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Towards Reducing the Reaction Time of Emergency
Services through Improved Situation Assessment
Odd Erik Gundersen
Department of Computer and Information Science
Norwegian University of Science and Technology
Abstract—Our goal is to reduce the reaction time between
an emergency call is received and help has been dispatched.
The hypothesis is that the situation assessment of the operators
can be improved by relying less on oral communication by
enabling a smart phone application to send pre-registered and
real-time updated information. We identify some challenges of
how emergency situations are assessed by operators, discuss these
challenges, and present a computer system that addresses these.
As experiments with the aim of measuring the performance of
the presented system in an operational setting are on-going, only
some initial results are presented.
I. BACK GROUND
In a critical emergency, time is of the essence. Governments
provide emergency services with the purpose of being the ﬁrst
responders to emergency calls reporting emergency situations.
The three main emergency services are ﬁre and rescue, police
and medical services. Some countries also have a number of
other and supplementary services such as coastguard, lifeboat
services and air ambulance. Our focus is on the three main
emergency services. There is variation between countries in
how emergency services are organized. In some countries
the three main ones are integrated while in others they are
independent. The emergency services can be contacted by
phone, and the calls are answered by emergency call centre
operators that dispatch resources according to the information
provided by the callers. Some countries, such as UK, USA
and Australia, have one emergency number while others,
such as Norway, have separate emergency numbers for each
When an emergency occurs, someone that is aware of the
emergency calls the emergency call centre. Typically, this
someone is at the location of the emergency or close to it.
The task of the emergency call centre operator, or operator
from now on, is to assess the emergency situation so that
the proper resources needed to help managing the emergency
can be dispatched. The emergency situation is assessed by the
operator through an oral interview of the caller. In this way, the
situation awareness  needed to dispatch the proper resources
is acquired. The operators need answers to three questions: i)
the operator needs to know where the emergency situation is
located in order to direct the resource; ii) the operator needs
to know what type of emergency it is, so that the operator can
send the right resource to help mitigate it; and iii) the operator
needs to know who is calling, so that the operator can return
the call if the connection is lost or refer to the caller for legal
matters at some later time.
The goal of the research presented in this paper is to reduce
the reaction time between the operator receives an emergency
call and the help has been dispatched. Our hypothesis is that
this can be done by improving the situation assessment of the
operators by answering the three questions faster than they are
being answered today by relying less on oral communication
and having a smart phone application send pre-registered and
real-time updated information to the operators.
The contribution is three-fold: First, we identify some of the
challenges of how emergency situations are assessed by opera-
tors. Then, we discuss these challenges, and ﬁnally we present
a computer system that addresses these. Experiments with the
aim of measuring the performance of the presented system in
an operational setting is being conducted. However as these are
on-going, only some initial results can be shared. Although,
the research reported in this paper has been conducted in
Norway and this is reﬂected in our view on challenges and
solutions, we believe that our ﬁndings are generalizable.
Some related research includes how the internet of things
can enhance emergency response operations , communi-
cation between the control centres and the response units
, decision support for efﬁcient ambulance logistics ,
social network analysis of command and control in emergency
services operations , how Twitter can support in situation
assessment , and how vehicular communication networks
can help emergency services .
Emergencies can happen anywhere, and they do. Norway is
a long country with a long coast, high mountains and deep
fjords. The population is spread all over the country, and
both the population and tourists use the nature for outdoor
activities such as skiing, mountain climbing, kayaking and
ﬁshing. This means that the emergency services have to be
capable of solving their task of rescuing people, putting out
ﬁres or taking care of criminals whether the emergencies occur
in buildings, on streets, on the sea, or in the mountains.
The fact that emergencies can happen anywhere affect who
discovers them. It is not the experts at handling emergencies
that do; it can be anyone. Therefore, responses to emergencies
can be extremely varied, and this is why the citizens are trained
to call the emergency services ﬁrst when they encounter one.
