A PERFORMANCE COMPARISON OF COMMUNICATION LINKS BETWEEN RURAL HOSPITALS AND A DIGITAL HEALTH-SCIENCES LIBRARY

Background: Rural physicians need access to digital health sciences li braries (DHSLs) that is easy and reasonably rapid. The goal of this pr oject was to study rural hospitals' access to a DHSL on the Internet, by comparing differing access speeds with differing costs and their ac ceptability for retrieving text, image, and video information in a DHS L. Methods: DHSL system response time was measured at three different times during the day over three different types of network connections (T1, Frame Relay, Modem). Text, image, and video information was retr ieved. Costs were determined for installation and operation of the dif ferent types of network connections. Results: System response times we re consistent at the three different testing times for each media type retrieved by each of the three network connection types. System respo nse times for text retrieval met literature standards for all connecti ons. Image retrieval met literature standards for T1 and Frame relay c onnections. No connection met literature standards for video retrieval . Conclusions: High speed access to DHSLs is preferable; Frame relay c onnections provide substantively similar service as T1 connections at less cost. However, access via modem to a DHSL can provide access to t he majority of information-text-in a DHSL with an acceptable system re sponse time.