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The European Union (EU) is characterized by a large number of different emergency healthcare (EHC) systems. In this situation, a common policy for healthcare emergency handling is largely prevented and is a cause of an increase of the costs associated with such systems all over Europe. There is, hence, a need for a homogenization and integration of healthcare emergency systems in Europe. This turns out to be difficult because of the ethical, political, legal, and technological differences and peculiarities of the European scenario and the large investments that would be needed in this sector. The process of integration passes through the identification of the main functionalities-driven by the user needs in their real life conditions-along with the technologies that are best fitted for supporting them. In this paper, several aspects related to these problems are analyzed and a real case study, drawn from the project "Worldwide Emergency Telemedicine Services" (WETS), supported by the European Commission (DG-XIII), is presented. Within WETS, several pilot sites (in Italy, Spain, Greece, Denmark, and Iceland) consider different aspects of the integration of healthcare emergency systems with particular focus on the sharing of solutions that "traditionally" belong to different environments (i.e., land, air, and sea). The involvement of important hospitals, ship companies, airlines, and emergency health institutions allows us to devote a large part of this two-year project (1998-1999) to validate and demonstrate the results of the development phase in real-life conditions. Some more concrete details are given for the Italian pilot site, where the authors operate.