Laymen both overestimate and underestimate the seriousness
of emergencies, and this is because they do not have proper
situation awareness. Emergencies are underestimated because
they do not look severe, while others can be overestimated
because the patient is in severe pain. The varied quality of the
situation awareness of the public encountering the emergencies
results in emergency services having a built-in, but healthy,
skepticism in the caller. This skepticism is implied in the
ofﬁcial deﬁnition of terms used by the Norwegian medical
emergency services in which ﬁrst responder is deﬁned as
someone with ﬁrst aid training and training in how to use
Medical emergencies are categorized according to the Nor-
wegian Index for Medical Emergencies , which is a docu-
ment describing the best practices for handling emergencies,
and hence is the most important decision support tool for
medical emergency professionals in Norway. The three cat-
egories that are used for categorizing emergencies are based
on urgency. Acute means that the emergency is expected to
be serious and the patient has a critical condition where the
vital functions can be threatened or disrupted. In such cases,
an ambulance shall be dispatched and a medical doctor must
be alarmed. Urgent means that the emergency is expected
to be serious and the patient has a condition where the
vital functions might be threatened. A situation assessment
by a doctor or transport to the hospital is required. Regular
are emergencies where time is less critical for the medical
condition, and the patient can be assessed by a doctor at
ﬁrst suitable occasion. Note that these criteria are based on
the condition of the patient only. However, the degree of
seriousness of emergencies can be measured on how many are
affected by the emergency. For example, a ﬁre in an apartment
complex can in this view be seen as more serious than a ﬁre
in a villa, as the ﬁre in the apartment complex will affect more
people. We argue that emergencies should be assessed along
the two dimensions: i) severity for individuals and ii) how
many are affected by the emergency.
By measuring the degree of seriousness along these two
dimension, it is possible to analyze the cost of the emergency
for the society. Here, the term cost does not necessarily directly
translate to monetary cost, while it certainly can be. The
term can, for example, also be interpreted as decrease in trust
between citizens, which is a cost the society can pay for high
severity emergencies related to crime, such as school shootings
or terrorism. This is illustrated in ﬁgure 1, which shows that
emergencies with low severity along both dimensions have
low cost for the society and conversely emergencies with high
severity along both dimensions have a high cost to the society.
Emergencies that have high severity along one dimension and
low along the other have a medium cost for the society.
III. HANDLING EMERGENCY CALLS I N NORWAY
Emergency services are organized differently in different
countries. Here we give a brief overview of how emergency
calls are handled in Norway
Fig. 1. Cost for the society for different degrees of seriousness along the to
dimensions severity for the individual and the number of people affected.
A. Emergency Call Centre Organization
In Norway, the three emergency services ﬁre and rescue,
police and medical are organized separately. Each have their
own emergency phone number, 110, 112 and 113, respectively.
There is no central emergency call centre for each emergency
service, but all three emergency services operate their own
emergency centres around the country. Each local emergency
call centre is responsible for responding to emergency calls
in a given region. The ﬁre and rescue, police and medical
emergency service regions do not necessarily overlap.
The difference between the emergency services extend
beyond responsibilities and how they are organized. However,
there is a very important similarity. The personnel in the
emergency call centres are subject matter experts with many
years of experience. The operators of the medical emergency
call centres are typically experienced emergency nurses, while
the ﬁre emergency call centres are operated by experienced
ﬁre ﬁghters. Similarly, the police emergency call centres
are operated by experienced police ofﬁcers. Typically, the
operators rotate between being an operator at the emergency
call centre and their regular position. The rotation can be on a
daily basis, as it is for emergency nurses or yearly as it is for
ﬁre ﬁghters. Experienced personnel allow the emergency call
centres to provide professional aid to the resources at site.
B. The Operating Center
The operators answer calls from the operating centre, which
basically is a room at a ﬁre station, a police station or a
hospital. An operating centre is typically occupied by three
operators that can work separately or together if needed. Col-
laboration between the operators is similar to what is described
by Artman and Wærn . The operators sit behind a desk with
between 10 and 15 computer screens that display different
information. Every display is reserved for different software
that has different responsibilities. Map software is used for
showing the location of the caller, as well as the GPS-tracked
resources, such as ambulances, police cars and ﬁre trucks.
Information about the caller is displayed on another screen.
There are displays for phones and software for documenting
the emergency incident. The operator has several mouses
and keyboards for interacting with the different machines
running different software packages. They even have pedals
for controlling which communication lines are active, as the
operator can speak to the caller and emergency personnel
dispatched to mitigate emergency concurrently or separately.
Incoming calls are documented, and if a resource is dis-
patched, the situation description and actions taken by the
personnel at site are documented as well. The documentation
written by the operators can serve as a legal document, and
because of this, it is imperative that nothing that was stated
by the incident commander at site is forgotten.
