1. MedBiquitous May 15, 2008 Integrating Quality Improvement Data into a Web- based CME Activity MedBiquitous May 15, 2008 Annette D. Boyer, R.Ph. CECity.com, Inc.

2. Activity Based Approach to Performance Improvement Utilization Data integrated into a Web-based CME Activity A Clinical Personal Intervention Tool Teachable Moments “Real Time” Provider Utilization Focused Interventions “Real Time” Patient Profiles What is DynamicCME?

3. Innovative Technology Platform Secure integration of “real time” medical/pharmacy claim data Scalable solution Customized benchmarks & metrics Comparison to peer data Advanced outcomes: Level IV – VI Why is DynamicCME Unique?

4. DynamicCME Impact Focused on Improving Quality of Patient Care Reduce gap between “Perception” and “Reality” Behavior reinforcement Improve Health Plan Provider performance - Prescribing patterns - Adherence with disease practice standards - Understanding of Rx Therapies

5. User is presented with an Interactive CME question & responds User is shown the answer Evidence-based Resource link provided (Guidelines, Clinical Trials, etc.) DynamicCME Interactivity

6. Physician utilization data is displayed with benchmarks established by the Health Plan Data provided by Health Plan database Link is available to send a request for specific patient information DynamicCME Reinforcement

7. Closes educational loop by providing actual patient data for intervention DynamicCME Interventions

8. DynamicCME Behavior Network Physician Data displayed is the individual physician’s utilization data compared to the Health Plan, the practice and/or peers. Health Plan Network Data displayed is aggregate Health Plan, practice and/or peer utilization. Not related to an individual physician. Physician at Large No physician practice data or Health Plan data. Data displayed is the responses of those who participated in the eCME activity.

9. DynamicCME Outcomes Exceeds Level III Outcomes –Measurable behavior change and impact on patient care Compliance with national guidelines Changes in prescribing & compliance Measure influence of Dynamic vs Non-Dynamic Analysis of geographic variations NCQA - HEDIS measures

10. Future of DynamicCME Benefits  Web-based scalable solution  Ability to influence practice behavior – physician’s own data in real-time  Comparison to peers - competitive nature of highly educated users  Well positioned as interventions for broader CQI initiatives Challenges  Limitations of medical and pharmacy claims data  Frequency of refreshing claim data  For physicians with few patients, data may be skewed or misleading  Gaining physician confidence & acceptance