The technology of the Internet can open a lot of doors to information. But it can't do much unless it has plenty of speedy paths to those doors.
Those pathways are the same copper lines, fiber-optic threads and other network infrastructure that providers already are stringing among existing computer systems.
A comprehensive network to and from sources of information-laboratory, pharmacy, radiology, emergency, registration and so on-is the backbone of an intranet just the same as with pre-Internet electronic schemes, consultants say.
The good news for capital budgets is that the network-building investments racked up by provider organizations aren't diminished or rendered obsolete by the advent of Web-based network solutions, says Briggs Pille, senior manager in the Chicago office of First Consulting Group.
"The wires and cables and network electronics are the same things we've been using for the last three years," Pille says.
What's new are the "naming conventions" and search engines that plaster the data landscape with "addresses" and provide a consistent formula for fetching data no matter the hardware or software involved, says Michael Gorsage, senior manager in First Consulting's Atlanta office.
Attached to powerful "servers"-computers stocked with Web-based software innovations-the network infrastructure functions as the highway for browsers and data-ferreting protocols to work their communications magic.
Gorsage says it's like mailing a letter. A lot goes on behind the scenes to get a letter from one place to another, but as long as the destination has a postal address and it's written on the letter, there's a route and a means to get it there. "It's complex but it's also real logical," he says, and the same is true of an intranet.
But browsers can't bail out an existing network that's not performing well, Pille says. If it's too slow or too limited, the intranet will be just the same, he says.
Once established, an intranet may save money for a healthcare organization in the long run. But before organizations can move ahead on tapping the potential of an intranet, "they're going to have to go back and spend some money to get ready," Gorsage says.
Healthcare appears ready to spend, according to a recent survey on intranet plans by the Kennedy Group, a Redwood City, Calif.-based healthcare information technology consulting firm.
In a poll of more than 70 integrated health systems that are clients of the firm, 94% of responding organizations had deployed or were planning to deploy intranets systemwide. A year ago, that percentage was 54%.
The earliest to implement intranets were organizations with an infrastructure already in place to support it, thus requiring only modest spending to upgrade their networks, says Kennedy Group spokeswoman Marie Turks.
Those planning to have a deployed intranet within the next six months will spend $2.7 million on average to upgrade their infrastructure, according to the survey.
Organizations that envision an intranet also have to know it will require raising the skills of some computer programmers, Pille says.
And those skills are both scarce and in demand as other industries compete for expertise, making it expensive to bring in a crack crew to take the reins, he says.
Pille recommends "seeding" the organization with an expert and then building a team around that expert, bringing the skills of multiple staffers up to speed over time.
The expenses of expertise may be offset, however, by savings in labor costs as a result of lower computer system maintenance. That's a relief to chief information officers besieged by labor-intensive projects.
Today a physician-office connection requires a Pentium-class personal computer; specific software applications installed in the hard drives of all the network's PCs; and staff to install the software and then make rounds periodically to install any upgrades, CIOs say.
Browsers eliminate that cost and complexity by delivering applicationsthrough the intranet and updating them through that remote connection, says Daniel Walsh, CIO for the Philadelphia region of Allegheny Health, Education and Research Foundation.
Intranets also end the dilemma of deciding when to upgrade PCs as the computer industry keeps making more powerful versions, says Ward Keever, CIO of University of Pennsylvania Health System in Philadelphia.
Before Web technology, information systems departments were forced to "keep chasing that technology curve," Keever says. With plenty of high-priority projects on deck, "you don't want to spend all your time upgrading technology and migrating PCs" to the next level, he says.
Now what counts is not the new tier of machine but the capacity of the intranet processing computers, says Al Giacomucci, chief technical officer at Jefferson Health System in Radnor, Pa. "It's the difference between replacing three or four servers and thousands of PCs," he says.