CONTINUING MEDICAL EDUCATION INFORMATION
Sponsored by the Duke University School of Medicine.

Meeting the Unmet Needs in HCV Treatment:  A Performance Improvement/Quality Improvement Program

Posted Date: 4/9/2013; Expiration Date: 4/8/2014
Estimated Time to Complete: 30 minutes

Statement of Need: Hepatitis C (HCV) is a major health problem. It can lead to cirrhosis, liver failure, or liver cancer and is the nation’s leading reason for liver transplants. HCV now causes more deaths than HIV in the United States.   HCV is particularly a problem for baby boomers; nearly 75 percent of Americans with hepatitis C were born between 1945 and 1965. Effective treatment is vital to cure patients and prevent progression and deaths from cirrhosis and liver cancer.    With that in mind Duke Medicine, one of the world leaders in HCV care, has created a Performance Improvement/Quality Improvement initiative with a goal to address the unmet needs in HCV treatment. Central to this effort is the utilization of expert knowledge, technology and expertise in successfully implementing QI models to drive population health improvement. We would like to invite you and your organization to participate in this initiative.

Target Audience: Physicians, Nurse Practitioners, Physician Assistants and healthcare providers who care for patients with HepC.

Activity Description:
This Practice Improvement Activity (PIM) gives you the chance to compare your current practice to the recommendations in the guidelines and use simple quality improvement (QI) tools that are integral to practice improvement. You will identify areas of practice strength and opportunities for improvement through the collection of patient and practice data, develop a QI plan, implement interventions, and complete a post-assessment process to determine if improvement was achieved. Educational Interventions targeted to gaps that currently exists in practice related to HepC patient care will also be made available through the PIM activity.

Providers who complete the PI activity can receive up to 20 AMA PRA Category 1 CME Credits ™.

This Performance Improvement Activity will lead you through a three-stage quality improvement process. The steps include:

  1. Stage A:  Self-Assessment and Analysis of current practice - Providers will self-assess their practices through an online case-based questionnaire followed by chart reviews of 10 patients based on pre-defined performance metrics.  You are allowed 60 days to complete the Baseline Assessment Phase.
  2. Stage B: Action - Providers will participate and complete a tiered educational program designed to address the performance/QI gaps identified in Stage A. During the Action Phase you will implement the interventions identified, either on your own or in collaboration with your clinic staff.
  3. Stage C: Reassessment - After completing the Action Phase and after one year from the first self-assessment, providers will re-assess their practices and complete a self-assessment questionnaire and a second set of chart reviews.  An optional chart review may be requested. Compare your reassessment and baseline assessment results to identify what, if any changes, you have achieved and the impact of those changes on your practice and your patients.
  4. You must finish all three stages to obtain the 20 AMA PRA Category 1  credits this PI activity is eligible for.  This activity also fulfills all requirements for Part IV performance Improvement MOC credit and is approved by ABIM for the same.  The performance improvement process takes time; please allow at least a year complete the entire activity.

Learning Objectives: Here are the learning objectives that were in the application:

  • Provide optimal quality of care based on established quality indicators for HCV patients.
  • Implement HCV treatment to the fullest extent, ensuring all gaps in treatment are adequately addressed.
  • Describe DAA drug therapies so that they may be administered and monitored in HCV patients, in accordance with practice guidelines.
  • Implement HCV treatment to the fullest extent, ensuring all gaps in treatment are adequately addressed.
  • List three side effects of DAA agents.
  • Identify the timeframe for each side effect that may occur.

Accreditation Statement: The Duke University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation: The Duke University School of Medicine designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

How to Receive CME Credit: In order to receive CME credit, participants must view the CME materials on accreditation information, target audience , learning objectives, and disclosure information. View the presentation, and complete the post-test and evaluation.  Upon submission of the evaluation, participants will receive a printable CME certificate.  In order to successfully complete this activity for AMA PRA Category 1 Credit(s) ™, learners must achieve a minimum of 80% on the post-test.

