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Creating Behavioral Change to Boost Online CME Training


Getting busy physicians to participate in continuing medical education is almost impossible unless they think material is practical for them. It also helps if some of it is mandatory.

There’s no question that physicians who see their schedules get busier all the time prefer the convenience of obtaining continuing medical education (CME) online. They can do so in the comfort of their own home, at a reduced cost and can take a break whenever they choose. The results of a recent survey support these assertions.

According to the Joint Survey of Physician Digital Behavior, conducted by San Francisco-based ON24 and Boston-based MedData Group, 84% of the 971 doctors surveyed said they would prefer to attend events such as CME training online. However, only 6.4% say they participate in these events very often.

So, what’s the problem?

Providing incentive

Gar LaSalle, MD, FACEP, is the chief medical officer for TeamHealth, one of the country’s largest providers of hospital-based clinical outsourcing, as well as executive director of the TeamHealth Patient Safety Organization. Getting physicians engaged in ongoing training is his focus.

“You can only force people to do so much, and then you burn them out,” LaSalle says. “And so the responsibility, I think, of an educator is to really provide compelling information that is going to be practical for them, and that they’ll be able to use.”

It also helps to make some of it mandatory.

In 2009, TeamHealth became one of the 90 certified AHRQ patient safety organizations in the country. TeamHealth addressed this “sizeable responsibility” by mandating that every one of its physicians, mid-level practitioners and nurse practitioners had to be part of its patient safety organization.

The company’s ability to mitigate professional liability insurance costs and reduce malpractice actions arising from bad outcomes is highly dependent on being able to put high-risk information in front of physicians. However, they need to be able to do so in a protected manner so a plaintiff’s attorney couldn’t then use it against their physicians.

But TeamHealth didn’t stop there.

Push-pull technology

Coupled with the mandatory CME training, LaSalle and his team also created a wide range of other material posted online. Every year TeamHealth credits about 140,000 to 150,000 hours of category 1 CME to its more than 6,000 physicians and mid-level practitioners so that they can keep up with their credentialing requirements and their licensing requirements. The online material not only covers high-risk topics, but other things that are germane to the clinicians’ practices.

“What we have effectively created is something that is both a push technology, as well as a pull technology,” LaSalle explains. “And by push I mean, the mandatory process is they have to do this: they have to go to that site anyway for things that they do on a day-to-day basis. And the pull is that it’s incumbent on us to make the website attractive enough and user friendly enough that they will be compelled to explore that issue further.”

Most importantly, the strategy is working. TeamHealth has achieved 100% compliance with the mandatory, high-risk educational material that is being provided, and claims have been driven down enormously over the years. As far as the voluntary material is concerned, LaSalle says the organization has a much higher access rate than what is normally the industry standard.

And the company still isn’t stopping there.

Healthy competition

TeamHealth is currently beta testing several clinical initiatives, including providing every physician and mid-level practitioner access to his or her own data in comparison to everyone else within the organization who sees a specific type of patient.

“We can show them a display of all the patients they saw within a particular category in a given year, and let them see how they perform against all of the physicians within their group,” LaSalle says. “We can’t identify which doctors those are, but every physician is able to see his or her own data.”

LaSalle believes that once physicians see that they are below the mean in any category — even though that does not imply that they’ve done anything wrong — they’ll want to improve in that category. Not only are physicians very competitive, they also want to do the right thing for their patients.

LaSalle’s goal is to be able to tell a physician how he or she compares to peers: where they outperformed the group and where there is opportunity for improvement. And then to provide literature to back up the information provided.

“I anticipate that once they figure out how to use that tool, they’ll pay attention to the material,” he says. “And that’s pretty darn exciting. It creates behavioral change.”

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