Distribution of a primary care office information system

Primary Care Office InSite (PCOI) is a Web-based intranet application that provides ready access to a collection of information useful in primary care. The PCOI Web site was developed by, and is widely used within, the Massachusetts General Hospital (MGH) and its affiliated community practices. Over 1600 users logged 60,000 separate sessions in the past year. The site contains clinical practice guidelines, patient educational material, drug prescription and cost information and referral information, all designed for use during routine patient care activity. This paper discusses the problems encountered and the lessons learned during an ongoing experiment to disseminate PCOI via the Internet to four distant and very different ambulatory care sites. None of these sites (a rural community hospital, a city-wide health care network, an inner-city general hospital, and an Indian Health Service hospital have the resources to develop such an application internally.