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FROM ACCREDITATION SURVIVAL TO COMMENDATION
Session I: How To Plan CME Activities That Fit Into The “Big Picture”
February 20, 2008 2:00PM ET
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FROM ACCREDITATION SURVIVAL TO COMMENDATION
Session I: How To Plan CME Activities That Fit Into The “Big Picture”
February 20, 2008 2:00PM ET
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FROM ACCREDITATION SURVIVAL TO COMMENDATION
Session I: How To Plan CME Activities That Fit Into The “Big Picture”
February 20, 2008 2:00PM ET
Please take a moment to answer the poll question be low.What is your member section?
Hospitals/Health Systems Medical Schools Medical Specialty Societies State Specialty Societies Commercial SupporterFederal Health Care Educators Health Care Education Associations Medical Education and Communication Company Other
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• The Alliance for CME subject-matter experts, your faculty today, have an 8-step process for you to follow to deliver compliant activities, based on ACCME’s updated criteria.
• Print this out.• Use this as your guide.
The “Alliance Eight”
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• Vertically integrated health care system• 18 hospitals, 6000 physicians of all specialties• Since 2005, fully self funded CME program-we
do not accept funding from industry to support CME
Carol Havens, MDDirector of Clinical Education
Kaiser Permanente Northern California
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• Define your mission– Credit or improved patient care?
Step 1
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• Planner begins program• You figure out how to fill in the blanks on
the CME application so the elements are in compliance
• Activity evaluation is mainly assessment of faculty
If primary mission is credit…
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• Your conversation with your planner is very different
• How would anyone know what is your primary mission?
If primary mission is improving care…
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What’s your elevator story?
• How would you describe the value you bring to your organization/physicians?
• Which story better illustrates who you are– X activities for X credits for X physicians with an
average evaluation of 4.5– Story of an activity which improved outcomes
Step 2
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• Updated Criteria provide the framework to develop the story
• You need to partner with enthusiastic physicians and other to develop the activities which become the story
• You need to tell the story to everyone with whom you interact
How do you get the story?
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• Professional membership organization for physicians in Texas
• Content of CME– Primarily practice management, risk management,
professional responsibility. Some clinical at annual meeting.
Billie L. DalrympleDirector of CME
Texas Medical Association
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• Get your Leadership (CEO, BOT, Education Committee, Program Planning Committee, Current/Future Course Directors) to support your CME program– Organization is accredited, not just CME office/committee
• “CME/I can help you improve patient care.”• CME is a valued resource for early-career physicians.
They desire CME to prove competence and performance to:– Secure additional privileges at their hospital– Broaden their scope of practice– Take their career to the next level
Step 3
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• Leadership buy-in– Component of strategic plan– Leadership training – council/committee chairs/staff
aware of CME as mechanism to further charge and address priority issues
• CME can help you!– Attitude that there is an educational component in
resolving any problem– Requires knowledge of activities of your org – what’s
on the dashboard today?
At TMA
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• CME as a valuable resource for early-career physicians
• Electronic Medical Records(EMRs)(2007, four 3-hr seminars)– Gap: required quality reporting initiatives on horizon high # of
medication errors & malpractice claims (nat’l data); TMA 2005 survey – 30% of TX physicians use EMRs
– Need: recognize benefits of EMR re patient care; skills to select; skills to implement
At TMA
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• Barriers: cost; downtime to implement; patient privacy• Outcomes: Could have….
– Asked learners to list new skills (Competence)– Followed-up to ID actual implementations (Performance)
• Reinforced by: – enduring material (booklet/CD); – available 1-hr live sessions for hosp/county med societies;– web-based modules– articles in Texas Medicine (not CME)
– With Improved evaluation• What is current status of your office re EMRs?• What do you hope to gain by using an EMR system?
(List of 13 improvements to choose from.)
EMRs at TMA Continued
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• Need Assessment: The CONVERSATION with your Course Directors/Planners needs to change!
• Begin with a discussion about:– Their practice “headaches”– Patients who keep them up at night, etc.
• What data support the “problem” your physicians want to solve?
• You need to help your physicians discover what they don’t know as a safe, non-threatening partner in education.
