DISCRETE-EVENT SIMULATION OF A WIDE-AREA HEALTH-CARE NETWORK

Objective: Predict the behavior and estimate the telecommunication cos t of a wide-area message store-and-forward network for hearth care pro viders that uses the telephone system. Design: A tool with which to pe rform large-scale discrete-event simulations was developed. Network mo dels for star and mesh topologies were constructed to analyze the diff erences in performances and telecommunication costs. The distribution of nodes in the network models approximates the distribution of physic ians, hospitals, medical labs, and insurers in the Province of Saskatc hewan, Canada. Modeling parameters were based on measurements taken fr om a prototype telephone network and a survey conducted at two medical clinics. Simulation studies were conducted for both topologies. Resul ts: For either topology, the telecommunication cost of a network in Sa skatchewan is projected to be less than $100 (Canadian) per month per node. The estimated telecommunication cost of the star topology is app roximately half that of the mesh. Simulations predict that a mean end- to-end message delivery time of two hours or less is achievable at thi s cost. A doubling of the data volume results in an increase of less t han 50% in the mean end-to-end message transfer time. Conclusion: The simulation models provided an estimate of network performance and tele communication cost in a specific Canadian province. At the expected op erating point, network performance appeared to be relatively insensiti ve to increases in data volume. Similar results might be anticipated i n other rural states and provinces in North America where a telephone- based network is desired.