Physicians are facing increased pressure to demonstrate performance improvement and many are turning to a model of continuing medical education (CME) for tools to assess the care they provide to patients and to make measurable enhancements.
Since being introduced in the early 2000s, the concept of Performance Improvement Continuing Medical Education (PI CME) has expanded significantly. Demand is expected to continue to grow as the country shifts to a pay-for-performance system of care that emphasizes quality over volume.
This model attempts to bridge the gap to continuous improvement. Physicians will be increasingly required to find ways to improve their practice, and PI CME is a way for physicians to approach quality improvement.
Under the traditional CME model, physicians can receive credit for completing a quiz after attending a lecture, watching a video or taking an online tutorial. The concept of PI CME was developed to take this instructional information from the traditional CME model and integrate it into the practice setting and show measurable results.
According to the American Medical Association, PI CME involves three basic steps:
1) Assessment of the physician practice using identified evidence-based performance measures
2) Implementation of an intervention
3) Re-evaluation of those performance measures to gauge improvement
A major advantage of the PI CME model is the ability of physicians to compare patient outcomes with national benchmarks determined by the American Medical Association (AMA) and the American Academy of Family Physicians (AAFP).
An example of this can be seen by a physician treating patients for chronic conditions such as diabetes, asthma or chronic obstructive pulmonary disease. In the case of diabetes, a physician can evaluate his or her patient outcomes and compare this information to national data. To reduce diabetes-related complications among patients, the physician might develop an intervention to address the problem such as doing routine hemoglobin A1c checks and foot exams.
For osteopathic physicians, the equivalent of PI CME is the American Osteopathic Association's Clinical Assessment Program (CAP) which assesses the performance of resident physicians. CAP has the same three-step structure as PI CME.
Demand for PI CME is expected to grow with increased demand from payers, hospitals and certifying boards on improving quality of care through health system reform including implementation of more rigorous maintenance-of-certification and licensure requirements. PI CME not only benefits the physician practice, but also the patients who will receive more systematic, evidence-based care from their physicians.
Source: American Medical News, Vol. 56, No. 1, Jan. 14, 2013