International Journal of Telemedicine and Applications 3 Table 1: Services provided per pilot site. Connected end-points NCSR (server) Skylitsio General Hospital (monitoring station) Rural medical peripheral health centers residing in Chios Prefecture Municipalities of Volysos, Kardamyla, Oinousses, and Pyrgi “at risk” citizen (client) Intensive Care Unit of the Nicosia General Hospital (monitoring station) postsurgery patients in the municipalities of Nicosia, Larnaca, and Limassol (client) The teleconferencing scenario was realised with the use of a web camera connected to the computer, a set of speakers, and a microphone for the audio signal and the WinVicos software. In some cases commercially available teleconfer- encing software such as adobe connect (http://www.adobe .com/products/acrobatconnectpro/) has been adopted in those cases where the patients had to have routine telecon- ferencing sessions with their carers (Cyprus pilot). A frame rate of at least 25 fps at a resolution of 640 × 480 pixels was a preferred one for the real-time teleconferencing sessions. Teleconferencing has been introduced for two reasons: to improve the patients’ conﬁdence to the treatment creating a feeling of safety for the patient and to support the collabo- ration and consultation between remote located health care personnel. (2) Patients’ Peripheral Systems. For the ehealth services the following low-cost systems have been used for the provision of telemedical services in Chios Island and Cyprus. It consists of the following components: (i) personal computer (PC) or laptop, (ii) biosignal acquisition module (Wrist ClinicTM (http: //www.telcomed.ie/allinone.html)) which is respon- sible for biosignal collection (Figure 2); more specif- ically, this lightweight and mobile module is able to collect, record, store, and wirelessly transmit 1 lead ECG, SpO2, HR, BP, and TEMP up to 250 m; the device can store data if there is no connection, (iii) fully wireless weight scale (http://www.telcomed.ie/ scale.html) which allows untethered operation (no communication or power cords); the patient can use the weight scale anywhere within coverage area (250 m communication range in open space), (iv) software (client) for communication with the central database (Cyprus pilot), (v) application (client) for medical monitoring in public environments allowing multiple patients to use a single device (Chios pilot), Services EPR, Web services Teleconsultation, ehealth Teleconsultation, ehealth Teleconsultation, ehealth Data transferred between end-points Incident data: personal info, contacts, medical info (diseases, medication), medical data (vital signs) Medical data (vital signs), images Incident data: personal info, contacts, medical info (diseases, medication), medical data (vital signs), real-time video conference Incident data: personal info, contacts, medical info (diseases, medication), medical data (vital signs), real-time video conference (vi) two-way radio USB-based communication device (automatic data accumulation and transmission) which connects via ordinary internet connection; the device has 200 m communication range (open space), uses reliable data communication protocol, and has a unique digital ID for system identiﬁcation. The data are transmitted from the monitoring devices to the home computer using a wireless connection (WiFi). There is wireless connection between USB device (onboard the PC), the biosignal acquisition module, and the wireless weight scale. The selected data are stored to the PC, while an asymmetric digital subscriber line (ADSL) internet line is used for uploading data from the PC or laptop to the data base. 2.2. Remote Centralized Database. The EPR has been stored in an SQL-type database. The EPR information included patient details, medical info (diseases, medication), and the medical data (vital signs) acquired from the monitoring devices deployed. The data were structured in an eﬃcient way. The medical and care personnel were able to utilize a standard web browser to login on a webpage to view a patient’s record and search for readings that fall within a given range or from a speciﬁc time and date. This ability assisted medical personnel to reassure themselves about patient’s condition providing the patients with an extra feeling of safety. 2.3. Network Description. The broadband telecommunica- tion network integrated two types of networks, terrestrial and wireless. The network has been based on nodes of research institutes (National Center for Scientiﬁc Research “Demokritos”—NCSR), hospitals (Nikosia General Hospital and Chios Skylitsio Hospital), and the four rural peripheral medical centers in Island of Chios. Each node is connected to its appropriate router via an Ethernet link running TCP/IP protocol. The network provided broadband coverage to all the partners in Greece and Cyprus thus ensuring communi- cation between diﬀerent and remote parties allowing for data