International Journal of Telemedicine and Applications 5 Table 2: Overview of technical metrics of Tile-Ippokratis services. Home care Rural health centre Home care Rural health centre Home care Rural health centre Connectivity with networks Low rate of failures (∼< 1%) Low rate of failures (∼< 1%) Quality of data transmission Excellent Excellent User friendliness Users satisﬁed, amendments asked Users satisﬁed, amendments asked four sets of devices, the vital signs through a software application for medical monitoring in public environments were automatically transmitted and saved to their electronic personal records maintained by NCSR “Demokritos”. These data were accessed frequently, at least once per week, by the medical personnel of the Skylitsio General Hospital of Chios, who were able to provide remote consultations. Based on the monitoring data and on the direct sight of the patient through the videoconference facilities the doctors from the Skylitsio General Hospital of Chios provided a second opinion to the local doctors of the rural health centers when needed. Six postsurgery patients in Cyprus participated in the trials in Cyprus (home care trial) conducting daily from their home a full set of measurements: HR, SpO2, BP, 1 lead ECG, Temp, and weight where possible. In this scenario each patient owned one set of ehealth systems. The vital signs through the home gateway were automatically transferred and saved to their electronic personal records maintained by NCSR “Demokritos”. The medical personnel of the intensive care unit (two specialized doctors) of the Nikosia General Hospital accessed at least once per week the Electronic Patient Records providing remote consultations where necessary. The patients were able to contact their doctors via video/audio to seek medical advice. Furthermore an admin support and medical help desk has been integrated into the service concept in Cyprus pilot to motivate the patients to adhere the planned protocol. For the home care scenario, emergency events at home have been planned as possible to happen. The scenario concerned a patient who collects vital measurements when- ever he/she does not feel well. In case abnormal situations occur and the measurements exceed set levels for a given patient, alarms triggered and doctors, family members, and emergency services automatically were notiﬁed. It has to be mentioned that during the pilot phase this scenario has been rarely conducted. 4. Platform Evaluation and Discussion The evaluation of the Tile-Ippokratis ehealth platform has been primarily technical in order to verify that the systems can operate in reliable way and end users’ oriented (using questionnaires and interviews) in order to investigate how the system can be embedded in everyday clinical practice. Ease of data transmission No problems reported No problems reported Interference to other medical equipment None None Wrong ﬁndings No wrong alarms No wrong alarms During the trials the users from both server and client sites were asked to evaluate the system, in order to evaluate not only the one-way use of the system but also capture the impressions of ICT-mediated interaction. Taking into account the inherent variety in the project, Tile-Ippokratis consortium opted for an evaluation approach which collects data from a variety of sources in order to ensure the integrity and generalisability of the results. To this end, data were collected through the following methods: (i) Technical metrics deriving from monitoring the ehealth system during the pilots, (ii) Users’ acceptance metrics collecting quantitative and qualitative data pertaining to the usability of the system and its users’ overall experience. 4.1. Technical Evaluation. Tile-Ippokratis was evaluated on a number of critical technical factors which were identiﬁed as important by desk research and discussions with computer engineers and physicians. These factors guided the collection of data showing the performance of Tile-Ippokratis during its operation in the various scenarios tested during the trials; the overall results from these tests are shown in Table 2. More speciﬁcally the ﬁrst critical factor is connectivity which is deﬁned as the capability of the ehealth system to transmit data between client and server units without any disruptions. This is the basis for the operation of any ehealth system which aims at providing continuous support to its users. Tile-Ippokratis scored high in this area having low failure rate less than 1% in the “home care” and “rural health centre” scenarios. Ease of data transmission was the second evaluation factor. It accounts for both the ease of data transmission of biosignals and all other necessary data (e.g., video) for eﬀective diagnosis over the network as well as the ease of data entry by users into the Tile-Ippokratis system. Given the trial results in the above-mentioned technical factor (connectivity) the outcome of ease of data transmission follows the same pattern. In the “home care” and “rural health centre” scenarios there were no problems with ease of data transmission. Data were transmitted successfully during each repetition of the trials. The third factor quality of data transmission examines a parameter of paramount importance in telemedicine as suggested by relevant literature [15]. Data transmitted