Q: How can Internet medical education demonstrate ROI?

LS: We can proactively [identify] what we're looking for. The activity will then be designed so the outcomes are quantifiable. It's as much ROE [return on education] as ROI.

DY: [With Internet education] we are able to quantify things in a way we haven't been able to with traditional formats. You can see if you're getting the right message across, if the information is presented in an [effective] way. You can use the Internet as an interactive teaching tool: If someone gets a question wrong, you can point them right back to the place where the correct information is.

LS: You can see how much time [people] spend on each activity; you can really track progress. Over time, we can see if there is a deficit in learning in a particular area. We can correct that or change the question at minimal cost.

Q: What do health care organizations need to consider when developing an Internet education strategy?

DY: [It's similar to] the way you design other traditional activities. What are your goals? What are the characteristics of your target audience? I might do something different for specialty physicians on the Internet than I would for primary care physicians, because we know from data that specialists tend to be more Internet-savvy than PCPs.

LS: You don't have a medical writer write something for the Internet. You have to involve an instructional designer. Why? They know how to use the medium to get the message across. Don't just think of the Internet as a place to put a spin-off [from another format]. Think of ways to use the technology to design something health care professionals will enjoy. Give them warm and fuzzy, and they will come back for more.

Q: What are strategies for marketing e-education?

DY: You can't just throw something up on a site and think they will come. [You have to develop] a marketing plan.

LS: You have to use traditional methods to invite them to nontraditional activities. You still have to mail something out, give them a mouse pad. They won't find [your site] automatically. You put CME into a search engine, you get pornography, the Chicago Mercantile Exchange, companies that have the abbreviation CME. If someone [visits your site] specifically looking for education--education has to be what they find. If I don't find something in two or three clicks--I'm gone. It [shouldn't be] like going to the gym, where my finger had a workout.

Q: What trends do you predict for online medical education?

DY: The next wave will be targeted activities, moving away from here's [information] for the masses to very targeted strategic use of the Net.

LS: More of a concentration on education-specific sites, rather than sites that offer everything.

DY: More handheld devices, which changes how you communicate. I would not load a program that would require a lot of viewing on a palm device.

LS: But the evaluation could be hot-synced into the palm device, and e-mailed from the palm device at [the participant's] convenience to the sponsor for credit. You can register for activities off a palm device--the invitation arrives by e-mail, click on a button, send your reply. You can get your reminder messages, and download schedules. Perhaps a better percentage of those who register will actually participate.

Q: Do you think CME organizations should come up with specific regulations for Internet medical education?

LS: The reality is regulations need to be in place to quell the cowboys. My only caveat is that regulations need to [take into account] everything the Internet has to offer. The Internet is different from anything we've used before. It can be dynamic, a live webcast, a spin-off event, so you're looking at something live or enduring. You just need to be make sure regulations fit the medium and all the medium has to offer.