Continuing Medical Education in Emerging Market

June 2009

Dr Saurabh JainDirector – CME Solution

Indegene LifesystemsBangalore, INDIA

E Mail – sjain@indegene.com

Why should Doctors do CME Emerging Market?

Engaging ContentAbility to deliver content in an

engaging fashion and in a way that lends value to the physician’s

practice

Credible Content Developed in

Association with International Center of Excellence

ReachPartnered with

Pharmaceutical companies or Medical Associations to reach out

Physician

Performance Improvement

In Absence of regulation doctor will do CME only if it adds value in practice

Guiding Principle for effective Continuing Medical Education Programs in India

Performance Improvement Key for Success In Emerging Market

Performance Improvement Initiative

Create improvement plan and Create improvement plan and implement in practiceimplement in practice

Current practice Performance assessment

Application of performance Improvement to patient care

Evaluation of the Performance Improvement

Review patient charts and Review patient charts and record metrics of his/her current record metrics of his/her current

practicepractice

Review charts and compare Review charts and compare with baselinewith baseline

Reflect on benefits of Reflect on benefits of improvements to patientsimprovements to patients

A B C

KOL

Regional Faculty

Physicians

Indian /International

Faculty

Physicians

Partner with leading experts/International CME Provider to add credibility to program

Build program momentum

Deploy educational programming to meet physicians’ needs

KOL

Asses Current Practice and Identify the Gap to Build Curriculum

Tropical Diseases Chronic Diseases

Family Physician Specialist

Performance Improvement in Different Groups

Practice Assessment through Questioner

Practice Assessment is done through Virtual Case stimulations

Based on Practice Assessment Clusters are defined for Program implementation

Practice Assessment

Family Physician Specialist

Clustering Mechanics

Current Practice Assessment versus Guidelines

Assessment

Cluster 1 Cluster 2 Cluster 3 Cluster 4

Cluster Mapped through Benchmarking Data (Internationally accepted Guidelines)

Practice Assessment Through Questioner

Practice Assessment through Virtual Case stumulations

+Individual Doctor behavior Guidelines

Curriculum Mechanics

Patients Profiles in Diabetes as per Disease Continuum

Regional and local KOL Partnership to

formulate Curriculum

Categorization of Profile for different level based on Secondary research and KOL

feedback

Program A2.Lifestyle management3.Glucose control levels4.Clinical monitoring5.Glucose control: oral therapy6.Glucose control: insulin therapy

Program B2.Blood pressure control3.Cardiovascular risk protection4.Eye screening5.Kidney damage6.Foot care

Program C2.Nerve damage3.Pregnancy4.Children5.In-patient care6.Special Situation

Target Group

Cluster 1

Cluster 2

Cluster 3

Cluster 4

Q1 Q2 Q3 Q4

Program A2.Lifestyle management3.Glucose control levels4.Clinical monitoring5.Glucose control: oral therapy6.Glucose control: insulin therapy

Program B2.Blood pressure control3.Cardiovascular risk protection4.Eye screening5.Kidney damage6.Foot care

Program C2.Nerve damage3.Pregnancy4.Children5.In-patient care6.Special Situation

Program B2.Blood pressure control3.Cardiovascular risk protection4.Eye screening5.Kidney damage6.Foot care

Program C2.Nerve damage3.Pregnancy4.Children5.In-patient care6.Special Situation

Program C2.Nerve damage3.Pregnancy4.Children5.In-patient care6.Special Situation

Involved as Regional Faculty

Targeted CME for Behavior Change

Modular Format

Presentation

45 Min

Dis

cuss

ion

Lunch Break

30 Min

Case Discussion

30 Min

Pos

t E

valu

atio

n

Streptococcus Pneumoniae (pneumococcus)

A 63-year-old male presents with fever and cough

Lower Respiratory Track Infection

LRTI

Reading Material Handout

+ + +

Respiratory Symptoms URTI Asthma COPD TuberculosisLRTI

Indegene EventEngine™

Crossing Borders with integrated CME Programs

Need Gap IdentificationNEED GAPS through Dip stick study among target audience including subject matter experts.

Local Case Studies developed by Regional Faculties based on Defined learning Objective

Local Clinical Data collection for devloping

Program

1. All 16 cases to be sent to advisory board for review, advisory board selects 4 best cases collaborates and International Bodies designate members

2. CME Universe enhances the case contents as per the suggestions received and further sent to advisory board for review

CME Content Development

Defining Key Learning Define Key learning Objectives on basis of Primary research and secondary Research

4 Cases studies developed and presented at each country local Meet

Need Assessment and CME Content Development

Crossing Borders with Integrated CME Programs

India PhilippinesIndonesia Malaysia

Crossing Borders with Integrated CME Programs

Participant activity report and clinical reasoning and educational effectiveness report (CREE) developed.

Expert interviews and post activity reviewed as part of a continuous needs assessment.

Quantitative and Qualitative

Reporting of CME Activity

Recruitment 2400 Primary Care physician recruited for this activity through field force of Grantor

Interactive case stimulation delivered to Physicians in CD / summary booklet/Online Platform

Interactive Patient Simulations CME

An offline/online post-test and evaluation survey for completion of the initiative.

Certificates will be issued to participants.

Evaluation/Post-Test

Schematic of CME Activities

India

Print Module +

Online Modules

Indonesia

Print Module

Philippines

Print Module +

Online Modules

Malaysia

Online Module

10. Online module for reference (24 x 7 access)

11. Patient education Material

1. 24 x 7 online query handler at website.

2. Medical Representative Can also submit request on Behalf of doctor

3. All the queries will be answered through a personalized mail from mentor

1. All the request submitted at this will be forwarded to Mentor for answer

2. Medical Representative Can also submit request on Behalf of doctor

3. Center will coordinate with Mentor for answering these queries through Personalized call from Mentor

1. Once in month Mentor will be available for web chat and telephonic chat

Support and Guidance

Help Desk

Support platforms are key for driving compliance for CME programs in India

Summary

Most of Emerging Markets don't have any CME accreditation systems currently

Performance Improvement initiative customized to target audience is key for success

Multinational Pharmaceutical companies are key funders for unbiased CME activity in country

Support platforms are key for driving compliance for CME programs

International content, Institute and Association add credibility to CME programs designed for Specialist

Thank you.