The effect of an individualized practice-based CME program on physician performance and patient outcomes.

The Professional Competence Assurance Program (PROCAP) is an individualized educational program that examines physicians' performance in ambulatory practice. It uses medical record review to identify deficiencies in the care process that guides development of the educational intervention. Medical care is reassessed one year later. This program was used with 51 private practitioners to assess the care of 1,229 hypertensive patients. The educational program included a computer printout comparing one physician's performance with that of peers, readings targeted to management problems, and a conference call or group seminar with an expert stressing issues relevant to each physician's performance. Postintervention assessment showed that physicians prescribed beta-blockers (P<.01) and vasodilators (P<.01) more often. Improvement (P<.05) occurred in the control of diastolic blood pressure (</=90 mm of mercury) and in several other criteria. These results show that well-designed, individualized continuing medical education addressing specific deficiencies can change physicians' performance and patients' intermediate outcome.