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For the last five years, a system for the management and coordination of pre-hospital health emergency has been in regular use at the Emergency Coordination Centre of Heraklion, as part of HYGEIAnet, the Regional Health Information Network of Crete. Approximately 20,000 emergency episodes per year are currently being logged in the system. The need for better support of cardiac cases (about 20% of the total) prompted the extension of the system to include the continuous acquisition of 12-lead ECGs and their real-time transmission to the coordination centre for evaluation by an expert. The 12-lead ECG module has been developed and integrated in the existing system with special attention to the provision of an easy user interface so that the extra work required to the ambulance personnel is negligible. The overall system has been carefully tested and is now in daily use.