Hi, Just wanted to provide some feedback on our experience. We have had an on site-only subscription to UpToDate since 2003. In the first few years of the subscription, the price increases were out of line with our budget increases and usually about 20% although the price was flat for one year. Last year however, the price increase was about 90% and this year again the price increase is 90%. If we continue next year, we'll be paying six times our original subscription cost. We're now at the point where we may need to begin canceling other portions of our collection to support this product. We have tried to negotiate better pricing and terms for this product and have never had any success - our experience (which begins with me and goes on up through the library director to the dean of the medical school) is that they don't negotiate. Regarding the content, it's quite good, as is DynaMed. However, there is a strong brand preference for UpToDate, particularly in the medicine department, that seems to greatly outpace any comparison of content. We're now in a very difficult position - the product is very popular and very highly used and has some very vocal, powerful supporters, and it's also expensive and unpredictably priced. From a business perspective, we would like to cancel. From a user/usage perspective, it's a great product. Best of luck! Laura Abate I evaluated Clin-eguide, Zynx, MDConsult, Up-to-Date and Dynamed. I chose Ciln-eguide for our hospital system because it utilized much of the other content we were buying from Ovid. It is very nice system and easy to use. MDConsult was my second choice. I really liked content. Unfortunately, a third part URL link resolver is necessary to access other electronic content. Zynx was not very impressive, but it is a choice because it comes packaged with Order sheets software that works with our ERM system. The content is very limited. Dynamed was ok but not impressive. My next to last choice. I really disliked Up-to-Date. The salespeople are very difficult and take every opportunity to go over your head or to others in organization to sell product. They limit access to hospital computers only and are real difficult with making you prove that technology limits access. This alone killed deal for us because our doctors needed to use from offices and homes. They only provide thier product with no additional content. Several of the other systems have plenty of content that can be added. They had the highest prices, I thought outrageous. They provide content for only a few specialities and we have many areas that they did not cover. You might ask if they do anything in the area of Pathology. Summed up, the least for the most. Of course all of this is just my opinion. I would get trials and do some "live" searches and see what you think. Paul Deane Medical Librarian Alexian Brothers Medical Center Medical Library 800 Biesterfield Elk Grove, IL 60007 847-437-5500 X4750 847-981-5922 Fax [log in to unmask] Cleo Wilkinson | Library | Sullivan Nicolaides Pathology P +61 (07) 33778525 | E [log in to unmask]