Check out this video by Medical Meetings columnist and president of Global Education Group Stephen Lewis, who points out a bright side of the otherwise fairly dismal information in the 2009 ACCME data report:

Like most, I was riveted by the pretty startling drops in commercial support and total income, and didn’t think to look at per-HCP costs. Funny how different people bring different perspectives to the same set of data, isn’t it?

But it gets me wondering why the per-HCP cost is decreasing. Is it because of the type of activities (i.e., Internet-based activities instead of live courses)? More HCPs per activity? You’d think it would be increasing, since the cost of everything else is increasing. How are you all able to do this?

The good folks over at Policy and Medicine have put together a handy chart of companies that disclose their educational grant payments for 2009 and 2010.

I read an interesting editorial in yesterday’s Boston Globe about Massachusetts’ $250,000 academic detailing pilot program, and I can’t help but be a tad impressed by it. I know a few years ago there was a lot of talk, if not action, around academic detailing, but I haven’t heard much recently.

Is this a promising direction for CME in the future? If so, who will pay for it? It sounds like some states and countries are willing to invest in it, but with the rate of innovation we have in healthcare, need could quickly overtake the financial resources available. Would docs pay out of pocket for it? Hmm.

There’s been lots of talk lately on the CME LinkedIn group about the need for someone, anyone, to take the lead in advocating the value of continuing medical education.

I think the ACCME is listening. In its June/July e-newsletter, ACCME also announced a survey it’s conducting to find out what accredited CME providers and other CME stakeholders are doing to “promote accredited CME’s value as a strategic priority,” from what you’re doing to what is and isn’t working to get the word out in your own organization, and the world at large. They’re also asking for ideas on how ACCME can “support you in these efforts.” ACCME plans to publish the survey results in an upcoming newsletter.

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Why is it that ACCME always manages to release something juicy either right before or right after Medical Meetings goes off to the printer? Just minutes after all the files were finalized, the June/July edition of The ACCME Report hit my in-box, and it’s crammed full of goodies.

Amongst said goodies is a pdf download link to the Annual Report Data 2009, which gives us a peek into what’s going with with ACCME-accredited providers, plus state- and medical society-accredited providers. I haven’t had a chance to crunch the numbers yet, but others are already on top of it (query: Does anyone else wonder if Thomas Sullivan ever sleeps?).

Just a quick glance at the 2009-2008 numbers tells a story, though:

Total CME income: down almost 8 percent

Commercial support: down almost 18 percent

Number of accredited providers: down by 18

Number of activities: down almost 6 percent

Hours of instruction: down 10 percent

(Here’s a link to our writeup of last year’s report, which wasn’t terribly rosy, either.)

What, me worry?

This just in from the ACCME (press release):

Chicago, June 28, 2010— The Accreditation Council for Continuing Medical Education has provided additional guidance related to the role of ACCME-defined commercial interest employees in accredited CME. The guidance outlines the ACCME standards for ensuring independence for CME about discovery and research.

We are providing the updated guidance as a result of discussions we have had over the last several months with accredited providers concerning the role of commercial interest employees in accredited CME about research and discovery. The ACCME’s objective is to support the free flow of scientific exchange while safeguarding accredited CME from commercial influence.

The 2004 ACCME Standards for Commercial Support: Standards to Ensure Independence in CME Activities call for accredited providers to produce accredited CME that is independent and free of the control of ACCME-defined commercial interests.

In 2009, in response to questions from providers, the ACCME provided guidance about the role of employees of ACCME-defined commercial interests in accredited CME. The ACCME said that under some circumstances, employees of ACCME-defined commercial interests can plan, speak and present in accredited CME – and in some circumstances they cannot. This ACCME policy relates to Standard 1: Independence.

In order to serve the best interests of the public, the ACCME is careful to avoid making policy that would interfere with the translation of discovery into appropriate use.

We recognize that it is important for accredited CME to include reporting about the discovery phase of product development. We also realize that employees of ACCME-defined commercial interests are often involved in research and discovery. We appreciate that accredited providers face complex challenges when determining how to integrate discovery and research into accredited CME while safeguarding independence and complying with ACCME requirements. Over the last two years, the ACCME has worked closely with accredited providers as they have adapted their CME programs to comply with ACCME policy regarding the role of employees of ACCME-defined commercial interests in accredited CME. The ACCME and accredited providers have worked together to develop strategies that facilitate the appropriate flow of new information, while at the same time preserving accredited CME’s independence.

Together, the ACCME and accredited providers have recognized that there are circumstances where an employee of an ACCME-defined commercial interest can make a scientific presentation within accredited CME about their company’s research — and be compliant with the ACCME Standards for Commercial Support. The guidance includes examples of important factors for providers and the ACCME to consider in determining an appropriate role for an employee of an ACCME-defined commercial interest in planning or presenting accredited CME.

The ACCME will continue to answer providers’ questions and support them through the process of developing and implementing strategies to meet ACCME standards for independence.

