Results are presented for each feature of the dashboard prototype. For the following results see Fig. 1, features 2–3 of the dashboard.

In the clinical context, the injured figure (2) can be useful for procedural planning, such as organizing necessary interventions and materials, including therapeutic equipment or imaging. However, physicians were concerned about a potential biased approach. They noted that pre-arrival information could unintentionally cause physicians in the ETR to focus on certain areas of the patient's body, potentially resulting in the treatment of other areas that may also require attention. For the physicians surveyed, the ECG (3) is primarily useful in the context of circulatory disorders. It indicates the potential presence of a shock and provides information about cardiologic pre-medications and pre-existing therapies. However, some surgeons mentioned, that this information is more relevant for anesthesiologists.

For the following results see Fig. 1, features 4-7 of the dashboard. The physicians also stated that patient data (4) such as arrival time, patient name, and date of birth were essential. This information is necessary for scheduling and preparing for upcoming procedures or alerting relevant staff. Additionally, the arrival time enables alerted physicians to manage their time efficiently, attending to other patients during the waiting period before the new patient's arrival. The ABCDE scheme (5) allows for more effective preparation of personnel and materials, as well as planning the sequence of procedures in the hospital. For example, it can help the ETR team check the availability of blood reserves in the case of known volume loss, or avoid preparing unnecessary materials, thereby optimizing the use of resources. Vital signs (6) are important indicators of a patient’s current health condition and play a crucial role in guiding subsequent medical interventions. The physicians indicated for instance that low oxygen saturation could indicate the possibility of a pneumothorax, leading the ETR staff to anticipate and prepare for a thoracic drainage procedure. The emergency history (7) serves a beneficial feature by providing information about the accident, as well as information about the patient's allergies, pre-existing conditions, and medications. These details are crucial for subsequent and follow-up treatments, such as preparing for medication administration or alerting additional specialists.

For the following results see Fig. 1, features 4–7 of the dashboard. In the multimedia section (8) of the dashboard, the physicians had mixed opinions about the possibility of a video call feature to facilitate communication between the ambulance and the hospital. On the positive side, this feature would allow direct questioning of the EMS, while also allowing hospital staff to assist the EMS if needed. However, there were concerns about the practicality of this implementation. Emergency physicians at the accident scene are often occupied and may not have sufficient time to engage in video calls. Additionally, the surveyed physicians expressed a desire to visually assess the patient via camera. This would complement the other data presented on the dashboard, providing insights into the patient's current condition, such as burns, motor functions, or signs of epileptic seizures. Images from the accident scene are valuable in helping physicians to assess the mechanism of the accident and the severity of injuries. Often, ETR staff receives such images, but they are usually transmitted through other channels, like cell phone messages. Furthermore, physicians stated that they would like to see photos of injuries before a dressing is applied to earlier assess whether additional specialties are required. Secondly, the dressing does not have to be removed for assessment in the ETR and the patient can be taken directly to the operating room.

Sonography images can be useful for physicians in preparing staff and materials. For example, the operating room can be prepared in advance, saving time and increasing the efficiency of patient care. However, sonography is primarily relevant for specific cases, such as pneumothorax or assessing the presence of free fluid. It is important to note that the effectiveness of sonography is highly dependent on the examiner, which in turn affects the quality of the images. The surveyed physicians found it helpful to alert selected colleagues using the alert feature on the dashboard. Bilateral feedback would be desirable to ensure that the alerted staff acknowledge the alert. Physicians would benefit from receiving audio-visual notifications through a notification feature when values on the dashboard change, particularly in life-threatening situations where alarm limits are exceeded and arrival time updates are necessary. Displaying all past changes to patient information in a small window on the dashboard may be useful for documentation purposes, but it does not add any value to the direct care of the patient. During the evaluation, it was observed that physicians at different trauma centers had different perspectives on the usefulness of the information displayed on the dashboard. These perspectives were influenced by factors such as the size and location of the trauma center. Physicians at smaller trauma centers (LTC) appreciated the detailed information provided in the ABCDE scheme and the multimedia section. They considered that this would give them a better understanding of the incoming patient's condition and enable them to make informed decisions about transferring the patient to another hospital with more extensive equipment and treatment options. Some physicians from trauma centers located in more urban areas with shorter transport distance from the accident site to the hospital (STC, RTC) stated that information such as emergency events, the multimedia section, and the notification feature may be helpful, but they also believe that it is more relevant for longer transport distance. For shorter trips in cities, there is limited time to read all the information.

The initial responses of the physicians to the dashboard were mixed. Some found it logically organized, while others felt overwhelmed by the amount of information presented at first glance. However, there was a consensus that with time and familiarity with its features, the dashboard would be effective to work with. During the exploration of the dashboard, the surveyed physicians highlighted the following aspects: Considering the dashboard prototype, physicians identified difficulties in the ABCDE scheme, primarily due to the integration of both medical issues and therapies, such as critical bleeding and oxygen therapy. This mix, together with the use of red markings, created confusion. It was unclear whether red markings indicated completion of a therapy or highlighted a medical issue. The physicians expressed a desire for a more distinct organization of medical issues and therapies, as well as an improved wording for the scheme, to enhance clarity and usability. For the vital signs, the physicians would like to combine the vital signs as numbers and curves, which is how they are displayed on the monitors in the hospital. To improve clarity, emergency history should be presented in a more effective form. If narrative text is used, its length should be minimized. The physicians recommended that accident images and the video call option should be displayed only when needed. For the sonography transmission display, they suggested it would be helpful to indicate the specific body region from which the image was captured. Additionally, they observed that the injured figure used in the dashboard did not adequately represent the abdominal region and the spine, indicating a need for a more accurate and comprehensive depiction. With the ability to customize an individual view of the dashboard depending on the team or trauma leader, standardization with a common view for all is preferable. Some physicians suggested a customized view of the dashboard on their own smartphone. Physicians are divided on the issue of viewing a mobile version of the dashboard on a mobile device (e.g., tablet, smartphone). They see the advantage of mobility within the hospital, being able to access the dashboard from anywhere, for example, to check the arrival time and complete other tasks before the patient arrives. Furthermore, this could facilitate information access for the call service even before they leave home. On the other hand, some physicians consider the mobile version to be redundant, as they prefer to use the dashboard only in the ETR due to the short distances within the hospital.

Based on the findings and feedback from the interviews, an enhanced prototype was developed towards the end of the project, in order to refine the functionality and user experience. Some changes in the new prototype are outlined below, building on the reasons presented in Sects. “Evaluation of the Features” and “Evaluation of the Visualization” (Fig. 2).

New dashboard prototype at the end of the project, considering the interview results

The configurability in the multimedia section (4) was kept, where different tabs on the right-side display different types of information. As an additional feature, the alarm feature (5) for ETR staff was introduced. Alerts can be set based on specific cases, specialties, or individual staff members. The selected staff will be informed via app on mobile devices. This feature was provided to us and integrated into our system (Alarm Dispatcher, Dresden, Germany). Furthermore, a feature of a patient history window (3) was also introduced in this prototype to display past changes in the patient's health status and new therapeutic steps. The ABCDE scheme (2) was restructured to distinguish between medical issues (red) and therapy (blue), which only appear if they are urgent or currently in progress. For example, if there is no problem under 'A', that column remains empty. In addition, we added a medication administration tracking feature (1) to the patient information section. This allows ETR staff to track what medications have been administered and in what quantities.