The system was first implemented by the Washington Hospital Center emergency department to reduce average waiting times. It was also used by the District of Columbia Department of Health for management of such mass-casualty incidents as a bioterrorism attack and in a variety of other settings in Arizona, Maryland, and Virginia. The Cleveland Clinic installed the system in a pilot project as an imaging and data integration system. Besides clinical data, Amalga is also designed to collect financial and operational data for hospital administrators.