I’d like to say that CME is in the news because of an amazing activity that is improving patients’ health, but alas, it’s not to be. No, instead it’s the latest wrinkle in the “is commercial support and/or industry-provider collaboration evil” debate that was featured in the New York Times: Debate Over Industry Role in Educating Doctors

If you can, I hope you get outcomes like this doc did when she got creative in getting patients to get their mammograms: A Smashing Good Time.

If you do offer activities designed to help physicians look into different ways to get their patients to comply with best healthcare practices, please let me know (here’s my e-mail). I’d love to hear how you did it — and what the outcomes were!

Today I got a press release about something called Disaster Hero. From the release: “Video game developer and publisher Legacy Interactive® today announced a contract with the American College of Emergency Physicians to develop a game designed to teach children and their families how to prepare for all types of hazards or emergencies. This project is funded by a grant (2008-GT-T8-K028) from the Department of Homeland Security.” (Aside: Interesting form of nontraditional commercial support!) I could easily see another version of this game being developed for healthcare providers and emergency care workers as well.

It reminded me of a session on games at GAME (which sounds funny now that I think about it!) Tyson Greer, CEO of Ambient Insight, gave a very cool session on mobile applications for healthcare learning. I wish I could link to her presentation, but I don’t think it’s posted yet. She talked about how healthcare is leading the mobile learning evolution because of what she called a “perfect storm”: a large and growing buyer demographic, powerful Internet-connected convergent devices, new mobile learning development tools and delivery platforms–4,800 apps have already been developed for health, fitness, and medical use–and an explosion of new learning content apps and mass-market content distribution channels. Oh yeah, and the growth in wireless broadband.

And some of those apps are pretty cool. She mentioned things like Active Ingredient, where you create a world based on what the heart monitor you’re wearing says (if it’s good, you walk down a pretty path; not so good, not so pretty). Another very cool sounding game that’s more physician-focused was Healing Blade (”Are you an Apothecary Healer or a Lord of Pestilence? This is the question posed by Healing Blade, a table-top card battle game designed by two physicians that combines sorcery and creatures with a real-world knowledge of infectious diseases and therapeutics.”) She also mentioned apps developed by MedPage Today that teaches docs how to discuss with patients all the health-related news they’re hearing about on TV and in the papers (and on Twitter, etc., etc.). And she said there are mobile learning products aimed at healthcare licensing exam prep.

As Greer said, “Learning can be fun. Learning in an engaging environment works.” I think we’re going to be seeing a lot more of it.

Just a week and a half ago I was in beautiful Montreal, Canada, for the 15th Annual Global Alliance for Medical Education meeting. Now I’ve been to a bunch of Alliance for CME conferences, and the Annual Conference of the National Task Force on CME Provider/Industry Collaboration, and the “CME Olympics,” not to mention a workshop or two and even a CME boot camp. So I’m a little jaded when it comes to this type of event.

It just blew me away. The opening keynote by Thomas Stossel, MD, from Harvard Medical School (who would have guessed that someone so passionate and intense could be so funny?), was intriguing, thought-provoking, and squirm-inducing, all at the same time. I didn’t agree with everything he had to say, but I love that someone cares this deeply about the role of industry-provider collaboration in healthcare innovation.

The glimpses into the worlds of both healthcare and CME in countries as diverse as the U.S., Canada, Malaysia, Argentina, Mexico, Japan, India, and the European union were both eye-opening, and a little scary (really, only 0.6 physicians per 1,000 people in India, a country with a population of more than a billion? And, according to Saurabh Jain, MD, director CME solutions, Indegene Lifesystems, Bangalore, it has “no real CME system.”)

The performance improvement programs sessions were among the best I’ve attended, and I’ve been to some really good ones. Finally, a session about data and performance improvement that I actually understood! Thank you to Michael Barbouche, MD, with Odeondata, for making me laugh while turning on that data lightbulb.

But they saved some of the best sessions for last—Suzanne Murray of Axdev broke us up into small groups to talk about international collaboration initiatives we have been a part of, including the challenges, barriers, and things that worked well. The energy level in the room skyrocketed, and while I knew that regular communication–face-to-face, if possible–is vital to international collaboration, I learned that it’s also important to define your terms, even if you all speak the same language. (Did you know that satellite symposia are very different things in the U.S. than they are in Europe?)

At the end of the last day, three experts gave us a glimpse into the future of CME, from mobile learning—there are some awesome apps out there already, and more coming online daily—to simulations, and of course social media, which was used throughout the meeting, mainly through Twitter. Yes, I was a tweeting fool, at least until my netbook battery died, ironically, just before the social media session. Check out the #game2010 twitter stream for yourself to see what the buzz was about.

Look for articles on all of the above in future issues of Medical Meetings, and if you are at all interested in collaborating internationally on CME, give some serious thought to attending next year’s meeting in Munich, Germany. Really, it was that good.