A medical information networking system between practitioners and academia.

This paper reports on a one-year experience with an information networking system (MIS) between 47 rural practitioners and an academic center. Physicians were invited to phone in non-emergency clinical questions specific to daily practice needs to a telephone answering service located in the medical school library. Two-hundred-forty questions triggered by patient visits, colleagues, local rounds, allied health or local professionals, and on-site administrative meetings were forwarded to the MIS. All inquiries were classified according to the International Classification of Disease-9th Revision-Clinical Modification, and categorized into three areas of practice: diagnostic/investigative, general treatment, and pharmacology (therapeutics). The paper outlines how specific practice questions are being screened and adopted for decisions relating to four current activities which assist the ongoing maintenance of competence: 1) CME program planning, 2) residency/undergraduate curriculum development, 3) individualized CME for specific practitioners and sites, and 4) future CME research. The physician inquiries represent true needs in rural medical practice and as such should be given high priority in programs and assessments addressing the maintenance of competence.