Step 4
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Example: Medicare and Medicaid– Advocate for Medicare/Medicaid patients and their doctors– Planners: TMA reimbursement specialists, Council on
Socioeconomics; Trailblazer (Texas Medicare Carrier) – regular meetings
– Data: Nat’l/state laws & policies; local stats re ratio M/M patients/physician; TMA biennial surveys; focus groups
– Gap: Reimbursement rates for M/M care lower than other insurance carriers; new rules, e.g. NPI numbers; fewer phys taking M/M patients
– Action: CME part of advocacy plan, e.g. annual updates since 1981 on new rules; moving to more defined outcomes (e.g I am able to apply for NPI – yes or no. If no, what other info do you need?)
Needs Assessment @ TMA
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• Non-Profit Physician Membership Organization• Specialty Societies
Ed Dellert, RN, MBAVice President, Educational ResourcesAmerican College of Chest Physicians
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About ACCP• Founded in 1935• Organizational mission: “To promote the prevention and
treatment of diseases of the chest through leadership, education, research and communication.”
• Represents a multiprofessional and multidisciplinary international medical discipline consisting of adult & pediatric pulmonology, adult & pediatric critical care medicine, sleep, cardiology and cardiothoracic surgery.
• One of 267 Non-Profit (Physician Membership Organizations)
American College of Chest Physicians
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Non-Profit Physician Member Organization Data
Non-Profit Physician Membership-Financial
• Commercial Support (15%): $179,932,423• Advertising & Exhibit (82%): $199,895,535• Other (43%): $403,171,634
• Total Income (33%): $782,999,590• Total Expense (29%): $535,217,267• Total Net Income (44%) $247,782,323
Non-Profit Physician MembershipEducational
• 16,586 (23%) total directly sponsored activities
• 5,052 (23%) total jointly sponsored activities
• 1,780,789 physician participants (25%) in directly sponsored activities
• 214,317 physician participants (17%) in jointly sponsored activities
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Emphasis Upon Faculty Impact Upon Educational Models
Step 5
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Identify Clinical Domains, Diversify Educational Methodologies, and Correlate with Impact upon CME Program Educational Mission
Step 6
Educational Domain
Learning Category I:Traditional Education & Learning
Learning Category II:Self-Directed Learning
Learning Category III:Evidence-Based Learning
Learning Category IV:Case & Problem Based Learning
Learning Category V:Experiential Simulated Learning
Learning Category VI:Quality Improvement & Learning
Clinical Domain1. Allergy and Airway2. Chest Infections3. Disorders of the Pleura
4. Lung Cancer5. Obstructive Lung Disease6. Sleep Disorders
7. Pulmonary Physiology8. Cultural Diversity9. Transplantation
10. Imaging
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• University of Virginia School of Medicine• Nationally accredited with commendation• 230 activities/year• CME Affiliate and Outreach Program• Joint Sponsorships• Web-based activities
Jann Balmer, RN, PhD, FACMEDirector, CME
University of Virginia School of Medicine
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• Formats: Use mixed methods for content delivery, along with multiple exposures to the content by the learner for a single CME Activity.
• Especially consider the value of case-based learning:– A critical component to make your CME activity a
pathway for physicians to make a change in practice behavior (online v. didactic).
• Create “Memory Hooks” for your learner
Step 7
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• Cardiovillage.com– web-based interactive educational program– multi-media approach includes tutorials, case studies, synthesized literature
• Convert content from cath conferences etc
• Links to live activities, print resources, etc
Example: Cardiovillage
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• Study– Evaluate and decrease time from ED to Cath Lab
• Compared live and web-based educational interventions—
• Cardiovillage web-based intervention was combination of tutorial and case studies
• Documented decrease in time from ED-CathLab–
Institutional Study
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• Large Internal Medicine Course -250 participants
• Incorporate case studies as part of course content
• Track questions from Q &A sessions-create as FAQ on website– email link to participants
Live Conference Example
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Bottom Line: Your role as a CME professional is to take great scientists and content experts and help them become superior communicators and educatorswho provide opportunities (through your CME activity) to make others (your CME participants) even greater physicians and providers of patient care.
Step 8
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Please submit your questions at this time.
Q&A
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Next Session: How To Write a Mission Statement & Stick To It
Wednesday, April 16, 2008 at 2:00 PM ET
Alliance for CME PACME Spring Summit
Upcoming Programs
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Thank you!