C. The Process
Emergencies can happen at the same time, and thus several
resources might have to be managed concurrently. When an
incoming call is received at the emergency call centre, an alarm
goes off. One of the operators answers the call and lets the
caller know that she has reached the speciﬁc emergency call
central. The operator asks the caller about where and what
type of emergency it is, and who is calling. These questions
are partly answered by software that the operator uses. The
position of the caller is shown on a digital map, and the
name and the address of owner of the phone subscription are
listed. Using this information the operator dispatch the closest
available resources that are capable of handling the given type
of emergency. Typically, the resources have to be on their
way before a minute has passed. The operators can follow
the resources on their map and can provide the caller with an
estimate of when they will arrive.
Some emergencies are of such a character that more than
one emergency service need to respond to them. If all of the
three main emergency services are needed, the term used for
describing this is triple alert. Typically when an emergency
situation that needs more than one emergency service occurs,
a person at the scene of the emergency calls one of the
emergency services. The operator interviews the caller in order
to assess the situation, which leads to the operator contacting
the other emergency services through a conference call in
which the caller attends. In the conference call, the operator
that responded to the emergency call ﬁrst briefs the operators
at the other emergency call centres by iterating what the caller
said. Then, the proper response is decided and the resources
are sent to the scene of the emergency.
E. Reaction Time
For emergency services, the goal is to help as quickly as
possible, and reaction time is their main key performance
indicator. The reaction time for medical emergency services is
deﬁned as the sum of the access time and the activation time.
The access time is the time it takes for the operator to respond
to the incoming emergency call, while activation time is the
time the operators uses to assess the situation and alarm the
IV. THE CHALLENGES
As is apparent from the above discussion, there are some
fundamental challenges with how emergencies are handled.
These challenges are hard to solve as they are intrinsic to
emergencies and how they are reported. However, there are
some challenges with the tools that are used for supporting
the operators as well, and these are easier to solve.
A. Fundamental Challenges
The operator’s task is to send the right resources to mitigate
the emergency. Disregarding luck, the proper response to a
situation requires having a good situation awareness, which
again requires good assessment of the situation. The operators
in the emergency call centres assess remote situations through
callers, which fundamentally is an impossible task. Given that
the communication technology works, the situation can only
be understood by the operator to the degree that the caller
describes the situation. This means that the limiting factors
are the caller’s situation awareness and ability to properly
describe the situation in a timely manner. We have identiﬁed
four fundamental challenges related to these limiting factors:
Communication issues: Around 700 000 or 14% of the
population in Norway is hearing impaired, and of these around
5000 are deaf. Additionally, there are mute people and people
not speaking Norwegian nor English. Describing the situation
in a timely manner might be impossible for these groups of
people. As the emergency services only can respond to callers
that orally describe the emergency using a regular phone,
somewhere between 50 000 to 100 000 Norwegians cannot
alert the emergency services if they detect or ﬁnd themselves
in an emergency, although this is required by Norwegian law.
Stress: Stress can affect the ability to communicate coher-
ently. A parent calling the emergency call services because of
an injured child might not be able to describe the emergency
nor their location. This exact situation was observed by one
of the authors during a session in an medical emergency
call centre. The parent was not able to speak coherently and
after a while just ended the phone call. The operators, which
understood that a critical emergency was occurring, were not
able to help until the spouse called later and described the
situation in a calm manner. This is not an uncommon situation.
According to statistics collected by the medical emergency
service in Sør-Trøndelag1, 29.1% of the callers are the patients
while 28.7% are relatives of the patients.
Incomplete situation awareness: The situation awareness
of the caller is not necessarily complete, and hence this
will affect the appropriateness of the operator’s response. For
1Total: 17560, patients: 5112, relatives: 5042. Period: Jan 1 to Sep 18 2015.
example, someone might call the ﬁre and rescue emergency
number to report about a crashed lorry. Although this is a
proper description of the situation, a caller might not be aware
of the chemical transport code that the lorry is marked with,
which again implies that the situation is highly dangerous.
Thus, the resources that are sent to mitigate the emergency
are not aware of the danger of the situation, nor do they bring
the right tools for handling the chemical cargo.
