The future of military medical evacuation: literature analysis focused on the potential adoption of emerging technologies and advanced decision-analysis techniques

A fundamental component of any military medical support system is medical evacuation. The main goal of evacuation is to reduce mortality among critically injured combat casualties. To achieve this goal, several decision problems including, the location of medical treatment facilities, relocation, dispatching, and routing have to be effective across all levels (tactical, operational, and strategic). This study concentrates on the three key types of medical evacuation (MEDEVAC) systems—forward, tactical, and strategic—and the related decision problems. Even though, over the last few years, some review papers have discussed the different topics of MEDEVAC systems (e.g., the evolution of MEDEVAC, evacuation timelines, and types of injuries), no research has been conducted on the full range (i.e., total care pathway) of MEDEVAC systems and the adoption of emerging technologies to improve future MEDEVAC. In this paper, a systematic review of the literature is described, including the decision problems involved in the total military medical evacuation process. This paper also reviews forecast challenges of future MEDEVAC and potential emerging technologies, concepts, and advanced decision-analysis methods to tackle these challenges. In future MEDEVAC processes, emerging technologies and concepts will be important to support improved medical capability; however, military planners will also need to adopt advanced decision-support techniques to efficiently employ these technologies.