Vivacity Consulting

Bringing energy and experience to your CME activity

Perspectives on PARS

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The ACCME’s PARS – Program and Activity Reporting System

Ready or not, it’s time to get ready for another year of data input into PARS. PARS is the online data input system all ACCME providers and soon, all state providers, must use to input detailed date regarding their CME program. It’s a lot of data.

What happens to all of this data? Why are we, providers, required to enter so much information (even more in 2014!)

According to the ACCME, the data entered “will provide a more detailed and comprehensive picture of the national CME enterprise and assist the ACCME, accredited providers and other stakeholders in demonstrating the value and scope of CME.”

My opinion is that much of this data probably is useful to the ACCME behind the scenes, in the way that providers’ individual activity data can be useful as a guide to the development of overall educational curriculum. (See my post about Criterion 6 as an example of this.)

However, I think it’s providers who ultimately will need to make the argument on behalf of accredited CME. I want to call out a fantastic presentation from the recent Alliance for CE in the Health Professions Annual Conference. I didn’t get t see it live, but I saw a Tweet from Erik Brady, PhD about it, and so I downloaded the slides when I got home.  The talk is titled, “Estimating Healthcare Cost Savings Resulting from CME Activities Using the Outcomes Impact Analysis Model.” It was presented by Dana Ravyn, PhD, MPH, Scientific Director, and Rob Lowney, BA, MBA, Managing Director, CMEology, West Hartford, CT, West Hartford, Connecticut. In a nutshell, “CME-related learning, when favorably affecting clinical practice, can yield substantial cost savings…” in this instance, over $5 MILLION as a result of the decrease in surgical bleeding-related complications and reoperation for bleeding.

$5 MILLION! 

How would you like to walk into your Director or CEO’s office and tell them you can potentially save your organization millions??? Obviously, we have a ways to go before we get there. But in the meantime, kudos to CMEology, don’t forget to enter your data into PARS, and then let’s get to work!

Using Data to Improve Medical Education

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A Case-Study: Using Data From Participant Evaluations

When the ACCME came out with the new Criteria (back in the 2000s!), many of us from  non-hospital-based organizations struggled to understand how to incorporate the concept of using data into our planning process. I remember whining a lot. “We’re a specialty society. We don’t have patient data!”  Not only that but, “we only see our attendees one time a year!”

Flash forward 7 years. The SAGES Continuing Medical Education Committee is pleased to announce the publication of the article entitled, “Evolution of practice gaps in gastrointestinal and endoscopic surgery: 2012 report from the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Continuing Education Committee.” In this article, we describe the process by which we have collected data from our attendees through post-activity surveys, analyzed this data by “Learning Themes,” and then identified potential practice gaps which have or may be addressed at future educational activities.

If you have a subscription, you can access the article here:

http://link.springer.com/article/10.1007%2Fs00464-013-3263-2

I just read that some journal publishers are getting tougher about copyright violations, so message me if you would like me to send you a “draft” version of the paper. I’ll present a summary of this work during CMEPALOOZA, a web-conference being held March 20, 2014.

And congrats to my co-authors who did the bulk of the data work,

  • John T. Paige, MD
  • Timothy M. Farrell, MD
  • Simon Bergman, MD
  • Niazy Selim, MD
  • Alan E. Harzman, MD
  • Yumi Hori,
  • Jason Levine,
  • Daniel J. Scott, MD

Turns out specialty societies actually do have the ability to collect valuable data, and there are ways of using this data to, dare I say, improve the education delivered.

CME Research – Let’s Get Serious

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Does CME Research Impact My Job?

Every time the JCEHP arrives in my in-box, I’ll admit it,  I groan a little. Will it be another study about improvements made by implementing an ongoing clinical intervention connected to a patient outcomes tracking system? Many of us don’t have access to something so sophisticated (or expensive).

Or maybe it’s another “Framework” for doing something – measuring outcomes, assessing effectiveness, etc, etc. Who has time to implement another framework?! I’ve got work to get done!

But recently, one of my physician clients asked in all seriousness, “Is there really a correlation between being ACCME compliant and providing an excellent meeting experience for attendees?” My gut answer is a resounding, “YES!” And lucky for me, many of our esteemed colleagues have created an incredible pool of proof, in the JCEHP and elsewhere, putting their time and possibly tears into producing research that backs up my experience with data.

Ah, data. Tricky thing, data. Tricky to collect, tricky to analyze, tricky to write up.

So to those of you who are contributing to this important and evolving area of study, THANK YOU! And to the rest of us, let’s get serious. Serious about how important it is to support those who work to improve our profession. If research isn’t your thing, perhaps you can inspire others to participate?

The editors of the JCEHP recently published a helpful editorial, pointing out errors that are often made when reporting evaluations of educational outcomes. This will be useful as I work with one of my clients to finalize the update to this manuscript. I commit to doing everything I can to support this effort and advocate/nag them into producing the next update as soon as possible.

Will you join me?

 

 

Can CME Make You Happy?

