The nurses are clearly on to something. Four years after they started the Kansas Primary Care Nurse Practitioner Program, almost 250 nurse practitioners have graduated. Two-thirds of them practice today in underserved rural areas. Most of the rest work in low-income clinics in the inner city. Indeed, the Kansas program has proved so successful that it is fast becoming a model for delivering basic health care in rural areas across the U.S.

Like an old-fashioned barn raising, it took the skills and hard work of hundreds of people to turn this vision into reality. Four different nursing schools pooled their resources to make classes available to students all over Kansas via compressed video, a medium that digitizes both visual images and sound, then "compresses" the information for transmission over high-speed telephone lines to specially configured television sets. But if any two people can be said to represent the heart and soul of the program, they are Helen Conners, 54, and Gemma Doll, 48.

An associate dean at the University of Kansas School of Nursing in Kansas City, Conners is that rarest of all professionals, a bureaucrat who is also a successful innovator. She conceived the idea for the long-distance educational program, drummed up the seed money and shepherded the concept through countless meetings and strategy sessions. "I've always enjoyed thinking about new ways of doing things," Conners says. "Once we got started, the whole thing just kind of snowballed."

When it comes to teaching medical techniques, of course, some of the instruction has to be hands-on, and that is where people like Doll come in. A longtime nurse practitioner from Garden City, Doll also happens to be a Dominican sister who lives in a modest home with two other members of her order. By day, Doll works for two community-health clinics that care for about 1,300 children, most of them Mexican American, whose parents may work but may not necessarily have insurance. In the evening she teaches local nurse-practitioner students how to suture wounds, treat joint injuries and interpret X rays, among other things. "The call to nursing came first, followed by the spiritual call," she says. "Ever since I was in the first or second grade, I've wanted to reach out and help others."

What links these two women--and dramatically shrinks the distance from Kansas City to Garden City--is one of the shrewdest applications of telecommunications technology that can be found anywhere in medicine today. In 1995 Kansas extended its network of high-speed telephone lines to reach Garden City specifically so that St. Catherine Hospital, a local 132-bed facility owned by the Dominican Sisters, could set up a compressed-video classroom and become part of the statewide nurse-practitioner program. "It breaks the isolation," says Doll, who sits in on her students' classes at the hospital. "It keeps us abreast of all the latest things."

Other health-care experts have championed various kinds of satellite broadcasts, which can cost $2,000 an hour, for long-distance learning. But the Kansans' choice--compressed video-- costs just $30 an hour. Its quality is almost as good as satellite TV, enabling students and teachers to interact with only a slight, almost imperceptible lag. And since transmission occurs over telephone lines, the cost of adding on to the network is relatively low.