Life Science Compliance Update

April 03, 2017

ACCME President and CEO Calls for Healthcare Leaders to Leverage CME

Graham%20T_%20McMahon_photo

Graham McMahon, MD, MMSc, President and CEO of the Accreditation Council for Continuing Medical Education (ACCME), recently published an article in Academic Medicine, “The Leadership Case for Investing in Continuing Professional Development.”

In his article, Dr. McMahon calls upon healthcare leaders to recognize and appreciate the power and capacity of accredited CME to address many of the challenges in the healthcare environment, from clinician well-being to national imperatives for better health, better care, and lower costs. McMahon also offers principles and action steps for aligning leadership and educational strategy, while urging institutional leaders to embrace the continuing professional development of their human capital as an organizational responsibility and opportunity.

McMahon opines that CME is “an underused and low cost solution that can improve clinical performance, nurture effective collaborative teams, create meaning at work, and reduce burnout.” He believes that to optimize CME benefits, clinical leaders need to think of CME as a way to help drive change and achieve institutional goals, in concert with quality improvement efforts, patient safety, and other systems changes.

McMahon notes, “The perception of CME as only lectures in dark rooms or grand rounds with dwindling numbers of participants listening passively to an expert is increasingly anachronistic. Equally outdated is the view that CME is about rubber-stamping applications for credit. The end point of CME is not the credit that’s attained for licensing, certification, or credentials; rather, it is learning.”

A CME program that is properly utilized – with a multi-professional scope and educational expertise – can contribute to initiatives that focus on clinical and nonclinical areas alike. Some such initiatives can include quality and safety, professionalism, team communication, and process improvements. By supporting the achievement of quality and safety goals and engaging in public health priorities, CME programs can help organizations reach various strategic goals and demonstrate leadership.

He further argued that to “reap the greatest return on your institution’s investment in education, you will need to build a collaborative learning culture. We acculturate clinicians to be decisive and confident, but patient safety is compromised when confidence is not matched by ability. Promoting self-awareness as part of your institution’s culture is key to improving patient care and safety because it allows clinicians to stop if they are unsure, seek advice from a colleague or access resources, and ensure they are making the right decision at the right time.”

Additionally, “[b]reaking down silos among professions and throughout the medical education continuum, including the involvement of undergraduate and graduate medical education leadership, improves efficiency and the allocation of resources across an institution’s educational programs. An integrated learning environment that enables health care professionals, residents, and students to share conferencing space, learning management systems, and other resources will help drive team development.”

In conclusion, Dr. McMahon notes, “Healthcare leaders who recognize the strategic value of education can expect a meaningful return on their investment – not only in terms of the quality and safety of their clinicians’ work but also in the spirit and cohesiveness of the clinicians who work at the institution.”

March 02, 2017

CME Outcomes Increase with Local Participation in Content

CME Conference

Teams from Rockpointe and Potomac Center for Medical Education worked together to draft an article recently published in the Alliance Almanac, walking readers through the outcomes-based activity design. Throughout the article, readers learn how they structured their ground rounds courses and the modifications needed to address different audiences. They also illustrate how relying upon expert opinions during a needs assessment could create a disconnect between the content and learners’ true needs.

The article focused on “Type 2 Diabetes Management: A Team Approach to Managing Hypoglycemia, Comorbidities, and Patient Challenges,” a one-hour grand rounds activity series held in community hospitals. The activity was designed to educate clinicians on patient-engagement strategies and guideline-based management of T2DM (type 2 diabetes mellitus), specifically in patients with comorbidities or at a high risk for hypoglycemia. The CME activity was held in thirty hospitals in nineteen different states, over the course of seven months from 2014 to 2015.

According to the article, the most effective strategies for educational design contain a multidimensional approach. As such,  

[t]he content for the series was entirely case-based and tailored to the needs of each hosting venue.

The curriculum included six patient case scenarios, with two cases per learning objective. Each host site selected one of the cases per learning objective (three cases total) at the recommendation of the institution’s department chair or clinicians.

The outcomes methodology relies on assessment of responses to a series of case-vignette questions from a sample of HCPs who participated in the CME activity (participants) as compared to responses from a comparable, demographically matched group of HCPs who did not receive the education (nonparticipants).

Comparing the differences in response patterns between the participant and nonparticipant groups allowed for assessment of the following:

  • whether the therapeutic choices of participants were consistent with the clinical evidence;
  • whether practice choices of participants were different from those of nonparticipants;
  • what barriers exist to the optimal management of T2DM; and
  • which educational needs remain.