Staff and Content Validation Reviewer Disclosure: The staff involved with this activity and any content validation reviewers of this activity have reported no relevant financial relationships with commercial interests.

Resolution of Conflicts of Interest: In accordance with the ACCME Standards for Commercial Support of CME, the Duke University School of Medicine implemented mechanisms, prior to the planning and implementation of this CME activity, to identify and resolve conflicts of interest for all individuals in a position to control content of this CME activity.

Faculty and Planning Committee/Faculty Disclosure:

Andrew Muir, MD- Activity Medical Director
Director, Gastroenterolgy & Hepatology Research, Duke Clinical Research Institute,
Associate Professor, Department of Medicine, Duke University School of Medicine
Durham, North Carolina

Kevin Monroe, MBA- Steering Committee
IT Strategy Consultant, Duke Clinical Research Institute
Durham, North Carolina

Susanna Naggie, MD- Steering Committee
Assistant Professor, Department of Medicine, Duke University School of Medicine
Durham, North Carolina

Mitchell Shiffman, MD- Steering Committee
Director, Liver Institute of Virginia
Richmond, Virginia

Mitchell Mah’moud, MD- Steering Committee
Professor of Medicine, Duke University School of Medicine
Durham, North Carolina

The following speakers and/or planning committee members have indicated they have no relationship(s) with industry to disclose relative to the content of this CME activity:

  • Kevin Monroe

The following speakers and/or planning committee members have indicated that they have relationship(s) with industry to disclose:

  • Andrew Muir, MD, fulfills the role of principal investigator for Abbott Pharmaceuticals, Achillion, Bristol-Myers Squibb, Gilead, GlaxoSmithKline, Intercept, Merck, Pfizer, Roche, and Vertex; the role of Advisory Board Member for Achillion, Bristol-Myers Squibb, Gilead, Merck, Profectus and Vertex; the role of consultant for GlaxoSmithKline, Salix and Scynexis.
  • Susanna Naggie, MD, fulfills the role of Advisory Board Member for Abbott Pharmaceuticals, Boehring Ingelheim, Janssen and Vertex; the role of principal investigator for Bristol-Myers Squibb, Gilead and Vertex; role of back-up medical mentor for Anadys; role of virologic monitor for Synexis and Vertex; the role of back-up virologic menitor for Gilead and Medtronic; role of speaker for Clinical Care Options, France Foundation and QuantiaMD
  • Mitchell Shiffman, MD, fulfills the role of Advisory Board Member for Achillion, Anadys, Bristol Myers-Squibb, Boehringer-Ingelheim, Gilead, GlaxoSmithKline, Janssen, Merck, Novartis, Roche/Genentech and Vertex; the role of principal investigator for Abbott, Achillion, Anadys, Bristol Myers-Squibb, Boehringer-Ingelheim, Gilead, Globeimmune, Idenix, Intercept, Merck, Novartis and Roche/Genentech; role of speaker for Bayer, Gilead, Merck, Roche/Genentech and Vertex; the role of consultant for Conatus, Gen-Probe and GlaxoSmithKline
  • Mitchell Mah’moud, MD, fulfills the role of speaker for Merck

Acknowledgement of Commercial Support:
This CME activity is supported by educational grants from Merck and Vertex

Unapproved Use Disclosure: Duke School of Medicine requires CME faculty (speakers) to disclose to the attendees when products or procedures being discussed are off-label, unlabeled, experimental, and/or investigational (not FDA approved); and any limitations on the information that is presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion. Faculty at this symposium may discuss information about pharmaceutical agents that is outside of U.S. Food and Drug Administration approved labeling. This information is intended solely for continuing medical education and is not intended to promote off-label use of these medications. If you have questions, contact the medical affairs department of the manufacturer for the most recent prescribing information.

Disclaimer: The information provided at this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient's medical condition.

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