This software is often expensive to license and from what I understand heavily patent protected (like much educational software), making it an absolute minefield to enter unless you're a massive publisher or similar.
I would have thought putting multiple choice questions online (internet or intranet) would be incredibly easy. Infact, I've done so myself.
A number of apps have been built to address this (remember "bump" technology for example), but most have fallen out of favor. Until there is near-universal adoption of some kind of alternative, I'll have to keep carrying around business cards...which just seems silly...