title: A performance comparison of communication links between rural hospitals and a digital health sciences library.
abstract: BACKGROUND
  Rural physicians need access to digital health sciences libraries (DHSLs) that is easy and reasonably rapid. The goal of this project was to study rural hospitals' access to a DHSL on the Internet, by comparing differing access speeds with differing costs and their acceptability for retrieving text, image, and video information in a DHSL.
  
  
  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 retrieved. Costs were determined for installation and operation of the different types of network connections.
  
  
  RESULTS
  System response times were consistent at the three different testing times for each media type retrieved by each of the three network connection types. System response times for text retrieval met literature standards for all connections. Image retrieval met literature standards for T1 and Frame relay connections. No connection met literature standards for video retrieval.
  
  
  CONCLUSIONS
  High speed access to DHSLs is preferable; Frame relay connections provide substantively similar service as T1 connections at less cost. However, access via modem to a DHSL can provide access to the majority of information--text--in a DHSL with an acceptable system response time.
authors.affiliation: Department of Radiology, University of Iowa, College of Medicine, Iowa City 52242, USA. michael-dalessandro@uiowa.edu
authors.forename: M P
authors.initials: MP
authors.lastname: D'Alessandro
authors.forename: D M
authors.initials: DM
authors.lastname: D'Alessandro
authors.forename: J B
authors.initials: JB
authors.lastname: Kash
authors.forename: D A
authors.initials: DA
authors.lastname: Jurca
authors.forename: D S
authors.initials: DS
authors.lastname: Wakefield
authors.forename: S J
authors.initials: SJ
authors.lastname: Schallau
authors.forename: J R
authors.initials: JR
authors.lastname: Galvin
authors.forename: W E
authors.initials: WE
authors.lastname: Erkonen
mesh_terms: D003365:Costs and Cost Analysis; D005069:Evaluation Studies as Topic; D006780:Hospitals, Rural / Q000191:economics; D016247:Information Storage and Retrieval; D020407:Internet / Q000191:economics; D007993:Libraries, Medical / Q000191:economics; D013685:Telecommunications / Q000191:economics; D013997:Time Factors; D014584:User-Computer Interface