In 1990, the College of American Pathologists Informatics Committee surveyed 14,785 laboratorians for their experiences with a clinical laboratory information system. A 16.25% response rate was achieved, representing 2402 questionnaires that were analyzed. Despite the perceived satisfaction of the clinical laboratory information system users with more expensive systems, no economy of scale was demonstrated with increasing system cost through either laboratory staff reduction or increased number of specimens per day. The strongest predictors of system satisfaction were (1) vendor success measured by number of installations and (2) a selection process that involved the pathologist/laboratory director and included a formal request for proposal. The need for integration of clinical laboratory information systems with hospital information systems, as well as the universal adoption of standard productivity terminology, including work load units, was evident.