Enabling the Tracking and Measurement of CME and Performance Improvement

1
Enabling the Tracking and Measurement of CME and
Performance Improvement

• Peter Greene, M.D.
• Executive DirectorMedBiquitous
• Associate Dean for Emerging Technologies
• Johns Hopkins Medicine
• Repositioning CME Summit
• Chicago
• November 17, 2005

2
Current Problems with CME Tracking and Measurement

• We arent tracking CME
• We dont help the learner assess gaps
• We cant tell if CME matches learners
  practice-based needs
• We dont measure CME value consistently
• We dont verify claimed credits for certification
  or licensure

3
CME Needs a Technology Transfusion

• Selective therapy
• Judiciously applied
• Therapeutic outcome
• Reinvigorated
• Connected
• Highly valued

4
Learners Need a New System

• A system that helps learners
• Identify practice-based needs
• Locate relevant resources
• Track their accomplishments against required
  competencies

Identify gaps in competency
Identify relevant resources
Track accomplishments
Learner Portfolio
5
Providers Need a New System

• A system that
• Lets providers better support learners
• Ties assessment and learning to competencies
• Connects providers with MOC and MOL requirements
• Measures outcomes instead of process

Deploy learner portfolios
Implement competency framework
Report CME activities
Report metrics for accreditation
6
The Public Needs a New System

• A system that
• Enables certification and licensure boards to
  verify CME activity
• Ensures continuing professional development in
  area of practice

7
Digital CME Certificate
Flow of Digital CME Certificates
8
Reporting and Tracking CME
Provider A
Activity report
ltxmlgt
Dr. John Does CME Tracker A Asthma Management
.5 cr B Bronchodialators .5 cr A Pain
Management .5 cr Report to Board
CME Tracker
Activity report
ltxmlgt
Provider B
9
Overwhelmed?

• Without enabling technologies, providers will be
  overwhelmed by the additional data gathering and
  reporting requirements of practice-based CME.

10
What Will Be Required?

• Common vision
• Collaboration
• Supporting technologies

11
Supporting Technologies

• Using organization specific technologies
  (homegrown) will be insufficient
• Industry-wide standards are essential to avoid a
  Tower of Babel

12
The Result Interoperability
CME Provider
Clinical Practice
CME Provider
Certifying Board
Licensing Board
13
What Supporting Technology Can Do

• Put data in front of the learner
• Self-assessment relevant to practice
• Education addressing identified gaps in
  competency
• Performance improvement activities
• Portfolio of educational accomplishments
• Competency framework
• Put data in front of evaluators
• Report from learner CME portfolio
• Report from performance improvement activities

14
Technology Building Blocks

• Common description of competencies
• Common description of resources
• Common way of identifying and describing learners
• Common CME certificate
• Common way of reporting MOC activities
• Common ways of measuring and reporting CME
  efficacy

15
Caution Technology Ahead

• Simple
• Collaborative
• Supportive of good pedagogy
• Consensus is essential

ltxmlgt
16
ltCompetenciesgt
Identify gaps in competency
ltlomgt
Identify relevant resources
Identify learner
ltMembergt
ltActivityReportgt

• John Does Portfolio
• CME
• Course 1
• Course 2
• Course 3

Track accomplishments
Learner Portfolio
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Linking Content and Competencies
Competency Map
Healthcare Learning Object Metadata
Learning Objects/Activities
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Common Way of Identifying and Describing
Learners Healthcare Professional Profile

• ltMembergt
• ltUniqueID domain "American College of
  Surgeons"gt 21556222lt/UniqueIDgt
• ltNamegt ltnFirstNamegt Percy
  lt/nFirstNamegt
• ltnMiddleNamegt Bysshe
  lt/nMiddleNamegt
• ltnFamilyNamegt Shelley
  lt/nFamilyNamegt
• ltnDegreegtMDlt/nDegreegt
• lt/Namegt
• lt/Membergt

ltMembergt
19
Common CME Certificate/Way of Reporting MOC
Activities Activity Report

• ltCreditCertificategt
• ltCreditReceived providerAccreditation?ACCME
  ? activityCertification?AMA PRA category 1?
  creditType?CME? unit?Credits?gt1.5lt/CreditRece
  ivedgt
• ltCreditIDgtheid1234.3214.7896.8521.9632ltCred
  itIDgt
• lt/CreditCertificategt
• lt/Modulegt

ltActivityReportgt

• John Does Portfolio
• CME
• Course 1
• Course 2
• Course 3

Learner Portfolio
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Common Way of Describing Learning Resources
(Healthcare LOM)

• Facilitates discovery of content across
  repositories for reuse/repurposing
• Facilitates management of content to ensure
  compliance and accuracy

Educator

• Facilitates search based on subject,
  competency, curriculum
• Connects information/education to clinical
  systems

Learner
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Common Ways of Measuring and Reporting CME
Efficacy Metrics

• ltMedicalEducationMetricsgt
• ltParticipantActivityEvaluationgt
• ltRelevantToLearningNeedsgt
• ltStronglyAgreegt24
• lt/StronglyAgreegt
• ltAgreegt16lt/Agreegt
• ltNeutralgt10lt/Neutralgt
• ltDisagreegt5lt/Disagreegt
• ltStronglyDisagreegt4
• lt/StronglyDisagreegt
• lt/RelevantToLearningNeedsgt
• lt/ParticipantActivityEvaluationgt
• lt/MedicalEducationMetricsgt

Learner Survey Please indicate whether you
strongly agree, agree, are neutral, disagree,
orstrongly disagree with the following
statements.
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MedBiquitous Mission

• To advance healthcare education through
  technology standards that promote professional
  competence, collaboration, and better patient
  care.
• Non-profit, member-driven, standards development
  organization

23
MedBiquitous Technology Standards for
Healthcare Education

• 45 member organizations
• 6 Working Groups
• ANSI process
• Openness
• Transparency
• Consensus
• Due process
• Work with leading organizations that can drive
  adoption

Professional Profile
Learning Objects
Activity Reporting
Metrics
Virtual Patients
Journal
Competencies
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ANSI Accredited Standards Developer

• MedBiquitous develops information technology
  (XML) standards for
• Healthcare education and training
• Healthcare professional competence assessment,
  certification, and licensure
• Healthcare professional and scientific
  publications
• Healthcare professional online communities and
  portals

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Moving to a New Model of CME

• Old Model
• Paper-based
• Process-oriented
• Provider-centric
• Knowldege

• New model
• Electronic
• Outcomes-oriented
• Learner-centric
• Practice

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Action Items

• Leverage technology to interlink self-assessment,
  quality improvement, CME, and competencies
• Provide learners with a comprehensive view of CME
  accomplishments (learner portfolio)
• Implement core technology standards for
  communications across professional medicine
• Participate in industry-wide efforts to advance
  technology standards

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What do you think?

• Does your organization offer a CME portfolio for
  physician learners, or are there plans to offer
  such a portfolio? 
• Yes, we currently offer a CME portfolio.
• We have plans to offer a CME portfolio.
• No, we have no CME portfolio or plans to offer
  such a portfolio.

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What Do You Think?

• Would it be helpful for learners to have a common
  way of electronically tracking CME
  certificates? 
• Yes
• No