The Internet has dramatically changed the means by which information i
s obtained. Accurate, up-to-date information is vital to maintain the
quality of healthcare, especially as US healthcare delivery changes to
a primary care-based system. The availability of this new and potenti
ally vast source of information also affects strategies for medical de
cision making. In this article, use of online information in our medic
al center is discussed, together with the impact of a locally-develope
d decision support system. This system first contained components for
differential diagnosis as well as computer-assisted instruction. Initi
ally, online searching was limited to Medline literature searches. Thi
s component has now been expanded to include important new tools for a
ccessing medical information on the Internet. (C) 1997 Elsevier Scienc
e B.V.