All CME Must Have an Improvement Focus

October 27, 2008 at 11:31 pm Leave a comment

During the recent meeting of the National Task Force on CME Provider/Industry Collaboration Dr. Norman Kahn, Jr., Executive Vice President and Chief Executive Officer of the Council of Medical Specialty Societies made a compelling presentation on “The Important Role of CME in Impacting Patient Care”. In the presentation Dr. Kahn gave 12 reasons why the field of CME should move to “Performance Improvement CME.”

  1. Physicians can actually show improvements in quality measures in their practices.
  2. Evidence-based clinical practice guidelines actually move from “dust covered shelves” into real practice.
  3. Physicians will be involved in CME activities that actually improve patient care, countering recent criticisms of CME that doesn’t change practice.
  4. PI-CME is worth a lot of CME credit per activity, decreasing the burden on physicians to meet required CME credits.
  5. PI-CME is expected to qualify for Maintenance of Certification Part IV credit in all specialties.
  6. PI-CME is designed to qualify for Maintenance of Licensure, as MOL, is implemented each state soon.
  7. PI-CME enables physicians to be eligible for Pay for Performance in many programs currently, and more to come (CMS-PQRI, CO, NC, PA, others). .
  8. PI-CME is what practices will report when public reporting is required.
  9. CME providers will be a part of, if not leading, change that is coming anyway.
  10. PI-CME creates a “Culture of Improvement in medical practice, where physicians are continually measuring and improving the care they deliver, with documented improved outcomes.
  11. PI-CME fulfills the two primary tenets of professionalism: putting patients first (outcomes) and voluntary self regulation (minimizing external regulation).
  12. PI-CME may mitigate against threatening government inquiries into CME (Senate Finance and Aging Committees recently.

Perhaps one of the most compelling gains suggested by Dr. Kahn for physician participation in PI-CME was “improved quality of care within one year”. Most PI-CME initiatives will last less than one year during which time physicians will be engaged assessing the care they deliver, measuring against national benchmarks, comparing their performance with peers and documenting improvement over time.

I recently did a podcast with Dr. Kahn where we discussed PI-CME. You might find it interesting. Click here.

The ACCME considers CME as being synonymous with practice-based learning and improvement.

  • Activities are linked to practice-based needs (Criterion 2)
  • Content of CME matches the scope of the learner’s practice (Criterion 4)
  • Measurements of change in competence, performance or patient outcomes will be available (Criterion 11)

The ACCME requires that all CME be directly involved in performance improvement. That doesn’t mean all CME providers have to offer learners education designed to meet the AMA format of PI-CME. But accredited providers are required to show a report of the evaluation data and information about changes in physician learners’ competence, performance and/or patient outcomes.
All accredited CME providers are now required to be squarely in the health care quality improvement business. To be effective we must:

  • learn improvement “science”.
  • understand the tools used in improvement initiatives.
  • find partners to work with that are in the health care quality improvement business.
  • create cultures of improvement in our own CME operations.
  • Transform our overall CME programs into improvement focused operations.

Will CME lead, follow, or get left behind? If CME is ineffective in this challenge someone will supplant us and do do the job.


Entry filed under: ACCME, Accreditation, CME, CME Issues, Continuing Medical Education, Physician Continuing Education, Physician Education.

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