Internists gain new practice modules

Colonoscopy, hepatitis C and HIV are among the new topics general internists and subspecialists can learn about in computer-based practice improvement modules that earn credit toward maintenance of certification.

The American Board of Internal Medicine said the modules enhance quality of care by letting doctors review current clinical practice guidelines and compare them with their own practice.

"We need multiple [modules], given that we cover a broad spectrum of specialties," said Eric Holmboe, MD, ABIM vice president for evaluation research and director of clinical performance services. "The doctors who have done them have enjoyed them."

In March 2003, the board introduced its first practice improvement module, which dealt with preventive cardiology. Other PIMs address diabetes, asthma, hypertension, general preventive services and care of the vulnerable elderly.

The newly added colonoscopy module is based on evidence-based guidelines developed by gastroenterology societies and examines steps from pre-procedure care to biopsy results.

"It's a very positive move on the part of the board to offer a recertification tool that also has the potential for legitimate practice improvement. It's practical and it goes beyond simple knowledge assessment," said Philip Katz, MD, chair of the division of gastroenterology at Albert Einstein Medical Center in Philadelphia.

The hepatitis C module helps physicians identify areas of care that can be improved. The HIV module guides doctors through a review of care to HIV patients to pinpoint gaps in care. A hospital-based patient care module uses performance data collected by hospitals to take physicians through an evaluation of the quality of care for patients with community-acquired pneumonia and other conditions, the board said.

ABIM officials said the board was developing additional modules that would focus on care for patients with osteoporosis, communications between physicians and patients, comprehensive care and care of patients on mechanical ventilation. Release dates have not been announced.