False alarms: People lie. The ratio of false to true alarms
differ between the three emergency services. While ﬁre and
rescue and medical emergency call centres have relatively
few false alarms, around 90% of the calls made to the
police emergency call centres are false alarms. Therefore an
important part of the job of an operator is to verify that the
current call is about an actual emergency. Dealing with false
alarms removes the focus of the operators, and they use time
on unnecessary calls which might impact actual emergencies
that are in the call queue.
B. Challenges with Current Software Tools
We have identiﬁed the following challenges related to
software solutions for handling the incoming emergency calls:
Operator focus: Current solutions are developed with the
operators in mind and seek to solve challenges related to the
operator’s process of answering calls. The solutions do only to
a small degree take the public into consideration as their only
tools for reporting emergencies are phones. Despite nothing
has changed for years, the types of emergencies that can be
reported to the ECC have increased immensely, not because
of an advancement in the solutions for reporting emergencies,
but because of the advancement of the phone itself, which
for example is no longer stationary. However, the capabilities
of the phones used by the public has advanced dramatically
in other regards as well, and there is a great potential in
utilizing these features to increase the situation awareness of
Collaboration: Emergency call centres are considered to be
islands in current solutions, and there are little support for col-
laboration between the different call centres and organizations.
Basically, all the information is shared in conference calls
between the emergency call centres. This can lead to repetition
of information, information being lost and most importantly
increased reaction time.
Position Accuracy: The position of the caller provided
by current solutions is not very accurate, as it is based on
the position of the GSM base station cells. Hence, the best
accuracy is achieved in urban areas while rural areas have
lower accuracy. According to , the highest accuracy of
GSM based localization systems is 70-200 meters outdoors. In
densely populated areas in Norway, the best accuracy achieved
typically has a radius of ∼300 meters while the radius can be
up 20 kilometres in rural areas.
Oral situation descriptions: Basically, all information is
conveyed orally. Because of the inaccuracy of the GSM
based positioning, extensive time is used on ﬁnding out
where emergencies are located. Stress, communication issues
and incomplete situation awareness affect the oral situation
descriptions, which increases the reaction time. The medical
ECC has a goal of dispatching a resource within two minutes,
but often have trouble meeting this goal because the callers
are not able to coherently explain themselves.
Severity of the emergency: The current way of assessing
the degree of seriousness of the emergency focus on the
state of the patient, while we have suggested that this way
of assessing the degree of seriousness of an emergency is
insufﬁcient. The amount of callers reporting about a severe
emergency increases with the severity of the emergency. For
example, the amount of incoming callers broke one of the
systems used by the ECCs during the terror attack of July
22nd 2011 in Norway as it was not designed to tackle such
an amount of incoming callers according to .
Managing large groups of callers: Operators have no way
of communicating to large groups of callers calling at the
same time. According to some operators the authors talked
to, in situations where many call at the same time, some of
the calls in the call queue are answered while the rest is
assumed to be about the same incident, so they will not be
answered. This assumption allows the operators to use their
time on mitigating the emergency rather than answering calls
duplicating the alarms. However, his means that callers calling
about other emergencies happening at the same time might not
get through to the operators.
V. TOWAR DS A SOLU TI ON : INVOLVING THE PUBLIC
There has been a communication revolution the last 25
years. According to TNS Gallup , around 80% of the
Norwegian population has a smart phone, which is a phone
with an internet connection according to their deﬁnition.
However, a large part of the smart phones do not only have
an internet connection; they are small computers with built in
GPS, cameras and keyboards. According to The Norwegian
Board of Technology , which is an independent advisor to
the Norwegian Parliament and the Norwegian Government, the
plan is to allow the public to communicate with emergency call
centres through text messages when the emergency network
infrastructure that has been build for emergency services was
introduced in 2015. However, there exist no plan to utilize the
capabilities of smart phones to improve the effectiveness of
the emergency services.
GSM positioning is inaccurate, and thus the operators still
have to use quite a lot of time to understand where the
caller is. According to personnel from St Olavs Hospital,
the University Hospital in Trondheim Norway, the last 100
meters takes the longest time when trying to get to a patient.
