An interview with UpToDate appears in the Journal of Electronic Resources for Medical Libraries v. 2 (4) 81-92 2005.

I think Elizabeth Connor did a good job asking some of the very questions that many librarians would have asked UpToDate. After reading the interview I have some questions regarding UpToDate's answers. Will anybody from UpToDate read this and respond? Who knows...probably not, but I want to get my thoughts and questions out there.

1. Regarding the perceived high cost of UpToDate, Connor asks whether libraries need to focus on the price per use, collect more rigorous usage statistics, and participate in group purchasing.
   
   UpToDate response: "Studies that compared use of various resourses indicated that on a price per use basis UpToDate was the least expensive resource by far, simply because it was used so often."
   
   Krafty's question:
   When you look at it from the price per use perspective I can see that it can be a very good value. However, it costs even some of the smallest hospitals over $10,000 for access and is quite possibly the most expensive of any single product for that small hospital library. Quite clearly your product is sometimes out of the budget of the library. Given its price and its burden upon library budgets has UpToDate trancended libraries all together and has become more of a hospital product to considered and purchased similar to other system critical hospital programs such as electronic medical record or patient scheduling software? It is appropriate for UpToDate to be even marketing to libraries any more?
   Second, you never answered the last part of the Elizabeth Connor's question regarding group purchasing. So I ask, since you base your price on the number of FTE physicians isn't participating in group purchasing pointless? Do you think this hurts you and don't you think you would get more hospitals signing up if you offered group purchasing?
   
2. Conners asks what the future holds for UpToDate, specifically in regards to clinical information systems and handheld technology.
   
   UpToDate response: "We are currently experimenting with electronic medical records providers as one area where clinical content can combine with patient information to affect patient care."
   "Beyond Pocket PCs, we are actively developing a version of UpToDate that can be installed and used on Plam handhelds. Although it is not widely known, hospitals and practices that have wireless networks can access UpToDate http://www.pda.uptodate (krafty librarian note, that url does not work) for handheld appropriate format, including some Palm handhelds with Web browsers that fully support both HTML and cookies and connect to the Internet. "
   
   Krafty's questions:
   I realize and understand that because of your competitors you perhaps may be reluctant to divulge too much about your expermintations with electronic medical records. However, could you please go into a little more depth about what plans you might have with integrating UpToDate into the medical record? We already know MDConsult's is looking at integrating customizable formularies and order sets in iConsult to work within the hospital's EMR. Are you working with hospitals as well while creating your EMR component?
   From your answer you it first appeared to me as if you offer institutions access for handheld devices. However, when I called my UpToDate rep today (December 14, 2005) she mentioned that the handheld product was not for institutions but for individuals. She said once our hospital had wireless access, then our doctors who had handheld devices (mainly those with Pocket PCs) could access UpToDate using the hospital's wireless network. In my opinion this type of access is not unlike a person accessing UpToDate from their wireless lap top in the hospital and is not exactly a handheld product. Additionally, whether it is a type o' or not, it is important to know that the URL given in your response does not work. Institutions who have wireless access and have users who want to access UpToDate with their wireless device should go to http://www.utdol.com . When compared to its competitors it appears UpToDate has been very slow to create a cross platform handheld product and institutional access for handheld devices. Why is this the case? Do you think this could impact the popularity of your overall product?
   
   
3. Connors did not ask specifically about institutional access from home, but I would like to know your theories and any statistics you might have supporting your policies and charges for institutional access. One of the major complaints libraries and hospitals have with UpToDate is regarding home access for institutional subscribers. Do you have any statistics specifically showing that you would lose individual sales if you provided institutions with at home access? Do you feel you your policies and prices for home access for institutional users could backfire and cause doctors, hospitals, and librarians to look at your competitors a little more and perhaps choose them over you?

These are just some questions and statements I have regarding UpToDate. The interview with Elizabeth Conner was very interesting and I recommend it to other librarians. I welcome anybody elses thoughts on the subject. Perhaps you can shed some light on some of the issues I ask.