues at the point of system design.