An Online Continuing Education Module to Support Evidence-based Clinical Guidelines
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1 An Online Continuing Education Module to Support Evidence-based Clinical Guidelines Craig Robbins, MD, David Price, MD, Sarah Shimer, Helen Morant, MD, Gladys Tom, Carolyn Simpkins, MD
2 About Kaiser Permanente (KP) Northwest Region Washington Oregon Largest U.S. nonprofit health plan Integrated health care delivery system No. California Region So. California Region Colorado Region Mid-Atlantic Region - Virginia - Maryland - D.C. Social Mission ($1.9 billion invested in communities) Serving 8 states and the District of Columbia Georgia Region 9.1 million members Hawaii Region 17,000+ physicians 48,000+ nurses 174,000+ employees Kaiser Foundation Kaiser Permanente Structure Kaiser Foundation Hospitals Health Plan + + Permanente Medical Group 38 hospitals 600+ medical offices & other facilities $53.1 billion operating revenue (2013)
3 KP National Guideline Program (NGP) Provides evidence-based clinical recommendations on core clinical topics. Implemented guideline recommendations help to reduce unwarranted variation in care and improve clinical outcomes. 3
4 KP NGP Portfolio Asthma Integrated Behavioral Health ADHD Depression Cancer Screening Breast Cancer Screening Cervical Cancer Screening Colorectal Cancer Screening Lung Cancer Screening Prostate Cancer Screening Integrated Cardiovascular Health CVD Risk Reduction Coronary Artery Disease Diabetes Dyslipidemia Hypertension Heart Failure HIV-STD Screening and Prevention Osteoporosis and Treatment 4
5 BMJ Learning Global medical education platform Founded in 2003 Over 250,000 users globally Module based e learning Personalized website experience with certificates and tracking (BMJ Portfolio) Hosts over 1000 modules including Core content modules for primary care and internal medicine Journal related CME modules commissioned by and for specific audiences learning.bmj.com 5
6 BMJ Learning Editorial Process BMJ Learning engages: Expert Authors Clinical Editors Multimedia producers BMJ ensures the modules are: Peer reviewed (during production) User reviewed (post-production) 6
7 Methods Modules: Cervical Cancer Screening Hypertension in African American patients Brief (20-30 minutes), focused on clinical actions. Active learning by multiple choice questions (MCQs), critiques, case presentations, learner narrative reflection, judicious use of multimedia, graphic and tabular presentation of key content, and learner identification of commitment to change (CTC) statements (Wakefield, 2003; Price, 2008) and identification of barriers to intended practice change (Price, 2010). 7
8 Large Single Point Slide 8
9 Results- Cervical Cancer Screening In concordance with the new guidelines and the information presented in this CME activity: % Highly Likely In the next 3 months, how likely are you to identify when to start screening women for cervical cancer screening? In the next 3 months, how likely are you to identify when to use pap smears and HPV testing for cervical cancer screening? In the next 3 months, how likely are you to tailor recommendations for screening intervals for women based upon their risk factors? % (18) 58.1% (18) 51.2% (16)
10 10
11 Results- Hypertension In the next 3 months: How likely are you to assess and address sodium sensitivity as a potential factor in hypertension control? How likely are you to use the CMI Hypertension Guideline and the information presented in this module to tailor pharmacologic treatment to help improve hypertension control in African American patients? % Highly Likely 77.3% (28) 77.3% (28) 11
12 Most Common Barriers 12
13 Conclusions Guideline utility depends on implementation Online continuing education modules may support evidence-based guideline implementation To be more useful in the future, we must learn how to engage more clinicians in accessing and completing the online modules 13
14 Questions? 14
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