Enhancing crisis response efficiency through ICT: A Delphi study on operational and decision-making improvements in mass casualty incidents

The potential of information and communication technology (ICT) to improve coordination and decision-making during the training and operational phases of mass casualty incidents (MCIs) has not yet been sufficiently explored. This three-round Delphi study investigates whether ICT use in MCIs can enhance decision-making and increase victim survival rates. The study was conducted from 10 February to 20 September 2024, with 25 international experts from academia, clinical practice, and health informatics. The results were summarised using a SWOT analysis, confirming ICT's perceived potential in MCI management. The analysis revealed a critical asymmetry: while the strengths and opportunities were mainly associated with technical factors (e.g. the effectiveness of drones, global positioning systems, artificial intelligence, dashboards, and virtual and augmented reality to improve the cost-effectiveness of training), weaknesses and threats were mainly social and organisational. These included a lack of standardisation and interoperability, limited ICT-supported training, infrastructure and cybersecurity gaps, resistance to change, legal constraints, underfunding, low technological readiness, and scepticism about the cost-effectiveness of ICT in real-world MCI contexts. Our findings highlight the gap between technological readiness and implementation challenges, suggesting that ICT innovation alone is insufficient without supportive governance, infrastructure, and stakeholder engagement. As the first Delphi study of its kind, it provides a strategic foundation for evidence-based ICT integration in training and operational MCI responses. The findings provide clear priorities for future policy development and empirical validation, emphasising the need to address persistent non-technical barriers to realise ICT’s full potential in crisis management.