title: Innovative peer review model for rural physicians: system design and implementation.
abstract: BACKGROUND
  The peer review process in small rural hospitals is complicated by limited numbers of physicians, conflict of interest, issues related to appropriate utilization of new technology, possibility for conflicting recommendations, and need for external expertise.
  
  
  OBJECTIVE
  The purpose of this project was to design, test, and implement a virtual peer review system for small rural hospitals in Texas. We sought to define the characteristics of a virtual peer review system in the context of rural health care, and to explore the benefits from peer review administration within a rural network supported by a university.
  
  
  METHODS
  Physicians from small rural hospitals participated in pilot testing of the system. Policies and procedures reflecting the innovative character of the new peer review process were developed based on legal/regulatory requirements and desired educational focus of the process. An information technology system to support the virtual peer review was selected, tested, and deployed.
  
  
  RESULTS
  The system tests suggested feasibility of the procedures, reliability of the communication lines, and functional anonymity of the hospitals and physicians participating in the virtual peer review. Participating institutions and individual physicians expressed satisfaction with the reliability and user friendliness of the system as demonstrated during the pilot tests.
  
  
  CONCLUSIONS
  Hospital licensing and accreditation require a process to monitor and evaluate the care of patients. Utilizing means of virtual communication is a viable option for small rural hospitals. This process is dependable, user-friendly and provides functional anonymity to participating hospitals and physicians. The peer review system has successfully functioned since 2004.
authors.affiliation: Rural and Community Health Institute, The Texas A&M University System Health Science Center, Bryan, Texas 77802, USA.
authors.forename: Josie R
authors.initials: JR
authors.lastname: Williams
authors.forename: Kathy
authors.initials: K
authors.lastname: Mechler
authors.forename: Ralitsa B
authors.initials: RB
authors.lastname: Akins
mesh_terms: D004059:Diffusion of Innovation; D006780:Hospitals, Rural; D006801:Humans; D008962:Models, Theoretical; D010380:Peer Review / Q000379:methods*; D010820:Physicians / Q000592:standards*; D010865:Pilot Projects; D016730:Program Development; D011787:Quality of Health Care; D012424:Rural Population; D013781:Texas