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Online CME Accreditation for Point-of-Care Learning

Online CME Accreditation for Point-of-Care Learning . Marc Edelstein, MD, PhD Chief Medical Officer and Co-Director, Tufts Health Care Institute and Tufts University School of Medicine Office of Continuing Education Ralph Halpern, MSW Director, Content Development & Program Evaluation

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Online CME Accreditation for Point-of-Care Learning

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  1. Online CME Accreditation for Point-of-Care Learning Marc Edelstein, MD, PhD Chief Medical Officer and Co-Director, Tufts Health Care Institute and Tufts University School of Medicine Office of Continuing Education Ralph Halpern, MSW Director, Content Development & Program Evaluation Tufts Health Care Institute MedBiquitous, April 2007. Point of Care Learning

  2. What’s Happening in CME? • Calls for reform in CME • Inadequacy of traditional didactic CME to improve practice • CME’s goal: improve patient care • A broader definition of education, from: individual learning to: quality improvement • Evolution from Continuing Education to CPD- Continuous Professional Development

  3. CME Providers’ Mission: Shrink the Quality Gap • Mission: Deliver programs that provide physicians with implementable knowledge and skills… • so that measurable changes in competence (“knowledge-in-action”), performance, or patient outcomes can be demonstrated.

  4. ACCME’s Updated Accreditation Criteria, 2006“CME as a Bridge to Quality” Accredited providers shall: • Focus on improving one or more of physician competence, physician performance, and/or the physician’s patient outcomes. • Provide CME activities based on practice-based and learner-based needs. • Evaluate success at meeting their change mission. • Engage with their environment to enhance the role of their program and of CME in promoting quality and safety.

  5. ACCME Expectations CME providers are expected to… • demonstrate progress towards implementation of these updated criteria by November 2008 … • and reach full compliance by 2012.

  6. ACCME & AMA Approve “New Formats” of CME • Accredited CME providers can now designate credit for • internet searching and learning, or point of care learning, • performance improvement activities, • test-item writing, • manuscript review.

  7. References • AMA:AMA Physician's Recognition Award Booklet. 2006 revision • http://www.ama-assn.org/ama1/pub/upload/mm/455/pra2006.pdf • ACCME: New Formats of Continuing Medical Education. May 2005 • http://www.accme.org/dir_docs/doc_upload/fd31627e-1510-4e6f-90bb-67b0adca2c38_uploaddocument.pdf

  8. Internet point of care (PoC) CME The learner may – • Identify a question in practice; • Access new information from ‘trusted source(s);’ • Integrate learning into patient care; and • Demonstrate what has been learned. • Earn 0.5 credits per search

  9. Examples: Internet point of care (PoC) CME • Structured, self-directed, practice-based learning in support of specific patient care. • MD uses a computer-based clinical decision-making support tool at the point of care. • A reflective process in which physicians must document 1)their clinical question, 2)the sources consulted and 3)the application to practice. • Even when the recommendation is not appropriate for the patient, the physician still learns something in the process.

  10. Tufts-InfoPOEMs POC CME • Tufts is accrediting searches Using infoPOEMs/InfoRetriever (Wiley) • Implementation requirements: • Contract (specs, funding) • Technical (POC site; credit tracking) • Testing

  11. InfoPOEMs® is owned by the publishing company John Wiley & Sons.

  12. Treatment Diagnosis Screening & prevention Prognosis Epidemiology Education

  13. Evaluation to claim POC CME • The InfoRetriever search(es) I completed help me make decisions about the care of one or more patients. (strongly agree….strongly disagree) • Compared to other forms of acquiring CME, searching the literature with InfoRetriever and reflecting on the implications for practice is … (more/equally/less valuable) • Overall I would rate this CME activity as … (excellent…poor) • Please give one example of how a search did or did not affect your diagnosis, treatment, and/or patient outcomes. (free text)

  14. Challenges • Was the search truly patient-related? • Option: require additional information from user to identify patient age/sex/diagnosis • Was the information source valid (a “trusted source”)? • Accreditor must approve the search engine’s tools and processes • Was the search completed and documented? • Does the accreditor collect complete information from the search engine or just assertions from the user?

  15. Contact Information • Marc M. Edelstein, MD, PhD, FAAP Chief Medical Officer and Co-Director Phone: (617) 636-0347marc_edelstein@tufts-health.com • Ralph Halpern, MSW Director, Content Development and Program EvaluationPhone: (617) 636-3991Email: ralph_halpern@tufts-health.com • http://www.thci.org/ • 617-636-1000

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