This is because of the inaccuracy of the position they get
from the GSM network. Smart phones improves positioning as
they utilize a hybrid solution for positioning combining GSM
based localization with GPS and WiFi positioning systems
. According to outdoor experiments conducted by , the
median horizontal error of position ﬁxes from mobile phones
varied between 5.0 and 8.5 metres, and the RMSE varied
between 6.0 and 12.5 metres. The maximum error during all
static outdoor tests never exceeded 30 metres. In this research,
the position accuracy of the GPS measurements of Android
phones was tested. However, these results are in line with the
results achieved by  in which the position accuracy of the
iPhone 3GS was tested. The position accuracy by the GPS in
mobile phones is considerably more accurate than GSM based
localization, while WiFi positioning is better than GSM based.
However, WiFi positioning is worse than GPS with 74 meters
in median error. GPS positioning provides better accuracy in
rural areas in contrast to GSM based positioning, which works
best in cities. GSM based location is the fallback solution for
phones if the two others do not work.
Other information that can be shared with the emergency
call centres in addition to position is preregistered data that
describes the caller and the patient. In this way the caller does
not need to present herself. Patient information can be impor-
tant in situations where the patient takes medicines that will
affect how the emergency doctor treats the patient. Addresses
can be used for ﬁnding the location of the accident, such as
ﬁres, quicker and the number of residents can be used to ensure
that everyone is saved from a burning house. Also, callers
could classify the emergency to some degree. Classiﬁcation of
emergencies will provide more value in countries that do not
have separate emergency numbers for the different emergency
A picture is worth a thousand words it is said. Images can
improve the situation awareness of operator if they receive
images of the emergency site from the caller. For example, one
of the authors observed that the operators displayed pictures
from the emergency site taken by the local news paper to
get a better situation awareness. The public is even willing
to help the emergency services. In a survey conducted by
Norstat on behalf of the Norwegian Board of Technology, it
was found that 77% of the Norwegian population is willing
to share pictures and video in order to improve the situation
awareness of the police in an emergency. The technology is
here and the public is willing to do their part.
Both position and information sharing have privacy con-
cerns. While the public is willing to share information in an
emergency situation, they will not accept to share everything
continuously. Norway has strong privacy laws and The Nor-
wegian Data Protection Authority2monitors that the laws are
followed by Norwegian authorities, organizations and private
companies. Also, the privacy of medical patient data is strong
and healthcare institutions follow Norwegian law strictly.
Emergencies with a high degree of seriousness where many
callers have called at the same time create problems for the
operators, not only because their systems are not necessarily
build for such situations and break, but because these systems
do not utilize the fact that many concurrent incoming calls is
information in itself. The amount of incoming calls and their
position should be used for supporting the decisions made by
the operators, exactly because this information provide insight
into the severity of the emergency. The current solutions do
Fig. 2. The SmartHelp clients communicate through the Smart Server with
the Smart Decision Support instances belonging to the emergency numbers
not show the position of all the callers in the phone queue,
but only the one that the operator talks to, and the result is
that the operator cannot use this information to infer whether
all the callers call about the same emergency. Hence, they
do not necessarily understand the severity of the situation
after talking to one of the callers, which again means that
the have to talk to several callers in order to respond with
the right resources. Situations where many call the emergency
services at the same time are not as frequent as emergencies
where few are involved. However, their cost to the society is
classiﬁed as medium to high according to the analysis above,
so understanding seriousness of the situation quickly helps
mitigating it quickly as well.
The only way that operators can communicate with the
callers is through talking with them one by one over the
phone. Hence, group communication is not supported. This
could be alleviated by introducing text message or chat support
for operators to communicate concurrently with all callers in
the call queue. Callers that do not have important information
about the emergency could be advised to hang up while
others that have relevant information about the emergency or
other emergencies can remain in the queue. Such a solution
would solve the problems with callers having no new infor-
mation blocking relevant information reaching the operators
and smaller emergencies drowning in larger ones.
VI. TH E IMPLEMENTED SYS TEM
The implemented system has a client server architecture as
shown i ﬁgure 2. The central server conveys the communi-
cation between the clients. SmartHelp is a mobile client ap-
plication, and Smart Decision Support is the decision support
system used by the emergency call centre operators. Screen
captures are shown in ﬁgure 3.
SmartHelp enables the user to call the emergency services
and provide them with relevant information that is both pre-
registered and updated continuously. On Android phones, the
Fig. 3. To the left the SmartHelp GUI is depicted, and the Smart Decision Support GUI is shown to the right.
information is sent even though the caller does not call the
emergency number through the app. Features include:
Proﬁle: Users can add information such as name, phone
number, email address, communication issues, disabilities,
home and work address. GPS coordinates for different ad-
dresses can also be speciﬁed.
