The learning management system (LMS) has become a critical tool for nearly all institutions of higher education, and a driving force in online learning. According to a 2014 report by the Educause Center for Analysis and Research, 99% of higher education institutions have an LMS in place, and the LMS is used by 85% of faculty and 83% of students. This was not always the case, however. There was a time in the not-so-distant past when using an LMS was considered highly innovative. Understanding the growth and adoption of the LMS is a stepping stone to understanding how faculty may choose to adopt other technological and pedagogical innovations. This study was conducted at a large, research-intensive public university in the Midwest, which has used the same LMS for 15 years. From a small pilot, adoption has grown to nearly universal use. This study used system logs and database queries to examine how faculty used the LMS. The results identified the features that were used most frequently and how usage had changed over time. In addition, the study compared the usage data for face-to-face and online courses to determine if there are differences in LMS use due to course modality. Based on this, it is possible to better understand the role the LMS plays in higher education and online learning, to inform development of next generation learning systems or other innovative technologies.

A distinction between the provision of information and the practice of medicine is essential to oversight of online medical care.by Tracy E. Miller and Arthur R. Derse ABSTRACT: An emerging consensus supports online communication between patients and physicians in an existing relationship to improve the quality, timeliness, and efficiency of medical care. Patients are also seeking medical care online from physicians they have never met, ranging from one-time interactions for a second opinion to psychotherapy. These practices call for a new regulatory paradigm to ensure accountability, establish acceptable parameters for online medical practice, and distinguish online health care delivery from online health information. The new patient-physician encounters also challenge the medical profession and society to reexamine core assumptions that define medical practice and the patient-physician relationship.T h e e m e r ge nc e o f t h e i n t e r n e t portends a dramatic shift for health care and the relationships of patients and physicians. The most immediate impact of the Internet has been consumers' access to an extraordinary array of information online. Despite broad variation in the quality of information, the Internet offers far-reaching potential to engage patients more fully as partners in medical decision making and in their course of treatment. 1The policy dilemmas posed by the range in the quality of online information, e-health sites' lack of transparency, and concerns about the privacy of patients' information elude simple public solutions but have been well aired in the policy arena. 2Unfolding at the same time, but more slowly and with less public scrutiny, is the practice of medicine online. As highlighted in a recent report by the Institute of Medicine (IOM), online communication between patients and physicians can improve health care quality, making health care delivery more effective, patient-centered, and timely. Indeed, while office visits will remain fundamental 1 6 8 J u l y /A u g u s t 2 0 0 2

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