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Case Conundrum: What to Do When Your CME Partners Balk

Having trouble getting institutions to give you the data you need to get your activity rolling? Try these solutions.

Say you’re a medical education company that’s received a grant to undertake an ambitious project that involves working with multiple institutions to collect and analyze each institution’s data on how they measure biomarkers for non-small-cell lung cancer and how biomarkers impact treatment selection.

You plan to bring in an external faculty member to deliver education to each institution based on your analysis of its specific data, and work with each institution to develop actionable steps to help meet its specific goals. Then you will deliver a series of educational activities to support the efforts of staff responsible for implementing the changes, then analyze the data six months later to gauge the intervention’s impact.

Sounds like a great plan, right? Unless, as in a case study presented at the Fall 2017 CMEpalooza, the participating institutions aren’t, well, participating. Despite multiple contacts, they’re coming up with all sorts of excuses for not giving you the data you need to get the program moving.

Unfortunately, this isn’t a rare scenario. Here are five things that will help you avoid this kind of crisis, according to the expert CMEpalooza panel.

1. Reach out to the institutions before you even get the grant. “Always include them in the proposal development,” said Amanda Kaczerski, MS, CHCP, director of educational strategy and design, Academy for Continued Healthcare Learning. It also can help to involve the faculty or primary investigator in the discussions, along with the head of the department. Also, working with a number of institutions likely means you will have a variety of barriers to success, including varying access to electronic medical health records, added Linda Gracie-King, MS, managing partner/cofounder, AXIS Medical Education. “Having them involved in the development and vetting the study design might have led to greater buy in and commitment to the data extraction.”

2. Make sure everyone understands what you’re looking for, what you’re trying to achieve, and where those measures will come from. While it can be tedious to involve key stakeholders from all of those institutions, “spelling everything out in the development phase helps tremendously,” Kaczerski said. However, said Gracie-King, it can be challenging for medical education companies to get to the right set of people. “We may have great relationships with CME directors, but getting to those quality and risk managers and clinical folks who have the responsibilities for clinical improvement within their practices is sometimes hard to do.” It helps to ensure that the institutions you work with truly have an appetite for change and a willingness to work collaboratively with a MEC to bring outside education in, she said.

3. Create of list of the data you need to collect, then have a medical assistant do a manual data extraction of the charts so you don’t have to navigate each institution’s electronic medical records system. However, this can be expensive, especially if you haven’t budgeted for it. Gracie-King suggested that another way to approach it is from a performance-improvement angle.

“Knowing that this data was not readily available in the electronic medical record, it begs the question of how the clinicians are getting this very important information to inform treatment decision making for personalized medicine. Is there a breakdown in communication or care communication that prevents this information from being reflected in the EMR? My suggestion would be to go back to each of those five institutions to help them advocate and put a process and plan in place to add fields to the EMRs: Was biomarker testing done? Y/N. What were the results? Those results are really what need to be driving treatment decisions, and we know that the right treatment for the right patient at the right time leads to cost savings across the system,” she said. 

4. Let them know that you’ll do the heavy lifting. “A lot of times one of the first responses is, ‘We would love to do something like this, but we’re short-staffed, we have limited time and resources.’ We say, ‘Let us help you with that,'” said Gracie-King. “We position it as we, the MEC, will take on as much of the burden as possible," said Kaczerski. “We’ll be the coordinator; we’ll make sure they have the resources they need, so they just have to get the team and their process-improvement goals together. They always seem to be receptive to improving on some measures. Just be sure to position it so that the burden won’t be on them.” 

5. Get it in writing. Have a formal contract that outlines the roles and responsibilities of each party: what each will provide, expectations on time commitments, and expected participation levels. “It serves us well when we’re doing a year-long commitment that this is what we set out to do, and this is our expectation from all parties involved,” said Kaczerski.

To listen to the full session, which includes how to take this proposal to a Level 6 outcome, and what to do when a grand rounds activity appears to be veering out of compliance, visit the CMEpalooza Fall 2017 archives. And mark your calendars for CMEpalooza Spring 2018, a two-day event scheduled for April 25–26.

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