UVM CME Policy Meeting Cheung Wong, MD May 7, 2013

Re-accreditation UVM COM CME re-accredited in April 2013 – ACCREDITATION WITH COMMENDATION Highest level of accreditation – Achieved by less than 20% of national programs Achieved because of the efforts of BOTH the CME staff AND course directors

What’s new in CME? New and Ever Changing Rules of ACCME “Why is filling out the planning document causing me a headache!?”

Slides from ACOG CCME 2013 Adapted from John Greene, MD’s slide deck – Chair, ACOG, Committee on CME – Verbal permission to share slides Encouraged to share slides

AMA Definition of CME CME consists of educational activities that serve to maintain, develop, or increase, skills and professional performance, the knowledge, and relationships that a physician uses to provide services for patients, the public, or the profession.

Goal of CME To provide educational activities to providers that will address knowledge or performance gaps in physician practices in order to improve the quality of care provided to patients

Definition of Certified CME Nonpromotional learning activities certified for credit PRIOR to the activity by an organization authorized bby the credit system owner Nonpromotional learning activity for which the credit system owner directly awards credit

Educational Content of Certified CME May include non-clinical subjects (e.g. office management, patient-physician communication, faculty development) as long as these are appropriate to a physician audience and benefit the profession, patient care or pubic health May describe or explain complimentary and alternative health care practices if the existing level of scientific evidence supports the practices

Activities Ineligible for AMA PRA Credit Learning which is incidental to the regular professional activities or practice of a physician – Clinical experience – Charity or mission work – Surveying – Committee, council, task force

Traditional CME Started with content, faculty, topic Passive learning format No requirement that learners improve performance in practice No motivation of planners/faculty to design learning experiences to impact performance

New Concepts in CME Planning Committee – No longer suffice to ask friend to come give a lecture New requirements to apply for CME credit New CME activities – Simulation

New Drivers of CME Maintenance of Certification (national) Maintenance of Licensure (state) Credentialing (local) Performance Improvement CME (individual) Healthcare Reform (government)

CME Activities Live conferences Enduring materials Learning modules

Planning Committee Initial discussions for CME activities Once topic discussed, it should be researched to find scope of practice gap Review past evaluations, survey target audience, review literature, gather local statistics Define specific issue, reason there is an issue, proposed solutions and recommendations KEEP MINUTES/LIST RESOURCES

Planning CME “The Headache” What performance needs to improve? Why (Professional Performance Gap)? Whose performance? What is goal/What will be taught? How will it be taught? How to measure success?

What Performance NEEDS to improve? How to identify NEED? – Inferred methods – Verbalized Interest – Demonstrated needs

Inferred Methods for Needs New methods of diagnosis or treatment New medications or indications New technology Expert input on advances in knowledge Acquisition of new equipment Legislative or regulatory changes affecting patient care

Verbalized Needs and Interests Requests on evaluation forms Survey of participants Informal comments Patient problem logs Consensus of faculty members

Demonstrated Needs Epidemiologic data Quality Assurance data Morbidity and Mortality review data Surgical procedures statistics Professional society requirements Re-credential reviews

Why? Professional practice gap – Gap analysis refers to steps to be taken to move from a current state to a desired future state – Refers to the difference between health care processes or outcomes currently observed and those potentially achievable on the basis of current professional knowledge

Whose performance? Who is the target audience

What is goal/What will be taught? Purpose/objective Content

How will it be taught? Methodology/Activity format Live activity, Journal club, Enduring material, Internet CME Educational Design – Didactics – Simulation – Small group

How to measure success? Evaluation process Assessment must go beyond reaction (good lecture) Should include LEARNING (what new knowledge was attained) Should include TRANSFER OF SKILLS (how will practice change as a result of program) Ultimately show RESULTS (how did patient outcome improve)

Planning Document Why is it causing a headache? – ACCME is constantly changing the requirements to attain CME credit – ACCME’s language is sometimes difficult to understand – Course directors (almost always a MD) have other clinical, administrative and research responsibilities Oh yeah, they also have a personal life

Planning Document How to solve the headache? – Proposing a pilot program where course directors/planning committees* can hire a CME staff at an hourly rate to assist in completing the planning document *Course directors/planning committee are vital to this process. Must identify the NEED and PERFORMANCE GAPS. CME staff will meet with course directors, attend planning meetings, perform research (if necessary) and complete the planning document so that it meets ACCME criteria

REMINDERS Monitoring Forms – Make sure that the PLANNING COMMITTEE’S DISCLOSURES are listed on the Monitoring forms all year.

TELEMEDICINE If your activity is watched via Telemedicine, please make sure that you use a Monitoring Form Disclosure Slide

FORMS When submitting an activity for credit, please go to our website to download a new copy of the forms (Disclosure, Planning Document, LOA, etc).

CHECKLIST Please use our Application Checklist!

TOOLS CME Website – Plan an Activity