The future of CME

Quality improvement CME gets thumbs up

After a pilot program that allowed physicians to earn CME credit for improving quality in a practice setting proved successful, the American Medical Association in September 2004 modified its standards so that accredited CME providers could offer practice-based performance improvement activities. As a result, doctors should start seeing more CME options that allow them to earn credit for integrating quality improvement into their clinical practices.

It’s the latest in a series of efforts to make CME more interactive and a part of physicians’ practices. For example, the AMA and American Academy of Family Physicians previously have supported CME credits for looking up answers to clinical questions in handheld computers.

The Centers for Medicare & Medicaid Services rolled out the performance improvement CME pilot in April 2003. To participate, physicians need to implement a quality improvement intervention in one of three areas — diabetes management, breast cancer screening, or influenza and pneumococcal immunization. Doctors then use performance measures to track the success of their care and adjust interventions if there is no improvement. Physicians earn up to 30 credits in the first year if they participate in all three interventions.

The AMA randomly surveyed 15% of the 4,000 doctors who participated in the pilot in 2003. About 82% of doctors found the CME materials at least somewhat helpful, 90% were satisfied or very satisfied with the program, and 95% found it to be a positive experience.

Recent studies (including this project) are bringing the education back into CME. Such studies avoid equating brilliant lectures with education. Teaching does not necessarily induce learning.

We (UAB CME) have spent that last several years trying to understand how to help physicians learn. Quality improvement projects represent one excellent example of a technique which works.

The future of CME must link education (and thus patient outcomes) with method. This study looks promising.