In-Depth

Web-to-Host Connections: A Healthy Alternative to Dial-Up Access

• By Joseph McKendrick
• 02/01/2001

Web to host holds great potential as a rapidly deployable e-business extender, EAI strategy or portal interface. However, the killer app that may launch Web to host as a mainstream technology exists at a far more basic level – as a cost-effective alternative to dial-up access. Yes, the Internet may rule, but millions of companies still support remote dial-ups from PC-based clients, with all the headaches that go with it – client maintenance and support, lost connections and high per-user charges. Why stick with dial-up? For many IT managers, this is still perceived as a far more secure form of remote access than the wild, woolly Internet.

Consider an industry that is a natural venue for dial-up access, where data security is not only vital to the business, but is also the law. In healthcare organizations, providing physicians or other healthcare workers with online access to patient health records may be a lifesaver, not to mention a cost-saver. However, putting patient data out on the Internet may run afoul of strict government privacy regulations. One healthcare organization had to go around this potentially litigious issue by putting data on an intranet, and requiring physicians to dial-in remotely to the intranet server.

The good news is that Web-to-host technology has moved to the point where it can replace dial-up access and address security issues. That’s how Henry Medical Center (Atlanta) was able to launch a new Web-based patient inquiry system, through which authorized physicians can access hospital information and check on their patients’ progress from a Web browser. It was a long, winding road to arrive at this solution.

Henry Medical’s goal was to improve the delivery of patient information from a mainframe-based SMS system to physicians’ offices, which were scattered throughout the region. Physicians and staffs spent valuable time waiting for hard copies and faxes, plus long delays on the telephone waiting for the staff to research information. "It wasn’t in realtime, so the information might be outdated by the time their office received the fax," says Susan Jarvis, RN, BS, CAPA, Clinical Information Systems Manager for Henry Medical. Physicians, most often, required data pertaining to medical history, allergies, test results and radiology information.

Jarvis originally considered direct dial-up access to the mainframe, but found the cost to provide emulation this way was prohibitive. Dial-up arrangements required installing software locally in every physician’s office, along with follow-up maintenance and support. Doctors are not computer experts, and do not have the time to spend finagling with modems and dial-up software. The costs for dial-up access typically run between $10 to $40 per user, per hour of connection time.

A more viable approach, once the security kinks were ironed out, was to provide Web-to-host access to the mainframe. In the initial rollout, about 80 physicians were provided access to the system, with plans to eventually extend to 200 end users. The system was configured to support about 25 concurrent sessions, since physicians’ access tends to be casual and intermittent.

The software, Attachmate’s Host Access Server, was built with Java Beans components that launch a terminal emulation session to acquire patient information from existing 3270 screens. A Windows NT-based Web server sits in the middle.

The system enables physicians to see patient list screens and may select an individual patient, or save all, or several, patients’ data to a queue for follow-up viewing. The Java Beans, which are host access objects, also are configurable as part of custom application development. Multiple face sheet screens, which contain basic patient information, are combined into one screen. A layer of security was also applied to the system to comply with government privacy regulations. System project leaders argue that by providing data in this form, there’s less of a risk of an intermediary pulling and printing the sensitive patient data. Additional benefits include reduced workloads for physicians and their staffs, as well as quicker access to life-saving information, says Jarvis.

In the future, Henry plans to look into providing mainframe data over wireless palmtops and cell phones. Such an implementation, "wouldn’t be a big leap," according to a representative of the project vendor, who notes that interest in wireless access is almost as prevalent in PC- browser access.