Lessons learned from the DEPRAD deployment

In April 1996, a deployable teleradiology system was installed in Bosnia-Herzegovina to support the 20,000 US troops recently deployed to the area. The purpose of the system was to provide radiology support to an area that had radiology imaging capability but limited access to a radiologist. The development of the system deployed in Bosnia-Herzegovina was a systems integration feat that included equipment from 11 different vendors and the use of the Digital Imaging and Communications in Medicine (DICOM) 3.0 standard for connectivity to integrate much of the equipment. While the development, integration and implementation were completed in 3 months, the project was not straightforward. The project was completed and implemented on time and has been supported remotely for the past two and one-half years, While the project has been seen as a huge success by many standards, there are still aspects of the implementation that would be done differently if the project were to be repeated today. These areas include hardware decisions, implementation issues, operational considerations, and continued maintenance and support items. This paper discusses briefly the details of the Deployable Radiology (DEPRAD) network, the clinical operations, and support mechanisms in place to keep the system operational two and one-half years after implementation. It then discusses the areas of the implementation that require consideration before undertaking such a project again as well as the lessons learned from such an experience.