According to the article, sixty-five percent of responding participants “indicated that they always or frequently evaluated the risk of hypoglycemia in their patients with T2DM and adjusted management as necessary to avoid hypoglycemic episodes. The education was perceived as very impactful to the participants, successfully addressing their practice needs.”

Additionally, compared to nonparticipants, the activity favorably impacted the clinical decision making of the participants. Participants were more likely to account for the cardiovascular impact of glucose-lowering agents, as well as their effects on weight, their hypoglycemia risk and their contraindications when recommending treatment in a variety of patient scenarios.

The article concluded with the following:

Participation in an interactive, case-based grand rounds activity was associated with increased HCP knowledge and competence in the management of T2DM. It was also associated with a 51 percent increased likelihood that patients would receive evidence-based care from participating physicians, specifically in the context of comorbidities, renal impairment, cardiovascular risk and the need to limit weight gain. Participation in the grand rounds series has the potential to improve T2DM patient care during 92,196 patient visits each month to participating clinicians.

February 15, 2017

ABIM Increases Physician Choice with New Assessment Option

ABIM

The American Board of Internal Medicine (ABIM) is providing more choice to physicians who are working to maintain their board certification. ABIM has decided to take this step after physicians asked for more flexible options that affirm to themselves, their patients, and their peers that they are staying current in medical knowledge.

As ABIM has been re-thinking the process for continuous certification, the organization invited all 200,000 ABIM Board Certified physicians and twenty-seven medical societies to share input. This first phase of dialogue guided the ABIM Council, a body of practicing physicians from several internal medicine subspecialties, to update the assessment process.

The option that emerged as the one that provided the most choice, relevance and convenience was short assessments every two years emerged. This will help physicians to maintain their certification and confidence that they are staying current in their education.

Physicians will able to choose to take assessments every two years or every 10 years. 

Details about the two-year assessment

  • You can choose to take the two-year assessment on your personal or work computer – or at a testing center.
  • You do not need a passing score on every two-year assessment. However, if you are unsuccessful twice in a row or if there is a longer gap between assessments, you will need to take additional steps to maintain certification.
  • You will have more dates from which to choose when scheduling the two-year assessment.
  • This “knowledge check-in” offers more continuous learning, feedback and improvement. Results will be available immediately after the assessment. More feedback will follow.

General Details

  • Beginning in 2018, physicians certified in Internal Medicine can choose to take shorter “knowledge check-ins”—at the location they choose—every two years.
  • To assist physicians with adjusting to changes—and for ABIM to learn from the process— there will be no consequences for unsuccessful performance on the two-year assessment in 2018.
  • ABIM will share updates on availability of these options for subspecialties in the coming months.
  • Physicians can still choose to take an assessment every 10 years in a testing center. ABIM is continuing to collaborate with physicians to make this option more reflective of practice.
  • ABIM is also working to make the 10-year assessment open book.

Dr. Richard J. Baron, President and CEO of ABIM, created a video message about these changes, which can be found here.

Industry Reaction

 “ABIM is changing because physicians are changing it. We are very proud to be collaborating with the many doctors who are constructively helping us update the assessment process,” said Richard J. Baron, MD, ABIM’s President and CEO and a board certified internist who practiced for 30 years in his Philadelphia community.

“Doctors want a certification program that integrates into their daily routine, while affirming to their patients and peers that they have up-to-date medical knowledge. That is exactly why ABIM is introducing assessment options.”

“By involving physicians in every step of the process, ABIM has been able to simplify its programs to focus on meaningful activities that increase knowledge, provide doctors confidence in their practice, and allow doctors more time to devote to patient care,” said Jeanne M. Marrazzo, MD, Chair of ABIM Council. “This work is constantly evolving as we move forward, and we’re proud that the steps we’re taking are informed by physicians who are dedicated to improving patient care.”

“The number of activities is just unprecedented in terms of ways we've been partnering with the physician community. Again, not abandoning the core principle of saying board certification means something,” said Clarence H. Braddock, III, MD, Chair of the ABIM Board of Directors. “It’s a badge of honor to have mastered a body of clinical knowledge and skills that you want to be able to proudly display, but at the same time, we want to make sure that it’s realistic and relevant through the eyes of the practicing physician.”

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