What started the push toward outcomes measurement in CME?

I just got an e-mail from someone who is looking to pinpoint the origin of the current focus on outcomes measurement in CME. He says,

    I understand that ACCME and pharmaceutical company education managers are demanding better outcomes data, but is there a watershed event that this can be traced back to?

It seems to me that the demand has grown over the years due to a number of factors, but I'm not sure what the initial impetus was that got the ball rolling. Was it an IOM report? A lawsuit? A particular newspaper account? If you know, please either e-mail me or drop it in the comments area below. Thanks in advance for any help you can provide!

Update: I hear that the watershed event was the new ACCME Essentials, called System 98, that went into effect maybe six years ago (that was before my time with Medical Meetings). Do you agree that's what instigated the movement toward outcomes measurement?

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