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  • 1. 1Tufts Health Care Institute/Office of Continuing Education Online CME Accreditation for Point-of-Care Learning Marc Edelstein, MD, PhD 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 MedBiquitous, April 2007. Point of Care Learning
  • 2. 2Tufts 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
  • 3. 3Tufts 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.
  • 4. 4Tufts 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.
  • 5. 5Tufts 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.
  • 6. 6Tufts 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.
  • 7. 7Tufts 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
  • 8. 8Tufts 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
  • 9. 9Tufts 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
  • 10. 10Tufts 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
  • 11. 11Tufts Health Care Institute/Office of Continuing Education InfoPOEMs® is owned by the publishing company John Wiley & Sons.
  • 12. 12Tufts Health Care Institute/Office of Continuing Education Treatment Diagnosis Screening & prevention Prognosis Epidemiology Education
  • 13. 13Tufts Health Care Institute/Office of Continuing Education
  • 14. 14Tufts Health Care Institute/Office of Continuing Education
  • 15. 15Tufts Health Care Institute/Office of Continuing Education
  • 16. 16Tufts Health Care Institute/Office of Continuing Education
  • 17. 17Tufts Health Care Institute/Office of Continuing Education
  • 18. 18Tufts 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)
  • 19. 19Tufts Health Care Institute/Office of Continuing Education
  • 20. 20Tufts Health Care Institute/Office of Continuing Education
  • 21. 21Tufts 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?
  • 22. 22Tufts Health Care Institute/Office of Continuing Education Contact Information Marc M. Edelstein, MD, PhD, FAAP Chief Medical Officer and Co-Director Phone: (617) 636-0347 marc_edelstein@tufts-health.com Ralph Halpern, MSW Director, Content Development and Program Evaluation Phone: (617) 636-3991 Email: ralph_halpern@tufts-health.com http://www.thci.org/ 617-636-1000