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商业利益在继续医学教育中的作用:电子健康记录供应商的定位在哪里?

Commercial Interests in Continuing Medical Education: Where Do Electronic Health Record Vendors Fit?

机构信息

P.F. Rubinstein is director, continuing and professional education, American Medical Informatics Association, Bethesda, Maryland.

B. Middleton is chief informatics and innovation officer, Apervita, Inc., Chicago, Illinois; ORCID: https://orcid.org/0000-0002-1819-1234.

出版信息

Acad Med. 2020 Nov;95(11):1674-1678. doi: 10.1097/ACM.0000000000003190.

Abstract

The Accreditation Council for Continuing Medical Education (ACCME) will not accredit an organization that it defines as a commercial interest, that is an entity that produces, markets, resells, or distributes health care goods or services consumed by, or used on, patients. Thus, commercial interests are not eligible to be accredited organizations offering continuing medical education (CME) credit to physicians. This decision is based on the concern that commercial interests may use CME events to market their products or services to physicians, who then might inappropriately prescribe or administer those products or services to patients. Studies have shown that CME events supported by pharmaceutical companies, for example, have influenced physicians' prescribing behaviors.Currently, however, the ACCME does not recognize electronic health record (EHR) vendors, which are part of a multi-billion-dollar business, as commercial interests, and it accredits them to provide or directly influence CME events. Like pharmaceutical company-sponsored CME events, EHR vendor activities, which inherently only focus on use of the sponsoring vendor's EHR system despite its potential intrinsic limitations, can lead to physician reciprocity. Such events also may inappropriately influence EHR system purchases, upgrades, and implementation decisions. These actions can negatively influence patient safety and care. Thus, the authors of this Perspective call on the ACCME to recognize EHR vendors as commercial interests and remove them from the list of accredited CME providers.

摘要

继续医学教育认证委员会 (ACCME) 将不会认证其定义为商业利益的组织,即生产、营销、转售或分销医疗保健产品或服务的实体,这些产品或服务由患者消费或用于患者。因此,商业利益没有资格成为提供继续医学教育 (CME) 学分的认可组织。这一决定基于以下担忧,即商业利益可能会利用 CME 活动向医生推销其产品或服务,而医生随后可能会不恰当地为患者开处方或使用这些产品或服务。例如,研究表明,制药公司赞助的 CME 活动已经影响了医生的处方行为。然而,目前 ACCME 并不将电子健康记录 (EHR) 供应商视为商业利益,尽管它们是价值数十亿美元的业务的一部分,但认可它们提供或直接影响 CME 活动。与制药公司赞助的 CME 活动一样,EHR 供应商的活动虽然仅固有地侧重于使用赞助供应商的 EHR 系统,但其潜在的固有局限性,可能导致医生的互惠行为。此类活动也可能不恰当地影响 EHR 系统的购买、升级和实施决策。这些行为可能会对患者安全和护理产生负面影响。因此,本文作者呼吁 ACCME 将 EHR 供应商视为商业利益,并将其从认可的 CME 提供者名单中删除。

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