By Terrance Govender, MD
VP of Medical Affairs
As we continue our journey of getting physicians engaged, trained, and then sustaining a positive change in their day-to-day documentation practices, the topic of offering CMEs for physicians comes up frequently. Often, this is usually the first thing that comes up, even by non-clinical leaders when considering a CDI physician education program.
CMEs can be looked at as a means for incentivizing physicians for their participation in CDI. I have previously outlined my thoughts on this, which can be found here: ‘Should We Incentivize Physicians in CDI?’ This piece will talk more specifically about CMEs and CDI education for physicians.
As mentioned, CMEs offered for physician education in CDI can be viewed as a means to get physicians engaged in or to participate in physician education modules/programs. Do they work? Absolutely.
Attaining CMEs, while a necessity, can be very inconvenient to a clinician. Physicians must set aside time to attain these annually, and while these are learning opportunities, a physician is always (or at least should be) adopting a “continuous learning” state. Documentation of CMEs earned is something that is universally attractive to physicians, and chances are high that you will get their attention if offering CMEs.
While attractive, and admitting that it does work in most cases, I have a few issues with the practice of using CMEs to draw physicians into education sessions for CDI.
CDI Education Is Not A One-And-Done Topic
Changing physician documentation practices cannot be achieved, let alone sustained, through the attendance of one CME session.
Firstly, even if the physician changes behavior, it will probably be along the lines of one or maybe two common physician documentation practices that were not previously aligned with the core fundamentals of CDI. We run the risk of the physician, literally, viewing CDI (especially if this is their first exposure) as something that they could just check off a box and move on with their lives just as before.
Meaningful CDI results will require ongoing physician education, rather than a one-and-done approach. I will say that an initial CME CDI presentation could be used as an awareness strategy to get docs engaged through compelling content, which could cause them to work collaboratively with CDI in the future.
CME programs have strict requirements before they can be approved. Some of those requirements may address core competencies such as:
- Medical knowledge
- Practice-based learning and improvement
- Quality improvement
- Utilization of informatics
- Employment of evidence-based practice
- Interpersonal and communication skills
While I can make a strong case for CDI education in almost all of the categories listed above, certain CME programs may not view CDI content as meeting many of those requirements, and that can be challenging in getting them approved. Furthermore, most CME sessions require a minimum length of education time, usually ranging between 40 minutes to an hour.
Based on my experience, I believe that when it comes to CDI, physicians need snippets of information without fluff to get the best results. These types of education sessions should ideally employ different modalities, be frequent and consistent, and be paired with ongoing performance monitoring. Unfortunately, this approach does not fit the traditional CME session mold.
CDI Education Content
As a general statement, physicians usually attend CME sessions with the intent on learning something groundbreaking, innovative, and new with regards to evidence-based medicine, which they can implement in their daily practice that will benefit their patients. These high expectations among physicians can lead to discussions that may derail the presentation.
I believe that CDI education should never be about how to practice clinical medicine, but rather, should be about how to document the medicine that they are already practicing. A common misconception amongst physicians is that their clinical judgment is being questioned by the CDI program and its efforts. Education efforts should not bolster such a misunderstanding.
While CMEs can be very effective at drawing physicians into CDI physician education sessions, this can only serve as the beginning of a successful, long-term CDI education strategy. A long-term CDI education strategy will be necessary to achieve and sustain changes to day-to-day documentation practices. The initial CME session could be used as an awareness strategy, but we run the risk of physicians believing that they have completed their CDI training by attending a CME session.
With this in mind, I believe that rather than luring physicians into attending a CDI education session via CMEs, organizations and, especially, clinical leadership should set clear expectations with physicians as to what success in CDI entails, and that a CME-accredited session alone does not check off the CDI box.
“No one can get an education, for of necessity education is a continuing process.”
(Original article was published on ClinIntell Inc)