CME has been shown to be effective and of value in several large studies. Yes, its effectiveness has been shown more convincingly for knowledge transfer than patient outcomes, but that is mostly secondary to the fact that CME was originally designed as a knowledge transfer medium. Only in the last few years has certified CME focused at level 5, 6 and 7 outcomes. Preliminary data from certified CME activities already looks positive and over the next few years as these projects mature, the results will be published in peer review journals and much of the present argument by a few vocal naysayers will be muted by hard data of improved outcomes.
CME is a strategic lever for change. Providers simply will not change unless they are educated as to why change is needed, what aspects of their practice need to change based on hard data, and a program of change that can be accomplished given barriers to care that exist within the present health care system. This sort of information and access to the experts regarding advances in care are principally provided through certified CME and thus it is fundamentally essential for improvement.
Numerous CME activities focus at quality and safety topics. The activities can and do serve a pivotal role in advancing these important aspects of health care. In case you doubt how important these topics are, at least from a fiscal perspective, recently the actuaries released a report on the cost of errors in health care (see links at bottom). They estimate “that measurable medical errors cost the U.S. economy $19.5 billion in 2008. Commissioned by the Society of Actuaries (SOA) and completed by consultants with Milliman, Inc., the report used claims data to provide an actuarially sound measurement of costs for avoidable medical injuries. Of the approximately $80 billion in costs associated with medical injuries, around 25 percent were the result of avoidable medical errors.” Key findings from the study include:
There were 6.3 million measurable medical injuries in the U.S.(2008); of the 6.3 million injuries, the report estimate that 1.5 million were associated with a medical error.
The average total cost per error was approximately $13,000.
In an inpatient setting, seven percent of admissions are estimated to result in some type of medical injury.
The measurable medical errors resulted in more than 2,500 avoidable deaths and more than 10 million excess days missed from work due to short-term disability.
Given the focus on quality and safety as key components of health care reform and the clear focus on cost control, the role that certified CME can play in this domain is critically important and frankly quite exciting. Certified CME can make health care reform work!