Asking for products that are "Internet-based" is not specific enough.
That's a Philadelphia-based company's experience with defining the qualities of the World Wide Web that are must-haves in a planned countywide data exchange.
It's one thing to employ Internet technology as a piece of the product puzzle and quite another to base the product's operation on the use of Web browsers. So says Chris Shull, technical architect for CareStandard, the subsidiary of Care Science that's developing the Internet-based Santa Barbara County Care Data Exchange.
The project envisions a strong reliance on browsers such as Netscape Navigator and Microsoft Explorer to provide cheap, ubiquitous and easily maintained points of access to information sources and to those who use them, Shull says. But the browser niche is "a murky thing," he says.
For instance, some information systems companies are using browser technology to do a better job of reaching into their traditional software databases to gather and organize data from multiple sources. Those computer moves were far more difficult to accomplish before Internet standards came along.
However, such "Web-enabled" system enhancements don't always extend all the way to the healthcare user, Shull says. The information shaken loose through Web techniques is delivered the same way as before to computers in a discrete network running Microsoft Windows. That restricts the ubiquitous availability of information, one of the main attractions of browser technology, he says.
In another less-than-complete adaptation, non-Internet-based features and functions can be "emulated" by a Web browser and transported to users wherever they're working.
But because the software programs were developed for quite a different computer architecture, they are likely to be slower and clumsier than programs created from the start with Internet technology, says David Brailer, who heads Care Science. "It's a cheap trick," he says of the move to wrap older applications in a Web blanket.
When the Internet is used as the transport, it does away with the expense of renting and maintaining a wide-area communications network, Shull says. But it changes the assumptions about provisions for speed and processing capacity that are built into a computer system.
Programmers take full advantage of what computer operating systems and brawny computer servers offer, and traditional applications often rely on an important division of labor between memory-laden personal computers and high-capacity servers, Shull says. That can lead to huge programs unable to move through an Internet-based network nearly as fast as one built for a Web-based world, which depends almost totally on remotely operated computer servers, he says.
CareStandard's search for the right stuff emphasizes the end result of a Web-based scheme, not whether pieces of it carry an Internet label, he says. Here are some central advantages in a network fundamentally based on an Internet approach:
* It serves as the basis for "anywhere, anytime" data-transfer capacity. The missing link in previous information strategies has been devising an easy and cheap method of putting valuable data in the hands of physicians and other healthcare professionals. Web browsers provide that link to authorized people wherever they may be, unlike applications that confine a user to PCs preconnected to a communications network.
* It imposes standards enforced, preserved and improved in a coordinated way. That advantage presumes an application is built on Internet technology from the ground up. Applications that are Web-enabled but not based on Web browsers may not necessarily be easy to change because their underlying computer architectures are still based on non-Internet schemes.
* It provides healthcare operations with the added benefit of universally upgrading the power and features of Web-based computer workstations and all the applications that run on them whenever browsers are upgraded for a particular application.