ACCME’s President and CEO, Graham McMahon, MD, MMSc, discusses how accredited CME can support physicians and improve patient care as healthcare delivery becomes increasingly digitized.
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Mimi Sang
Welcome to Coffee with Graham, a podcast brought to you by the Accreditation Council for Continuing Medical Education. I'm your host, Mimi Sang, and I'll be joined by ACCME’s President and CEO, Dr. Graham McMahon, as we discuss important topics brewing in the world of health care and continuing education. Grab yourself a cup of coffee or tea and join us for the discussion. On this Coffee with Graham episode,
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Mimi Sang
I want to start out by asking you what you're drinking these days. Coffee? Tea? What's your flavor?
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Graham McMahon
Tea? Coffee? Me? I'm reminded of the challenges that we are all facing and the fact that we indulge ourselves in times of trouble. I find myself getting myself going in the morning with coffee and then tea to kind of wind myself down at night. That comes from my Irish heritage, where tea is the way we connect with each other.
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Graham McMahon
There's always time for a cup of tea.
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Mimi Sang
So in this episode, we'll focus on the increasingly digital world of health care and health care delivery. These days, patients have a plethora of options for digitally managing their health from electronic medical records to web applications. And as a physician, what benefits do you see in digitizing health care?
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Graham McMahon
Well, what a huge topic to take on, Mimi. I have lots of responses to this. Part of it is being overwhelmed. Part of it is being excited and how to balance the remarkable opportunities we have with digital health care, with the challenges that we face and the burdens that are places on individual clinicians is a really difficult balance to make.
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Graham McMahon
And I find it myself in my own practice. As you know, I do a lot of diabetes care in the endocrinology clinic where I practice, and that requires a lot of interaction with patients between visits, not just and straightforward things like medication renewals or updates on a patient's lab results, but patients message me all the time on their digital systems and expect rapid communications and feedback back.
00:02:10:06 - 00:02:39:08
Graham McMahon
That creates big challenges for me in time management because patients expectations in a digital world are different. We know mobile phones are almost ubiquitous at this point. We know most browsing occurs around on mobile phones. We know patients expect to hear from their physician when they message them. Patients research their doctors, they research their conditions, they manage their medicines, all sorts of things in these mobile environments.
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Graham McMahon
And honestly, medicine has been slow to keep up with the expectations of our patient community, but we have lots of opportunities here too. Digital communications, as I mentioned, are opportune, create better relationships that are trust through interactivity. And once you establish the opening opportunity for patients to work with you, I have generally found patients very respectful of the boundaries that are reasonable for patients to work with me through an environment like that.
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Graham McMahon
But it's also really challenging for me to navigate the new expectations for managing my patients with large volumes of data, because now we see data being presented to me in my electronic health record in dashboard of sorts, and I'm starting to see patterns that I wasn't able to see before. And there are more patterns to be discovered if you have the time to invest in working with that increasingly complex and deep information that individual patients have and that are presented more nimbly by these systems.
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Graham McMahon
And then I think the third big thing is not just communications, telemedicine, and dashboarding, but then how to use digital devices in patients homes and how to work with that information. In my world, in diabetes care, obviously insulin pumps, continuous glucose monitors, home blood pressure meters, home weighing scales, step counters, are all core parts of how I deliver care, and I have to be familiar with how to bring that information to inform the recommendation I make for an individual patient.
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Graham McMahon
So between those three axes alone, communications, dashboarding, home devices, it is a transformed world. And if I don’t keep up, I will be behind. And there are challenges in keeping up because there are so many things to be kept up with.
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Mimi Sang
That make sense. How do you think physicians can best support their patients as health care becomes increasingly digitized? What is the value of digital literacy for not only patients, but also for their loved ones and caregivers?
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Graham McMahon
Well, it's inevitable that digitization will increase, not decrease. There’s no slowing down in this environment. So we best support our patients by presenting options for them that are most easily actionable. Now, an example might be an older patient who says, I'm not downloading an app for an electronic health system. I still want to be able to call the clinic.
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Graham McMahon
Do you still have a system of taking calls from the clinic, even though most of your patients have moved over to an app? Those create new demands for the system. But until everyone's in, you have to create options for patients who want to communicate or work with you in different ways. I have patients who don't want home devices.
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Graham McMahon
They don't want them monitoring, patients who want to use the pharmacy that they've trusted for years and don't want to move to virtual care pharmacies that might auto deliver their medicines more efficiently. So I think the key thing is supporting patients where they are, give them the extent of tools that you can and they seem to be willing to accept, but don't sell your patients short.
