Table 4.

Process’ modules

	Process manager (process workflow)
	It is the module of coordination and cooperation of the other modules, which implements the process workflow by addressing the reporting and patient transport requests according to dispatch centres’ resources. It also includes the applicative cooperation layer with external systems.
				Availability of an appropriate application designed to determine the most suitable dispatch centre
				Re-addressing function of reporting requests, with activation of the alert system, in the case of transmission of the application to the competent dispatch centre error
				Ability to interface with external systems via standard HL7 protocol
	Intervention management in emergency cardiology
	The module containing the functions dedicated to the health emergency personnel. It allows the collection of all data required for the subsequent assessment, including the instrumental data through two components of managing and interfacing electrocardiograph and defibrillator; it links data to the EMS ID code
Requirements				Ability to acquire ECG and EMS ID Code wirelessly transmitted by electrocardiographs/ defibrillators monitor
	Repository of data and reports
	Data and documents collected or produced during the process management module. It allows the storage, classification, research, and publication of data and documents, using competence and profiling criteria, previously configured, to regulate the access by users
Requirements				Storage capacity, and online management of at least 1 000 000 ECG in high definition on at least 12 leads
				ECG and report display and print function on the client systems of the dispatch centres
				Digital archiving of the report and ECG
				Ability to store more ECG (with related reports) relating to the same emergency event (the same EMS ID code)
				Ability to search in archives the ECG and the related reports according to the EMS ID code
	Reporting and analysis dashboard
	Framework in which functions and components dedicated to the analysis of clinical data and the production of the report digitally signed document are accessible. It manages the work lists of the dispatch centre and transmits the alarm signal. It uses of components dedicated to ECG analysis, the signature, reporting
Requirements				Possibility of reporting from multiple stations simultaneously
				Ability to process adult ECG
				Ability to process paediatric ECG
				Availability of an alarm system alerting the dispatch centre responsible for the ECG
				deactivation of the alert system after request processing by the competent dispatch central; ability to generate the report with date and time of request receipt tracking
				Capacity of digital or electronic report signature
				Management of reports’ state: ‘Waiting for processing’; ‘in process’ or ‘processing completed’
				Output data format DICOM, XML, PDF
All modules must comply with the following requirements
Requirements			Web-based architecture: application access via the web, through the major market browsers
			Online download for accessory applications for the remote computer's configuration
		Clinical decision support system
		After acquisition and of medical history, patient’s vital and instrumental data, DSS suggests activities, therapeutic pathways and information in accordance with approved protocols and literature validated at international level, both for the operator of the emergency network and for the reporting cardiologist, early diagnosing cases of STEMI/NSTEMI.

STEMI, ST-elevation myocardial infarction; NSTEMI, non-STEMI; DSS, decision support system; EMS, emergency medical service.