Online CME Accreditation for PointofCare Learning Marc Edelstein

Online CME Accreditation for Point-of-Care Learning Marc Edelstein, MD, Ph. D 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 Med. Biquitous, April 2007. Point of Care Learning 1 Tufts Health Care Institute/Office of Continuing Education

What’s Happening in CME? n Calls for reform in CME n Inadequacy of traditional didactic CME to improve practice n CME’s goal: improve patient care – A broader definition of education, from: individual learning to: quality improvement n Evolution from Continuing Education to CPDContinuous Professional Development 2 Tufts Health Care Institute/Office of Continuing Education

CME Providers’ Mission: Shrink the Quality Gap n Mission: Deliver programs that provide physicians with implementable knowledge and skills… n so that measurable changes in competence (“knowledge-in-action”), performance, or patient outcomes can be demonstrated. 3 Tufts Health Care Institute/Office of Continuing Education

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

ACCME Expectations CME providers are expected to… n demonstrate progress towards implementation of these updated criteria by November 2008 … n and reach full compliance by 2012. 5 Tufts Health Care Institute/Office of Continuing Education

ACCME & AMA Approve “New Formats” of CME n 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. 6 Tufts Health Care Institute/Office of Continuing Education

References n AMA: AMA Physician's Recognition Award Booklet. 2006 revision – http: //www. amaassn. org/ama 1/pub/upload/mm/455/pra 2006. pdf n ACCME: New Formats of Continuing Medical Education. May 2005 – http: //www. accme. org/dir_docs/doc_upload/fd 31627 e -1510 -4 e 6 f-90 bb 67 b 0 adca 2 c 38_uploaddocument. pdf 7 Tufts Health Care Institute/Office of Continuing Education

Internet point of care (Po. C) CME The learner may – n Identify a question in practice; n Access new information from ‘trusted source(s); ’ n Integrate learning into patient care; and n Demonstrate what has been learned. n Earn 0. 5 credits per search 8 Tufts Health Care Institute/Office of Continuing Education

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

Tufts-Info. POEMs POC CME n Tufts is accrediting searches Using info. POEMs/Info. Retriever (Wiley) n Implementation requirements: – Contract (specs, funding) – Technical (POC site; credit tracking) – Testing 10 Tufts Health Care Institute/Office of Continuing Education

Info. POEMs® is owned by the publishing company John Wiley & Sons. Tufts Health Care Institute/Office of Continuing Education 11

Treatment Diagnosis Screening & prevention Prognosis Epidemiology Education 12 Tufts Health Care Institute/Office of Continuing Education

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Evaluation to claim POC CME n The Info. Retriever search(es) I completed help me make decisions about the care of one or more patients. (strongly agree…. strongly disagree) n Compared to other forms of acquiring CME, searching the literature with Info. Retriever and reflecting on the implications for practice is … (more/equally/less valuable) n Overall I would rate this CME activity as … (excellent…poor) n Please give one example of how a search did or did not affect your diagnosis, treatment, and/or patient outcomes. (free text) 18 Tufts Health Care Institute/Office of Continuing Education

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Challenges n Was the search truly patient-related? – Option: require additional information from user to identify patient age/sex/diagnosis n Was the information source valid (a “trusted source”)? – Accreditor must approve the search engine’s tools and processes n Was the search completed and documented? – Does the accreditor collect complete information from the search engine or just assertions from the user? 21 Tufts Health Care Institute/Office of Continuing Education

Contact Information n Marc M. Edelstein, MD, Ph. D, FAAP Chief Medical Officer and Co-Director Phone: (617) 636 -0347 marc_edelstein@tufts-health. com n Ralph Halpern, MSW Director, Content Development and Program Evaluation Phone: (617) 636 -3991 Email: ralph_halpern@tufts-health. com n http: //www. thci. org/ n 617 -636 -1000 22 Tufts Health Care Institute/Office of Continuing Education