Abstract: A system and computer implemented method is provided to determine a need for a medical examination. The system includes a computerized device and a database accessible using an interface. Some data may include information about a patient that may be definable by a user. The system may also include a rules engine operated by the computerized device to manage rules and to retrieve the data from the database, retrieve the rules stored in the database relating to the need for the examination of the medical condition by a specialist practitioner, and compare the data that is retrieved with the rules to determine a need for an initial examination. Findings from the initial examination are storable in the database, and the findings are retrievable to be compared with the rules to determine a need for a subsequent examination.