'There are judgment and knowledge errors that lead to problems.'

5 reasons CME must (and will) change

By Jeff Rowe
12:39 PM

As in many fields, it's taken for granted that a physician's education never really ends. But when it comes to continuing medical education, many healthcare stakeholders believe that the current system is, in a nutshell, broken.

A 2010 report from the Institute of Medicine, "Redesigning Continuing Education in the Health Professions," summed it up: "The absence of a comprehensive and well-integrated system of continuing education in the health professions is an important contributing factor to knowledge and performance deficiencies at the individual and system levels."

Indeed, those "deficiencies" translate into a significantly increased risk of patient safety incidents as a result of provider error.

As Matthew Hanis, vice president of sales and interim CEO of Boston-based Advanced Practice Strategies, put it recently, "There are judgment and knowledge errors that lead to problems."

Solving those problems – or, rather, eliminating them altogether – is a big part of APS' mission, and its method involves offering physicians CME tools that aim to be both targeted and demonstrably effective.

According to Hanis, APS' focus on CME grew out of its original mission to provide physicians with "evidentiary delivery materials" for use in defending themselves against malpractice suits. The business was growing nicely, Hanis said, "But then the team decided to take it a step further by tackling the question of how to keep those cases from coming into the courtroom in the first place."

The answer, APS concluded, was to work on eliminating the very errors for which providers were finding themselves on trial. And that came down to developing CME tools that will, at the very least, reduce the risk of patient injury by ensuring that physicians are armed with up-to-date training and clinical knowledge.

As Hanis sees it, there are five reasons why the current CME system is bound to change:

  • It's already undergoing radical shift as a result of the Affordable Care Act. The ACA included regulations that finally prohibit big pharma and device companies from funding CME programs which often, not surprisingly, lead providers directly to their products, said Hanis.
  • That IOM report sounded a system-wide alarm. "There are major flaws in the way (CME) is conducted, financed, regulated, and evaluated," the report declared, and, according to Hanis, it documented "the fact that, in many cases, the hours spent by clinicians to reduce risk via CME made virtually no difference."
  • Currently, CME can be "incredibly expensive." Or at least doing it right is, said Hanis. Even if the content is free, organizations must be willing to invest significant resources in ensuring their clinical staffs are prepared.
  • Clinicians hate bad content. While obviously not all CME programs have been failures, Hanis pointed to a history of inconsistent quality when it comes to content, a pattern which, given the cost of the time and resources they commit to accessing that content, frustrates clinicians, to say the least.
  • Most CME material isn't measurable. "If it's measurable, you can do something with it," Hanis said of the ideal CME content. He pointed out, however, that that hasn't been the case.

Hanis said APS doesn't necessarily see itself as being in the CME business.: "We're in the business of healthcare risk management." CME, rather, is the company's choice of tool as it aims to improve provider proficiency and reduce the risk of patient injury.

As the IOM report noted, "To be most effective, health professionals at every stage of their careers must continue learning about advances in research and treatment in their fields (and related fields) in order to obtain and maintain up-to-date knowledge and skills in caring for their patients."

Needless to say, effective CME programs are the obvious key to ensuring that healthcare professionals continue to have the skills they need – and their patients depend on.

[See also: IOM calls for sweeping efforts on patient safety]