Online CME learning has hidden benefits
Hospitals that leverage online learning to reduce the cost of continuing education requirements may experience a bonus: lower lengths of stay, reduced readmissions and improved quality indicators.
So says Teresa Fugate, a case management consultant who credits online learning tools with lower lengths of stay at Knoxville, Tenn.-based Covenant Health, where she served as vice president of case management for five years. "We saw a reduction in LOS by getting tidbits (of information) on how to handle a chronic case," she says – adding that informed case managers made informed decisions.
"The more expertise, the more confident they are and assertive to have conversations with doctors," says Fugate. "If they knew the criteria and could cite the source, the doctor would have more respect and was more likely to take their suggestion."
Kathy Chappell, RN, vice president of accreditation and research at American Nurses Credentialing Center, says participation in continuing education "has a positive impact on healthcare provider performance" – adding that "there is a weaker, but still positive relationship between CE and patient outcomes."
Indeed, a 2014 systematic review published by the Accreditation Council for Continuing Medical Education correlates continuing ed with positive physician performance and patient health outcomes. Lead author Ronald Cervero, professor and associate vice president for instruction, the University of Georgia, Athens, says it's not a stretch to assume that better patient outcomes mean better provider performance.
"It's very difficult to show a clear link between CE and lower readmissions and LOS because there are many intervening variables that affect these outcomes," he said. "However, studies show that CE, designed according to evidence-based principles, can improve patient health outcomes and should also improve the outcomes related to readmissions and LOS, reducing Medicare penalties and achieving Joint Commission accreditation goals," he comments."
While many healthcare workers, including case managers, simply pursue CME to meet state requirements, some get more out of it.
"Taking these courses, you'd be pretty close to what you need to certify Certified Case Manager," says Fugate, who notes that a well-designed online program includes "case studies that apply information to real-world situations and source documents for information."
Deena Hannen, director of corporate care management at Seattle's Swedish Medical Center, says the extra curricula creates a well-rounded education that helps hospitals achieve goals.
"Case management is a specialty service that historically has little local educational opportunities," she says. "Getting this volume of specialized case management education is irreplaceable in time, travel and scope."
Noting potential barriers to access, Fugate says IT departments simply need to "make sure the online course website is not blocked."
Beyond that, the convenience factor is hard to argue with: "There are courses that can get a new orientee up to speed in a few weeks, and move advanced case managers forward. The result: economical CE and better use of staff time," she says.
"If you're buying for a group, online courses are more cost effective and you have 24-7 access to the materials," says Fugate. "I can give the courses needed for orientation and get a preceptor to provide the training. That frees my time to move the department forward."
The benefits of well-deployed and well-received online learning can spread throughout the organizations, says Chappell.
"Reducing readmissions can assist healthcare organizations with improving revenue," she says. "CE should be part of a multi-focused strategy to impact complex healthcare issues."
"The key is aligning CE to hospital strategy, designing (it) according to evidence-based principles to increase the likelihood it will improve important outcomes and then conducting the program evaluation to connect the dots," says Cervaro.
A 2013 report from American Hospital Association encourages hospitals and health systems to use continuing education "to advance the strategic aims of the organization." Noting that hospitals and health systems provide 35 percent of all CME activities, the study, "Continuing Medical Education as a Strategic Resource" calls for "greater use of technology to streamline CME processes."
Citing health plan estimates that place a three-day hospital readmission at between $9,000 and $10,000, Fugate offers the following formula to help hospital executives do a return-on-investment analysis and determine the value of online CE to their organization.
"Take the amount of money it will cost to care for a patient," she says. "Apply it to a reduction in readmissions and the cost per case to show a cost-benefit analysis."