What Did the Survey Find?
Vendors were asked to provide information about current and planned Internet capabilities as shown in Chart 1. Their responses indicated whether they currently had or planned in the next 12 months to have each of the 17 capabilities in the chart. Not surprisingly e-mail and company Web sites led the way with all forty companies planning to have both within one year. The fact that Frequently Asked Questions (FAQs) were offered by only 25% of vendors was surprising given their wide spread use on the Internet.
Chart 1
Significant contrasts are illustrated in Chart 2 when the responses are listed by vendor (numbered 1-40). Vendors are not being identified in this initial survey of Internet capabilities since we were more interested in determining the “state of the art” for both laboratories and vendors in this rapidly changing field. As with all other questions, we did not verify the responses to the survey so you should find out from vendors of interest exactly what they have to offer today.
Chart 2
At one extreme we see the first nine vendors currently claiming more than 60% of the listed features and all but 2 are shooting for 100% within one year. The last four on the list have no current capabilities but certainly have ambitious plans – 50-70% of the listed capabilities by year end. A number of firms that offer capabilities today indicated no future plans which could mean either a reluctance to divulge such information or a lack of planning.
The companies were asked to summarize their use of the Internet and the results are shown in Chart 3. Internet capability can be broadly categorized as to whether it is incorporated in the LIS – e.g. remote order entry or reporting – or whether it is used in the business operations of the firm – e.g. a company Web page or user group communications. It is likely that security concerns related to patient confidentiality resulted in business applications being more common than LIS applications by a margin of 67% to 45%.
Chart 3
Finally, Chart 4 indicates how long vendors thought it would be before the Internet played a major role in the LIS field. A significant majority (67%) thought this would happen in 1-2 years while only 9% thought it would take 4-5 years.
Chart 4
What Happened with the Online RFP?
Although it was a rocky start, the RFP process using a Web page did work out. While most people have little experience going from Web to Word Processor – it’s generally done the other way, the process is really quite simple for text oriented documents. Most modern browsers allow the user to save a page as “source” (including HTML tags) or “text” – a format that can be easily loaded into any word processing program. In the next few years when the Web becomes the standard medium of publication, on those occasions when a printed copy is needed it will be very common to go from the Web to word processing and page layout applications.
The next logical step – collecting RFP responses via a Web page would be considerably more difficult at the present for both vendors and the lab team so no attempt was made to do this. Web “forms” could be used for simple checklist type responses but questions involving more complex information would not be so straightforward. Our team felt it was prudent to limit Internet use on the first try and based on the vendor reaction, we believe we did go about as far as we should.
Certainly there are concerns about security since the Internet has been notoriously “open”. Fortunately business interests are rapidly developing solutions to both the privacy and authentication aspects of security so that electronic commerce can flourish. Public key encryption provides encoding of transmitted documents so only the intended receiver can read them as well as electronic signatures to assure the receiver that a request for information is legitimate.
Digital Certificates issued by a variety of organizations as well as Smart Cards – resembling credit cards with more capability than provided by a magnetic stripe – will provide a great part of the solution to the signature problem. Encryption – or scrambling of messages to prevent unauthorized reading – is not nearly as difficult and it will be widely used once it is made transparent so users do not have to take any special action for it to take effect.
Certainly it is important to consider availability of Internet access since not everyone has or will have it in the near future. It is safe to assume, however, that most professionals will have access to the Internet within one to two years much as they have access to FAX machines today. It is likely organizations will adopt online information technology just as they incorporated PCs over the last ten years. The organizations that suffer will be the ones that wait till “everybody else has it” before they take the leap. While you may not want to be first with this new technology, you certainly don’t want to be last.
Conclusion
It is no surprise that LIS firms are not leaders in the use of the Internet. The high cost and long lead times of their products combined with legitimate security concerns and competition for scare resources mean that technological advances come more slowly than many would like. The results of this survey, however, illustrate clearly that the Internet is becoming a major factor for most LIS vendors. The survey also shows that there is a wide disparity in how they are dealing with the Internet so you cannot assume that all vendors will be equal in this regard.
If you are planning to select or upgrade an LIS and you believe the Internet to be a critical factor, you must assess these capabilities of the potential vendors exactly like you would the more traditional elements such as report formats and HIS interfacing.