Online CME More sites available, but few opt for convenience

by David Orenstein free-lance writer

Online continuing medical education sites continue to grow, yet many physicians continue to ignore them.

When Computing Care last looked at online CME three years ago, it was no surprise that few doctors were getting credits through their browsers. Fewer physicians were Internet-savvy and far less CME was available online. But now that a lot more doctors and CME sites are online, why aren’t more doctors getting their CME credits via the Web?

Bernard M. Sklar, MD, spends a lot of time thinking about this. Dr Sklar, a physician turned online CME consultant in Berkeley, Calif, maintains a handy annotated list of CME Web sites at www.cmelist.com. He also compiles statistics about the growth of online CME and notes, “There is a disconnect between doctors going online to get medical information and doctors going online to get CME credits.”

When Dr Sklar started counting in April 1997, he found only 13 sites. Two years later the number had quintupled and by December 2000, his burgeoning database included 150 sites with 3510 activities, totaling about 5500 credit hours. The substantial growth continued unabated through his December 2002 study, in which the numbers reached 229 sites with 11,485 activities and totaling 19,105 hours.

During that time, Internet use among physicians also grew. According to the AMA, while only 24 percent of physicians accessed the Web daily in 1997, two thirds did so in December 2001. DMJ readers apparently are no different. According to our 2002 survey, two thirds of respondents had Internet access at the office where, presumably, they use it for something other than CME.

Online CME usage certainly has grown since 1997, but it remains a tiny portion of how CME is done overall. According to the Accreditation Council for Continuing Medical Education, online CME as a percentage of total CME grew from 0.34 percent in 1997 to 4.44 percent in 2001. The growth is substantial, but Web-based CME clearly remains irrelevant to most physicians.

What makes this puzzling is that online CME has much to offer. Live CME can’t beat online convenience. It is available 24 hours a day and accessible from anywhere. Online CME is not expensive, either. According to Dr Sklar, 53 percent of sites are free and another 21 percent charge $10 or less per hour. CME on the Web covers a variety of medical specialties—from cardiology to urology—and comes in a variety of formats—from straightforward reading to clever games. Any computer bought in the last three years can handle any CME technological requirements.

The legitimacy of online CME is beyond question. Baylor College of Medicine in Houston offers an especially well-respected site of cardiology-related CME, Dr Sklar points out.

He offers several explanations for why physicians have embraced the Web without embracing CME on the Web. The most important is that CME providers have not offered much CME credit for the information that doctors actually seek on the Web. Sites that combine CME with relevant content, Dr Sklar says, may be more appealing to physicians. “The key is to make it meaningful,” he says.

Some efforts have been undertaken to make online CME more enticing. SKOLAR, a Stanford University spin-off, offers CME credit for medical research done online, but it is costly. Other sites link medical news to CME credits by combining current stories with CME content and quizzes.

If the popularity of online CME doesn’t take off, however, it may be because attending live events sometimes comes with something the Internet will never deliver.

“Free breakfast is a very powerful inducement,” Dr Sklar quips.

David Orenstein is a technology and business writer in Silicon Valley. To learn more about a technology topic in Computing Care, e-mail him at davealli@comcast.net.