Accurate position: The application uses the hybrid posi-
tioning system on the phone, so that the most accurate position
coordinates can be sent to the emergency call centre. When the
connection between the mobile application and the decision
support is open, the the position is updated.
Type of emergency: When calling, the user can specify
from two to four different type of emergency categories.
Different categories can be speciﬁed for the different emer-
gency services, and they are broad and easy for the caller
to recognize. Examples includes car accident, drowning and
Privacy by Design: The information is heavily encrypted in
such a way that no one except for the owner of the phone can
decrypt it. It is stored centrally on a server, and no master
password exist. Information is shared with emergency call
centres only when the user gives permission. Whenever this
permission is withdrawn the information sharing is stopped.
B. Smart Decision Support
Smart Decision Support is the decision support system for
the emergency call centre operators. It is a lightweight web
Caller information: The position of the caller is shown as
a pin on the map that contain an icon representing the type
of emergency that the caller has speciﬁed. Also, if the caller
has communication issues, such as being hearing or speech
imparied, an icon indicating this is shown on top of the pin.
Accuracy of the position and the time of the last position
update are also indicated.
All callers visualized on the same map: A list of all
concurrent callers is shown to the operator. Each caller is
represented with an item that contains the name and number of
the caller, as well as a color coded position accuracy and the
time since last position update. The position of all callers are
visualized on the same map, which indicates to the operator
whether the callers might be calling about the same emergency
Group communication: Callers can be grouped manually
or geographically so that all callers from a geographic area are
put into the same group. Operators can send text messages to
individual callers or to all members of a group. This feature
can be used for informing the callers that the operators are
aware of speciﬁc accident and that they can hang up if they
do not have important information regarding this emergency
or they are reporting about something else.
Support for any smart phone: Text messages requesting
the position of any caller calling from a smart phone. The text
message contains the link to a web page that turn on position
sharing so that the position is shared with the decision support
system. This allows the operator to get the position of any
caller having a smart phone with a GPS.
Sharing: Emergency call centres can easily share informa-
tion between each other. Hence, a police emergency call centre
can easily share information with a medical emergency call
centre. Also, different emergency call centres from the same
organization, such as the police, can easily share information.
Both individual callers and groups can be shared.
VII. EXP ER IM ENT S AN D EVALUATIO N
Smart Decision Support is deployed at the medical emer-
gency call centre at the university hospital St Olavs Hospital
and at the Fire emergency call centre of Sør-Trøndelag,
which both are located in Trondheim of Norway. These two
emergency call centres cover a region with a population of
just above 315 000. Although the software is deployed at
the emergency call centres, only about 2% of the population
in the region has downloaded the software. The medical
emergency call centre receives around 60 calls per day while
the ﬁre emergency call centre receives substantially less calls.
In theory, this means that the medical emergency call centre
should receive one emergency call from SmartHelp every day,
and that the ﬁre emergency call centre should get a call a
couple times a week. This is not the case, and the number of
callers is substantially less than what theory suggests.
The low number of callers can be explained by at least three
theories. People are trained to call the emergency numbers
when an emergency occurs, and therefore they do not do
this through an application other than the phone application.
Secondly, most users that have downloaded the mobile appli-
cation use iOS. In contrast to Android, iOS does not allow
applications to monitor which number is called, and hence
the iOS application cannot send the proﬁle information and
position coordinates if the user does not call from the app.
Therefore, only third of the users will provide the information
even though they call directly to the emergency services not
using the app. The third reason could be that the demographic
of the smart phone owners that have downloaded the app is not
the same as the demographic of the callers calling to the ECC.
Because of the promise of privacy, this cannot be checked.
Anonymized data about incoming emergency calls is col-
lected. When a substantial amount of emergency calls using
the mobile application is recorded, a study comparing the
reaction time of operators when answering calls from callers
using the mobile application and callers not using the mobile
application will be conducted. Some initial results can be
shared. The ﬁre emergency call centre has requested the
position of a caller once through a text message sent by Smart
Decision Support. This was in an emergency in which a father
had lost his son on a mountain trip. The father got the text
message, pressed the link in the text message and shared his
position with the ﬁre emergency call centre, which shared the
coordinates with the air ambulance. The medical ECC has used
the same functionality over twenty times. They report that they
fail to get the position in around half of the cases. The reason
is that position sharing is turned off for the web browser and
users are not capable of turning it on. This is not the fault of
the system, but a feature of position sharing in most phone
operating systems. iOS users are required to call from the app
in order for the smart phone app to share information. This
is a disadvantage with the solution as users are encouraged to
call the emergency numbers directly. Currently, the solution
requires data trafﬁc in order to communicate position and data
to the operator, which is a problem when the phone network
does not allow this. Finally, the solution requires a phone
connection, but this is an inherent problem with ECCs.
