Three major CME organizations — the Accreditation Council for CME, the Mayo Clinic, and the Society for Academic CME — have joined together to launch an initiative aimed at developing a national agenda to improve CME and better align it with the wider healthcare system.
The effort was spurred by recent criticisms of CME, including the reports issued by the Josiah Macy Jr. Foundation and the Agency for Healthcare Research and Quality. It kicked off with an invitation-only conference held at the Mayo Clinic in Rochester, Minn., in September 2008, attended by more than 50 CME leaders.
A report with the conference proceedings was released in January. It is available at each of the sponsoring organization's Web sites. Several organizers of the Mayo CME Consensus Conference recapped the highlights during a plenary session at the Alliance for CME annual meeting in San Francisco in January.
One priority is to develop a cohesive, coordinated structure that includes a governance or oversight body and gives CME a national voice, brand, and identity, speakers explained. At present, the field is a conglomeration of disparate groups. “Who owns CME?” asked speaker Morris J. Blachman, PhD, assistant dean for CME at the University of South Carolina School of Medicine, Columbia. With so many diverse stakeholders, the answer right now seems to be everybody and nobody, he said. Blachman said the CME enterprise must do a better job of communicating its value to the larger healthcare system. “We have to define what we do and why,” he said. “We have a great story that's poorly told.”
Teach the Teams
In order to align CME with the needs of the wider healthcare system, it's critical to create activities that address the learning needs of entire teams, not just individual doctors, said presenter Melinda Steele, Med, director, CME, Texas Tech University Health Sciences Center, Lubbock; and president of SACME. “We need to design programs that embed CME as much as possible within the normal practice,” added Blachman, creating learning opportunities such as point-of-care.
Another priority is to develop a system to assess and monitor CME activities to facilitate continuous improvement and demonstrate CME's value. Measurement of CME's effectiveness must be applied across the board, Steele said, to individuals, teams, systems, microsystems. “There also need to be defined skill sets and a career path for CME professionals,” she said.
A primary focus of the initiative is to build a research agenda for CME. “We don't have any notion of the proper role of CME research,” said Blachman. Should a CME office have a research arm? “We need to build intellectual capital,” he said.
Ongoing analysis and findings from the first conference will be published in a peer-reviewed journal later this year. A follow-up conference, scheduled for April 26, will refine the initiative's agenda. There is no time frame for completion of the project, said Steele.
Sidebar: 800 Pound Gorilla?
One of the controversial statements in the Mayo CME Consensus Conference Proceedings concerns what appears to be a criticism of medical education and communication companies. The report says: “Having a variety of types of CME providers can provide richness to the system and we need all of them, but it was noted that the 800-pound gorilla is the for-profit provider; should CME stay within the realm of academics, societies, etc.?”
Stephen M. Lewis, CCMEP, president, North American Association of Medical Education and Communication Companies, responded: “What matters is the quality of the provider and the educational services provided, not business classification. Our collective focus should be on educational excellence and quality improvement for the benefit of patient health, regardless of the type of provider.”