How does PennCME/BestPractice PI CME work?
 
OVERVIEW
Performance Improvement (PI) CME credit can be earned through a structured, self-assessment process of continuous practice improvement. Physicians document their performance in practice based on evidence-based measures, participate in educational intervention(s), apply PI measures and strategies prospectively over a useful interval, and complete a post-intervention self-assessment to measure changes in clinical practice behavior and patient outcomes and to reflect on the PI exercise. Up to 20 AMA PRA Category 1 Credits can be earned through this process.
Your goal in using PI CME is to improve the care of your patients with chronic diseases and your practice performance by following 3 steps:
1.      Identify gaps in care of a group of your patients with a particular disease such as diabetes by comparing measures of your care with accepted guidelines and the performance of your peers.
2.      Take action to close these gaps by implementing 1 or more of the following methods: acquire new evidence-based knowledge, apply clinical tools and strategies at the practice management level, and/or improve communication and partner with your patients to better engage them in the management of their chronic disease. Apply changes in your practice over time.
3.      Assess the improvements in your clinical practice and patient healthcare outcomes by reassessing your practice using the same measures of care for a group of your patients and comparing those results with your initial assessment and against evidence-based guidelines and the performance of your peers.
 

PennCME/BestPractive Type 2 Diabetes Performance Improvement CME Module is approved through the American Board of Internal Medicine(ABIM) Approval Quality Improvement (AQI) Pathway and is eligible for 20 points towards the Self-Evaluation of Practice Performance requirement of Maintenance of Certification (MOC).

BENEFITS
  • Improved patient outcomes
  • Better organized practice
  • Improved patient satisfaction
  • Earn up to 20 AMA PRA Category 1 Creditsfor each PI CME exercise
  • Satisfy a Maintenance of Certification requirement (Part IV)
  • File your patient data with the Centers for Medicare and Medicaid Services (CMS) and qualify for a 2% bonus on all of your Medicare Part B charges in this calendar year through the Physician Quality Reporting Initiative (PQRS)

COST

  • There is no charge for your participation in any of the PennCME/BestPractice PI CME modules
  • Your investment will be in time spent to enter data, reflect on the findings, set goals, implement changes in your practice, and remeasure and analyze the results
  • Your staff may assist you in this process by pulling charts and organizing data for entry
  • The only direct cost to you is associated with your choice to participate in the PQRS program, in which case you will be charged a modest fee of $195 per annual submission to CMS

 

How can you measure the effectiveness of PennCME/BestPractice PI CME?
 
To begin with, you will enter data for a group of patients with, for example, diabetes. As the data sheet is completed, you will be able to see what percentage of patients has an HbA1c of <7% or blood pressure below 130/80 mm Hg, the norms in national guidelines. Suppose those percentages are 60% of patients at acceptable HbA1c levels and 65% within the normal range for blood pressure.
 
On reflection, you may decide that the goals should be at 80% for each measure over the next 6 months. Your next step is to decide how to move toward this goal. Perhaps you will want to review the latest evidence regarding treatment of type 2 diabetes with insulin and/or oral agents (available at Type 2 Diabetes Resources). Next, you may want to consider how to motivate patients to adhere more successfully to a regimen of diet and exercise (resources at 8 Steps to Streamlining – and Improving – Management of Your Diabetic Patients).
 
To check progress at 3 or 6 months, you remeasure a group of patients with type 2 diabetes, and you find that patient care is really improving. Now, 70% of patients have HbA1c levels of <7% and 75% have blood pressure readings of 130/80 mm Hg or below. You are on track to reach your goals, and now you may again reflect on what more you and your patients can do to get to that 80% target.
 
This educational resource is designed to be helpful to you; it is available as a self-study module whenever you choose to engage in it. It will allow you to complete multiple cycles of assessment and improvements by working on a single area of interest at a time. With this continuous quality improvement tool, you can set your own goals that will show you clear benefits in your personal practice and may help you drive improvements with other members of your team and the practice as a whole, as well as directly impact your patients’ health outcomes.
 
What you need to know
 
Recognizing that PI is a component of Continuing Professional Development (CPD), the AMA has developed a mechanism for awarding AMA PRA Category 1 CreditTMfor physicians participating as individuals or groups in these projects. These are the 3 components, each of which entitles you to 5 credits on completion. You will receive an additional 5 credits when you complete an entire cycle.
 
A.      Assess: Self-assessment of current practice: You must complete a self-assessment instrument and a review of a minimum of 10 patient charts in a given area of chronic disease, entering data based in the 10 specific measures that were derived from the nationally accepted evidence-based practice guidelines. You will then be comparing your practice performance with established guidelines and with the performance of your peers. The data and our feedback report will identify gaps between current and ideal practice and point to potential specific areas for improvement. Click here, to learn more about the Type 2 Diabetes PI-CME module, or to get started.
 
Critical point: If you wish to use some or all of the data you collected to participate in the PQRS program for Medicare bonuses, you must complete data on the PQRS  specific measures for 30 patients you have seen in a calendar year. Please note that the assessments and the chart abstraction tool are identical in PI and PQRS versions of the Assess phase. The only difference is the number of charts needed for submission and the subset of measures required for PQRS reporting. In addition, you will be charged $195 for submission of your data to CMS. There is no other charge associated with this module.
 
B.      Improve: Development and implementation of a PI plan: You will begin by reflecting on the gaps you have identified, and decide which of these to address. Then you will set goals for improvement. Finally, you will determine the interventions to address the performance gaps. These may include application of evidence-based guidelines and/or suggested educational activities and tools and strategies designed to improve delivery of patient care processes and procedures. You will be able to choose from many offered resources in addition to selecting your own interventions. You will record your plan on the form provided, and monitor your progress over the timeline you establish.
 
C.      Evaluate: Assessment of the impact of the PI plan: Using the measures identified in stage A, you will complete another 10 or more patient chart reviews to determine your progress toward your goals. You will be provided with feedback comparing your performance with your benchmark, the performance of your peers, and national goals. On the basis of this analysis, you may decide to participate in additional cycles of the same PI CME module, review and use additional resources, or identify new goals and engage in other PI CME modules.
 
D.     Reflect: The PI cycle is completed during the final stage of reflection on the process of improvement that was completed. The structured reflection on the process and the evaluation of its usefulness and effectiveness will be offered. During this phase you will be provided with an opportunity to engage in the next cycle of improvement, which may start directly with the “Improve” stage.
 
Up to 5 credits can be awarded for any of the 4 stages. Some of the PI CME stages are quite similar to the traditional CME planning and evaluation process and will include other CME-certified activities as interventions become available during the Improve stage. However, this new approach differs from how we have usually certified CME in that physicians are much more involved in determining personal gaps in practice and assessing individual and team-based needs, designing the interventions and applying them in practice and, finally, evaluating the changes.
 
Continue to learn more or enroll in the Type 2 Diabetes PI CME program.
 
Continue to learn more about PQRS.

 

Copyright © 2010-2013  Perelman School of Medicine at the University of Pennsylvania Office of Continuing Medical Education. All rights reserved.