The Results Of Simulating A Digital Imaging Network System In Echelon 3 Of Deployable Combat Medical Facilities

The U.S. Army is evaluating the conversion of all of its conventional medical radiological imaging capabilities to a filmless technology using a Digital Imaging Network System (DINS) in both fixed and field hospitals. The latter hospitals are called Deployable Combat Medical Facilities. Using DINS, the photosensitive films presently used to record and display x-ray images would be replaced by digitized images stored on either magnetic or optical devices and displayed on computer workstations (electronic lightboxes). This document describes the use of a simulation model as a tool in estimating the imaging caseload for field hospitals for the purpose of determining the required image storage capacities of the DINS workstations and the required throughput capacity of the inter-workstation local area network. The simulation follows a patient through the five echelons of field hospitals, recording the number of radiological images created in each ward of a hospital and the inter-ward movement of images. The simulation also provides information about the number of images transferred with a patient being evacuated to rear area hospitals. The detail included in the simulation model makes it possible to analyze the utilization of facilities within a hospital and the impact of queuing on patient care when these facilities are overloaded. Three simulation examples are presented that examine the impact on an Echelon 3 EVAC Hospital of the treatment of patients with combat-related injuries.