Original Research
Evaluation of ICT-based EMS implementation in medically underserved areas: usability, feasibility and impact
AUTHORS
Eui-Jae Kim1,2 PhD, Research Professor
So-Yeon Kong3 PhD, Principal Scientist 
Yun-Jeong Cha PhD Candidate
Gwan-Jin Park1,4 PhD, Professor
Young-Min Kim1,4 MD, Assistant Professor
Hyun-Seok Chai1,4 MD
Hoon Kim1,4 PhD, Professor
Sang-Chul Kim1,4 PhD, Professor *
AFFILIATIONS
1 Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju-si, Chungcheongbuk-do 28644, South Korea
2 Institute for the Human Sciences, Dankook University, Cheonan-si, Chungcheongnam-do 31116, South Korea
3 Strategic Research, Laerdal Medical, Stavanger 4002, Norway
4 Department of Emergency Medicine, College of Medicine, Chungbuk National University, Cheongju-si, Chungcheongbuk-do 28644, South Korea
ACCEPTED: 15 September 2025
Early Abstract:
Objectives: This study aimed to assess the usability, feasibility, acceptability, appropriateness, and user satisfaction of an ICT-based Emergency Medical Services (ICT-EMS) system among hospital healthcare providers in rural areas underserved by emergency medical services.
Methods: A cross-sectional survey was conducted with 260 hospital healthcare providers from 18 medical institutions, all of whom had over six months of experience using the ICT-EMS system. System performance was evaluated using validated instruments, including the System Usability Scale (SUS), Feasibility of Intervention Measure (FIM), Acceptability of Intervention Measure (AIM), Appropriateness of Intervention Measure (IAM), and a user satisfaction questionnaire. Descriptive statistics, t-tests, and ANOVA were conducted to evaluate overall system performance and to examine differences based on participant characteristics.
Results: The overall SUS score indicated moderate usability at 52.6 (SD = 13.7), with notable concerns related to system consistency, technical support, and user confidence. Usability ratings varied significantly by age and occupation (p < 0.05), with higher scores reported by older participants and physicians. While feasibility, acceptability, and appropriateness scores were above average, 43.5% of respondents reported dissatisfaction with the system’s capacity to provide adequate information for patient admission decisions. Regional emergency centers consistently reported lower scores across all measures, likely due to high patient volumes and heavy workloads.
Conclusion: The ICT-EMS system demonstrates potential for enhancing emergency medical communication and coordination in underserved areas. However, identified usability issues and gaps in user satisfaction underscore the need for ongoing system enhancements. Addressing these limitations will be essential to maximizing the system’s effectiveness in resource-limited emergency care settings.
Keywords: emergency medical service systems, information technology, medically underserved areas, rural areas, usability.