Exactly how to provide education-related Internet access without supporting recreational use of the web has become a serious issue in health science institutions. In order to determine how they are responding a question was posted the early Fall of 1996 to LISTSERVS for academic health science library directors [AAHSL] and medical educators [DR-ED] requesting information on provision of SLIPP/PPP connections by their institutions. Specific questions asked for information on whether the University made one or both of these services available, if the University provided modems [and how many] or contracted with an Internet Service Provider (ISP), charges to patrons, any limitations on use, and problems encountered.

Responses from 52 institutions were supplemented with data from three institutions that provided the information in other ways. The responses varied widely in the amount and precision of information given yet yielded information that should be useful as medical organizations grapple with this issue. The summary figures are: Yes, we provide SLIP OR PPP lines:Through an institutional modem bank: 36Through contract with an ISP: 6

Do not provide SLIP/PPP: 9Planning to provide SLIP/PPP: 4

There are many differences in how the services are provided. A few institutions have both internal modems and access via contract with an ISP. The majority of health science centers reporting internal modem banks said they were provided through the main university computer center. Others are migrating from internal modem banks to an ISP contract. Respondents from several schools that have modem pools recommended outsourcing.

Since the number of modems reported [from 8 to 1000] came primarily from main university computer centers, the majority of this data was not applicable to a health science university. Regarding user fees, the most frequent situation was that students and faculty had free and unlimited use of the SLIPP or PPP lines. A few schools charged technology fees in the $100 range. Reported limits on use ranged from 20 to 50 hours a month. One institution had two types of lines: one with a 15-minute session limit which was usually available and one with no time limit which was often busy. Others had user group differentials in charging and a few schools reported that some departments subsidized the fees for their faculty.

No institution reported subsidizing the fees of the ISPs. The fees negotiated for faculty and students were generally lower than the going commercial rate of $20/month for unlimited use. At least four schools are using the MCI academic program and one reported the MCI cost to be $12/mo. The range was $10 [no limits reported] to $16 for up to 50 hours/month. One school's contract guaranteed 95% availability and another a 20:1 modem to user ratio.

Schools that charged reported fewer problems than those that did not charge. Many of the latter group are having difficulty keeping up with the demand. Several persons noted that the saturation time was evenings. The number of services available through the SLIP or PPP connection makes a difference in usage patterns. Lack of support was cited as a major problem. A not-so-hidden cost is phone charges which can be substantial for persons living, working or studying outside the primary area code. These costs drive many users to ISPs even when the institution has free access. However, normally ISP users cannot use fee-based services or the Intranet because the services themselves are restricted to persons coming from a defined set of IP addresses. The solution is to contract with an ISP who will allocate IP addresses specific to the institution.

SLIP/PPP access is a "work in progress", as one respondent wrote, in most academic medical centers. Results of an update to this survey to be performed in the Spring of 1997 will be reported.