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Tufts Health Care Institute/Office of Continuing Education
Online CME Accreditation for Point-of-Care Learning
Marc Edelstein, MD, PhDChief Medical Officer and Co-Director,
Tufts Health Care Institute and Tufts University School of Medicine Office of Continuing Education
Ralph Halpern, MSWDirector, Content Development & Program Evaluation
Tufts Health Care Institute
MedBiquitous, April 2007. Point of Care Learning
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Tufts Health Care Institute/Office of Continuing Education
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
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Tufts Health Care Institute/Office of Continuing Education
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.
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Tufts Health Care Institute/Office of Continuing Education
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.
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Tufts Health Care Institute/Office of Continuing Education
ACCME Expectations
CME providers are expected to… demonstrate progress towards
implementation of these updated criteria by November 2008 …
and reach full compliance by 2012.
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Tufts Health Care Institute/Office of Continuing Education
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.
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Tufts Health Care Institute/Office of Continuing Education
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
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Tufts Health Care Institute/Office of Continuing Education
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
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Tufts Health Care Institute/Office of Continuing Education
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.
Examples: Internet point of care (PoC) CME
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Tufts Health Care Institute/Office of Continuing Education
Tufts-InfoPOEMs POC CME Tufts is accrediting searches Using
infoPOEMs/InfoRetriever (Wiley)
Implementation requirements:– Contract (specs, funding)– Technical (POC site; credit tracking)– Testing
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Tufts Health Care Institute/Office of Continuing Education
InfoPOEMs® is owned by the publishing company John Wiley & Sons.
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Tufts Health Care Institute/Office of Continuing Education
Treatment
Diagnosis
Screening & prevention
Prognosis
Epidemiology
Education
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Tufts Health Care Institute/Office of Continuing Education
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Tufts Health Care Institute/Office of Continuing Education
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Tufts Health Care Institute/Office of Continuing Education
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Tufts Health Care Institute/Office of Continuing Education
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Tufts Health Care Institute/Office of Continuing Education
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Tufts Health Care Institute/Office of Continuing Education
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)
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Tufts Health Care Institute/Office of Continuing Education
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Tufts Health Care Institute/Office of Continuing Education
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Tufts Health Care Institute/Office of Continuing Education
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?
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Tufts Health Care Institute/Office of Continuing Education
Contact Information Marc M. Edelstein, MD, PhD, FAAP Chief
Medical Officer and Co-Director Phone: (617) [email protected]
Ralph Halpern, MSW Director, Content Development and Program
EvaluationPhone: (617) 636-3991Email: [email protected]
http://www.thci.org/ 617-636-1000
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