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CME at hand: Information you need, when you need it

Pilot projects are giving physicians CME credit for point-of-care learning with handhelds as a way to apply practice guidelines more effectively.

By Myrle Croasdale, amednews staff. Nov. 24, 2003.

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Family physician Daniel F. McCarter, MD, has a library of evidence-based medicine, diagnostic calculators and best-practice guidelines at his fingertips via his handheld computer.

When a patient complains of an inflamed leg and shortness of breath and mentions that he's recently taken a plane trip, Dr. McCarter can look up the clinical decision rules for a pulmonary embolism on the handheld instead of reaching for a textbook.

He sees 20 to 25 patients on a typical day and uses his handheld on a regular basis during those interactions.

"I use [the handheld] so much I don't really think about it. It's almost like using the stethoscope," said Dr. McCarter, an associate professor of clinical family medicine and director of clinical affairs at the University of Virginia School of Medicine's Dept. of Family Medicine in Charlottesville.

But one thing is missing from his learning experience -- CME credit.

"If I could get credit for what I'm doing here, that would be tremendously helpful," he said. "Going to a conference and sitting there being put to sleep by the lecturer doesn't change behavior long term. When you actually get the information when it makes a difference -- that's the way to go."

Soon Dr. McCarter and other physicians who are using handhelds or other tools to learn on the job might get their wish.

It's well documented that adults learn best by solving problems, CME experts say, and for physicians this means learning in the exam room or at the patient's bedside. But the creation of CME that brings learning into the physician's office and then tracks the impact on patient outcomes has been slow in developing.