By Nanette Bahlinger, Jenny Mataj and Heidi Watts
The joke at our institution was that there were so many CME-certified activities that physicians could earn credit by walking down the hall. Why then, was it so difficult for some physicians to earn enough CME credits to maintain their license?
Like most states, Tennessee requires physicians to obtain a minimum number of CME credits for license renewal, and for years it fell to colleagues in Provider Support Services (PSS) to ensure compliance for all credentialed physicians at Vanderbilt University Medical Center. This process involved accessing the CME database to check individual transcripts — an enormously time-consuming task for PSS staff — that was not always appreciated by physicians whose credit totals fell short of the state’s standard.
When CME requirements were separated from the re-appointment credentialing process and PSS no longer had to monitor physicians’ credits, the institution recognized that if there was no longer a department responsible for tracking CME credits for physicians, this could be a potential risk for the medical center. And while the institution acknowledged that it was the physicians’ own responsibility to maintain their license(s), it also acknowledged that physicians were overburdened by deadlines, documentation, regulations, paperwork, meetings and many other non-clinically related duties.
The associate chief of staff and the director of PSS contacted the Office for Continuous Professional Development (OCPD) to explain the dilemma. “Could OCPD take over monitoring?” they asked. If OCPD would be required to contact each individual physician, the answer was no; our office was simply too small. Also, our office also did not have access to license numbers and renewal dates. We had requested this information from physicians for our online system, but so few knew their license numbers and dates that we opted to remove the fields from the profile page to avoid storing inaccurate information.
The online system we were using at the time had been purchased off the shelf and heavily customized by our internal Education Informatics program. Our original plan had been to create a learner dashboard that included license and board numbers, renewal dates, etc. for easy online access. It had never occurred to us to push out the information … until we were approached by the associate chief of staff and PSS. However, we still lacked a reliable source for the data.
After numerous meetings and approval from executive leadership, the institution agreed to transfer license renewal data from the PSS database to the CME database. Once we gained the ability to have access to license renewal data, we brainstormed how we could most efficiently utilize the information and give physicians’ updates regarding their CME credit totals and reminders regarding their license requirements. Our office decided that we would send out quarterly reminders to all physicians in our system regarding CME and license information to assist them in tracking their CME progress throughout the year.
The first reminders were distributed in August 2017 (thereafter they were sent quarterly (January, April, July and October), and the content was specific to each provider:
- Customized data included period of re-licensure, credits earned to date during that period, prescribing credits earned to date and license expiration date
- General data included state requirements, link to CME website with online prescribing activities and link to the state’s CME FAQ, including exempted specialties
- Providers were advised that they would be sent quarterly reminders, even if they had met the state’s requirements
- Providers were reminded that it was their responsibility to ensure that the data listed was accurate
- A “contact support” link appeared at the bottom of the email
Earlier this year, we decided to upgrade our learning management system, which houses all of our physician CME data. License renewal reminders were among our top requirements for the new system, and since none of the three online systems we were considering for purchase included the feature, we chose the vendor that immediately recognized its value. An upcoming release (2019) of CloudCME® will include many of the content items listed above, but on a larger scale. Providers will be able to enter CE requirements for a variety of healthcare professionals for all 50 states, for example. In addition, reminder messages will be customizable and will display in the portal once learners access the system.
In the end, our four email reminders a year turned a funny punchline into more meaningful education. Now when physicians walk down our hallways, they are fully aware they are maintaining their licenses while learning how to improve patient care — and soon healthcare providers at other institutions will be able to do the same.
- Obtain data from reliable sources.
- Customize the content of the reminders.
- All content should appear on one screen (no scrolling necessary).
- Patient care improves when the non-clinical burdens placed on providers are reduced.
- Collaboration leads to success.
- Helping physicians maintain their licenses makes CME relevant.
- Helping institutions to monitor license renewals for physicians makes CME providers relevant.
* Authors are colleagues in the Vanderbilt University Medical Center Office for Continuous Professional Development:
- Nanette Bahlinger, MTS; Assistant Director
- Jenny Mataj, MMHC; MOC Manager
- Heidi Watts; Program Manager (Heidi Wilson Watts earned her Healthcare CPD Associate Certificate in June, 2018)