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Or, Is It Possible to Follow CME Rules/Regulations/Criteria and Still Be Happy?

Often, new clients come to me when they are drastically unhappy. Their organization has received a Progress Report or Interim Report or even a Probation decision, and they don’t know what to do. Or they have had a staff member leave and they have to do the job now. Or they are a physician struggling to apply the CME criteria to their upcoming educational activity.

So a big part of my job is to help these very unhappy people find the fun in the challenges facing them.

“Fun?!” you may say, “Where’s the fun?” I once had an otolaryngologist say to me, “You really love this. I can tell. You love it ….” Implying that HE did not.

Perhaps my love of continuing medical education is a bit over the top, but I have found a few tricks over the years which help on those down days or weeks. You can do this as well. Here’s some ideas to turn the perceived burden of CME into an opportunity to be happy:

1. List your successes. Did you make a change to your evaluation form that helped you collect better data? Did you find an interesting journal article that describes a best practice? Did a physician provide an excellent practice gap on their CME activity request application? Research shows that writing down small positive memories enhances your mood, and this is as true in work life as in personal life.

2. Share your list with others. Incorporate successes into your Medical Education Committee agenda. Solicit successes from your Chairs and highlight them in your newsletter.  See this blog post about how one of my clients made Criterion 6 useful.

3. Smile. People react to positively to body language, and I have found this is true even when they cannot see you. Smile when you are talking, even on the phone, and you will be amazed at the change.

4. Remember that you are on a continuum. The ACCME rewards programs for growth and improvement. Rome wasn’t built in a day. Track your successes and set goals for the future.

If you want to hear an amazing talk about Happiness, listen to Nataly Kogan’s TedXBoston talk here. Also, I would recommend Gretchen Rubin’s book, The Happiness Project, and her blog on the same subject.

(Credit to http://terriblycute.com/ for the dog photo!) 

 

 

 

 

ACCME’s Criterion 6: How We Made This Useful

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ACCME’s Criterion 6: Not all Criteria Are Made the Same

It’s true. All of the criteria are important, but some are MORE IMPORTANT THAN OTHERS. Right? We all know this. Identifying gaps and needs is very important. Ensuring independence from commercial interests is very important. Criterion 6 is not at the top of the totem pole of importance.

However, one of my clients, SAGES, has embraced Criterion 6 in a pretty neat way to make it useful in the planning process (see below). Every year, each session of the Annual Meeting is linked to one or more “Physician Competencies.” We track this and then highlight for the next year’s Program Committee areas which may have been under-emphasized in previous years. Not all competencies are relevant to this large specialty societies’ annual meeting – but some are.

In this way, lowly Criterion 6 becomes not just required for compliance, but also provides insight into the CME program and therefore IT’S ACTUALLY HELPFUL! Which, of course, is the ultimate goal of the CME process.

Criterion 6

Example of ACCME’s Criterion 6 Used in Planning

Wait a Minute: Rethinking the ACCME Accreditation Revisions

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Rethinking the ACCME Accreditation Proposed Revisions

Today, I held a webmeeting with three of the smartest, most enthusiastic, ready-for-anything physician volunteers you can imagine.  We were conducting the overall mission assessment required by ACCME Accreditation Criterion 12 as the first step in a multi-month reaccreditation process. And it struck me.  If we eliminate C14 & 15, some of their motivation to get these changes accomplished might be reduced.  They are fired up to get these changes in place now so that we can measure the results.  Part of their enthusiasm stems from their core belief in the CME process, part of their enthusiasm is justifiably self-serving (they want to write a manuscript which may help them get promoted), but part of their enthusiasm, I really believe, comes from the fact that IT’S REQUIRED.  It’s human nature to respond to a deadline, and they know theirs is April 2014.

Maybe eliminating C14 & C15 might not be such a great idea.

ACCME reports that in the November 2012 cohort, 20-30% of providers were non-compliant with C15.  This could be a matter of timing (they didn’t start evaluating their program early enough to make changes and measure the effect.)  But it could also be because they missed the point.

C15 states, “The provider demonstrates that the impacts of program improvements, that are required to improve on the provider’s ability to meet the CME mission, are measured.” Without this, might we inadvertently stall the cycle of continuous improvement?

If we need to rethink this, what about the rest of the proposed changes?

I know that my job is easier when the rules are explicit – and Dr. Kopelow told us on the May 23, 2013 provider webinar that this is true for everyone. My smart, enthusiastic, BUSY physician volunteers would have been baffled if I tried to convince them that a mission statement should include anything more than our expected results … because “it doesn’t say so in the rules.” To me, it makes sense that we will continue to describe our purpose, content areas, target audience and type of activities in the mission statement, but to the person who doesn’t think about CME everyday, this might seem like a massive waste of time.

So, maybe ACCME Accreditation Criterion 1 should be left alone as well.

What do you think?  Make sure you submit your comments to the ACCME by July 2nd!

ACCME changes review

ACCME accreditation revisions – provider feedback due July 2nd!