Several fundamental challenges of emergencies in general
and issues with the current solution for emergency handling
and reporting speciﬁcally have been presented and discussed.
These challenges and issues have led to the development of a
mobile application and a decision support system that improve
warning the emergency call centres about emergencies. While
the system has contributed to saving lives, its effects have not
yet been properly measured.
 M. R. Endsley, “Toward a Theory of Situation Awareness in Dynamic
Systems,” Human Factors: The Journal of the Human Factors and
Ergonomics Society, vol. 37, pp. 32–64(33), 1995.
 L. Yang, S. Yang, and L. Plotnick, “How the internet
of things technology enhances emergency response operations,”
Technological Forecasting and Social Change, vol. 80, no. 9,
pp. 1854 – 1867, 2013, planning and Foresight Methodologies
in Emergency Preparedness and Management. [Online]. Available:
 T. Ludwig, C. Reuter, and V. Pipek, “What you see is what i need: Mo-
bile reporting practices in emergencies,” in ECSCW 2013: Proceedings
of the 13th European Conference on Computer Supported Cooperative
Work, 21-25 September 2013, Paphos, Cyprus. Springer, 2013, pp.
 T. Andersson and P. V¨
arbrand, “Decision support tools for ambulance
dispatch and relocation,” Journal of the Operational Research Society,
vol. 58, no. 2, pp. 195–201, 2007.
 R. J. Houghton, C. Baber, R. McMaster, N. A. Stanton, P. Salmon,
R. Stewart, and G. Walker, “Command and control in emergency services
operations: a social network analysis,” Ergonomics, vol. 49, no. 12-13,
pp. 1204–1225, 2006.
 T. Hossmann, F. Legendre, P. Carta, P. Gunningberg, and C. Rohner,
“Twitter in disaster mode: Opportunistic communication and distribution
of sensor data in emergencies,” in Proceedings of the 3rd Extreme
Conference on Communication: The Amazon Expedition. ACM, 2011,
 F. Martinez, C.-K. Toh, J.-C. Cano, C. Calafate, and P. Manzoni, “Emer-
gency services in future intelligent transportation systems based on
vehicular communication networks,” Intelligent Transportation Systems
Magazine, IEEE, vol. 2, no. 2, pp. 6–20, Summer 2010.
 ”Den Norske Legeforening”, “Norsk Indeks for Medisinsk
Nødhjelp,” 2009. [Online]. Available: http://www.helse-
 H. Artman and Y. Wærn, “Distributed cognition in an
emergency co-ordination center,” Cognition, Technology & Work,
vol. 1, no. 4, pp. 237–246, 1999. [Online]. Available:
 A. Varshavsky, M. Y. Chen, E. De Lara, J. Froehlich, D. Haehnel,
J. Hightower, A. Lamarca, F. Potter, T. Sohn, K. Tang et al., “Are GSM
phones THE solution for localization?” in Mobile Computing Systems
and Applications, 2006. WMCSA’06. Proceedings. 7th IEEE Workshop
on. IEEE, 2005, pp. 34–42.
 Live Oftedahl, “Teknologien sviktet,” News article, 2011. [Online].
 TNS Gallup, “Interbuss,” Report, 2015. [Online]. Available:
 T. N. B. of Technology, P˚
a Nett med Publikum. The Norwegian Board
of Technology, 2014.
 P. A. Zandbergen, “Accuracy of iPhone Locations: A Comparison
of Assisted GPS, WiFi and Cellular Positioning,” Transactions
in GIS, vol. 13, pp. 5–25, 2009. [Online]. Available:
 P. A. Zandbergen and S. J. Barbeau, “Positional Accuracy of Assisted
GPS Data from High-Sensitivity GPS-enabled Mobile Phones,” Journal
of Navigation, vol. 64, pp. 381–399, 7 2011. [Online]. Available: