In emergency settings, delayed communication and lack of access to accurate patient data can hinder medical procedures conducted by healthcare providers, therefore reducing the chances of positive medical outcomes among patients in emergency cases. Despite healthcare entities such as hospitals, ambulance service providers, specialists, and general practitioners adapting to independent digital healthcare applications, interoperable patient data exchange from one healthcare application to another is highlighted as a major challenge in both academic literature and real life. Moreover, decentralised healthcare databases storing redundant patient information cause more operational issues for both paramedics and emergency hospital staff when triaging urgent cases.

This study investigates the integration of digital health technologies, specifically mHealth applications, cloud computing and electronic health records, in improving operations such as emergency response triaging and patient administration conducted in emergency settings. Like many other global ambulance service providers, St John New Zealand experienced significant operational challenges during 2020-2022 due to the increase of emergency cases during coronavirus disease of 2019 (COVID-19). Paramedics experienced unprecedented circumstances of overrun hospital beds, a deficit of ambulance vehicles, staff burnout, and inaccurate patient data, which impeded positive patient outcomes.

The thesis explores the possibility of exchanging interoperable patient data between two crucial healthcare providers in emergency settings; paramedics and emergency department (ED) hospital units, using one mHealth application, a centralised cloud database and electronic health records. The capability was extended to include two additional healthcare providers, primary and secondary care to encompass less severe emergency outcome scenarios. The design-driven approach to support this thesis was implementing a prototype for smarter healthcare management in emergency settings. The prototype was named touchPoint to signify the point of interoperable patient data transfer between emergency healthcare providers. The development was accomplished using Xcode integrated development environment (IDE), Swift and Objective-C programming languages. Open Electronic Medical Records (OpenEMR) was used as a centralised database along with the international Fast Healthcare Interoperability Resources (FHIR) standards defining the rules and specifications of exchanging electronic health records between different systems. The results from the prototype showed the possibility of improving the data communication between emergency healthcare providers in real-life. The novelty lies in the ability to offer an efficient and convenient alternative approach to the current manual process.

This thesis does not include any references to personal patient information or questionnaire results conducted by humans. To test the prototype, open-source anonymised data sets in the form of application programming interfaces (APIs) were used from official healthcare development websites, including FHIR New Zealand and OpenEMR. Technical artifacts can be found in the Appendix and GitHub link provided in Chapter 4.