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Graham McMahon
A lot of my older patients are much more nimble and adroit with using these technologies than you might imagine or that I might have anticipated. So don't assume that just because a patient is of a certain demographic or age that they won't be able to, because in most cases they'll surprise you.
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Mimi Sang
That's a very hopeful note there. How can continuing medical education address digital literacy skills?
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Graham McMahon
Well, in order to change and evolve, we have to learn. And these are skills that we apply in our daily practices that are sometimes self taught and learned through experience. But increasingly they're also learned from our colleagues in our environments, from the technology companies, from our educational providers. And I think the first thing is not to be as scared of change because it's inevitable and it's going to actually help you in the long term.
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Graham McMahon
And the second is to engage with change and explore that change. Find training program or an attribution of of learning, whether it's from your peers or colleagues or your institution that will help support you to build these new skills. And then be patient with yourself to deploy those new skills. When I recently had to deploy onto a new electronic medical record system, which is a big transition for clinicians who are usually pretty fluid with how they work with digital data systems.
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Graham McMahon
I had to be patient with myself. I had to reduce the flow of patients to allow me to get used to using new electronic systems, set up my new templates, set up my ordering systems, work everything out so that I was able to navigate these systems. So identify the need, embrace the change, be patient with yourself, but then practice makes perfect and continuously check in, see how it's working for you and evolve.
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Graham McMahon
And the continuing education community is there for you to try and help you navigate these systems. And you can find relevant activities for whatever it is that you need from the 180,000 activities listed on CME Passport that'll help you find activities and learning experiences that are going to meet physicians’ needs.
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Mimi Sang
Great. As we discussed the benefits of digitizing health care, I wonder how this model can be applied to CME for physicians. More specifically, is there a way that physicians can find and track their CME credits similar to how patients view and monitor their records via digital platforms?
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Graham McMahon
Yeah, it's a really good point because we've talked about digital communications with patients, we've talked about digital care, telemedicine devices, mobile care, electronic health systems, even automated staffing. But now you have the opportunity to think about yourself and your own data around you to help you be a better health care professional. And that data comes from sources around us.
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Graham McMahon
And when it's aggregated, it can be a lot more powerful than the anecdote that might come across your email. I would say becoming more self aware is required for physicians in a very rapidly changing health care environment. And the best way to be aware of yourself is to look at how you're spending your learning time. And a way to do that is to look into a data repository or your own list of learning experiences that you’ve experienced and try and choose something new.
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Graham McMahon
A lot of us tend to gravitate to areas of strength, so I might choose to learn even more about diabetes when you know it's a large part of what I already do. I should be spending time making sure I understand more about dermatology or thyroid conditions or heart disease in my patients; other areas that are a little more outside of my sphere so that I can pay attention to those issues more effectively and be aware of the emerging trends in each of these areas.
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Graham McMahon
So staying aware of what you're already doing, planning for change by reflecting on what your broader needs might be, and then going and finding those activities that meet those needs are going to really help you grow as a professional.
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Mimi Sang
What is CME Passport and what is the value of this unified data system?
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Graham McMahon
Well, CMEPassport.org is a website that physicians can log into right now and see their completion data for organizations that are submitting information into that centralized transcript. That transcript can be shared with anyone who needs to see it, but is shared automatically with a variety of the certifying boards and the licensing boards all across the country to make it much easier for physicians to learn and meet their educational expectations for themselves without having to worry about the administration of their credits.
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Graham McMahon
So the credits can be reposited in a particular domain and then shared with a variety of entities who need to see it. And that's all in the power of the individual physician to control the destination of their transcript and decide where to send it to. Most physicians get their education from multiple sources, not just one. And having a central place where data is reported for that physician makes it easier for him or her to track and manage their own CE and their own learning life.
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Graham McMahon
We at ACCME are here to promote learning to thrive and learning for professional excellence. And this is a way to track and manage your own learning completions and make it easy to administer the allocation of those credits to wherever you need them to be seen.
00:11:28:02 - 00:11:52:08
Mimi Sang
Thank you, Graham, for discussing this topic today. And thanks to you, our listeners, for joining us. Check out previous episodes of Coffee with Graham on Spotify, Apple Music or Buzzsprout. If you have questions about today's podcast or suggestions for topics you'd like us to cover, write to us at info@accme.org. Thank you for listening and as always, Learn Well.