Emergency Health Care (EHC) is an extended and multi-professional protocol designed to make communication easier in the event of a health-care emergency. Information and communication technologies (ICTs) play a vital role within EHC by coordinating emergency responses across involved departments as well as to health-care providers in the pre-hospital and hospital settings. Despite advances in ICT, there are still a variety of challenges regarding ICT usage in emergencies. To identify these challenges, a semi-structured interview was conducted with pre-hospital and hospital staff at the Emergency Departments of Vaasa Central Hospital, Finland, and Umeå University Hospital, Sweden. The findings indicate that workflow practices and the applying of medical knowledge in a pre-hospital setting is more challenging in Vaasa due to limited accessibility to the patient electronic record system. In the hospital setting, the clinical workflow and application of medical knowledge is easier in Umeå than in Vaasa as a result of there being an integrated information system in the Umeå region compared to a disintegrated system in the Vaasa region. It was discovered that the lack of a national record system in Sweden is a challenge for practitioners in the hospital setting in Umeå. In addition, badly structured information in the Finnish national record system has made collaborative activities between departments and hospitals difficult within EHC. The results reveal that the capacity of IT tools to provide on-time accessibility to patient information is fundamental for safe decision making and collaborative activities across departments and hospitals within EHC.