Background/Purpose: Medical claims data have been used since 2008 to measure the implementation of the diagnostic and referral strategies resulting from participation in RAPID® CME activities. Since its inception, over 69,782 clinicians have completed at least one RAPID® CME activity. We have reported statistically significant improvements in the participants’ diagnostic and referral performance (Bender S, et al. CE Measure, 2016;10:10-15). While measuring diagnostic and referral patterns is critical to the success of the initiative, the claims database is limited in its ability to provide objective measures in other areas that the RAPID® curriculum addresses. Therefore, an electronic medical record analysis was used to determine the curriculum’s effectiveness in improving clinician’s performance of quality measures associated with rheumatoid arthritis (RA): smoking cessation counseling, cardiovascular (CV) risk, tuberculosis (TB) testing, influenza and other vaccination strategies.

Methods: A retrospective medical record review of recruited providers’ patients was conducted for 23 primary care providers (PCP) meeting the study’s inclusion criteria. To be included in the study, CME participants needed to be a primary care provider currently managing RA patients interested in improving the quality of the care of their RA patients. In order to assess effectiveness of CME on the use of quality measures and patient care, a two-part chart review (pre/post) was conducted with same data compared from random samples of providers’ patients. The target population was defined as all patients, who received a diagnosis of RA, that were being treated by participants of the CME activities. Baseline reviews of 202 random charts from 23 PCPs were examined and compared on follow up with 198 charts from 21 of the same providers who also had participated in baseline chart examination. Patient inclusion criteria included: RA patients >18 years of age; RA ICD–10 codes present; and patients should be seen at least once/year. The quality measures were: Care plan; preventive care and screening; Pneumonia Vaccination Status for Older Adults; Pain Assessment and Follow-Up; falls plan of care; TB screening; tobacco use screening; screening for high blood pressure and follow-up documented; TB Prevention for pso, PsA and RA Patients on a Biological Immune Response Modifier.

Results: Statistically significant improvements were observed for five of the nine quality measures. Measures reaching statistical significance included: Care plan (9.39% Pre/24.29% Post/P-value < 0.0001); preventive care and screening (24.83% Pre/30.14% Post/P-value 0.0422); Pain Assessment and Follow-Up (3.66% Pre/6.59% Post/P-value 0.0096); high blood pressure screening and follow-up (86.1% Pre/94.9% Post/P-value < 0.0001); TB Prevention for pso, PsA and RA Patients on a Biological Immune Response Modifier (1.41% Pre/5.33% Post/P-value 0.0126).

Conclusion: A CME initiative improved clinical performance of learners that will lead to improved care and outcomes for RA patients. While limited in its ability to reach a large number of clinicians, use of electronic medical record data is a useful tool for assessing performance change.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/measuring-quality-improvement-from-cme-participants-results-from-the-rapid-cme-initiative/