Best Practices / Research Oral Abstract

Four-year Collaboration in CME Among Latin American Institutions (O003)

Alvaro Margolis (EviMed) Benjamín Santiago (Triple-S Salud) Elisa Martínez (EviMed) Juan Dapueto (EviMed) Leticia Lorier (EviMed) Zenaida Fernández (Triple-S Salud) Thais Forster (EviMed) Natalia Miranda (EviMed) Carla Muñoz (EviMed) Antonio López (EviMed) 


EviMed is a CME Company with headquarters in Uruguay. Since 2007, it has worked with Triple-S Salud, a leading Managed Care Company in Puerto Rico affiliated to Blue Cross Blue Shield Association, and the University of Puerto Rico Medical Sciences Campus, implementing blended interactive CME for Puerto Rican primary care physicians.


There is a need for clinical practice improvement in frequent conditions. As part of this goal, the main health insurance company of Puerto Rico, Triple-S Salud, decided to include CME activities designed for impact on clinical practice. Since 2007, EviMed has helped Triple-S develop and implement this initiative, together with the University of Puerto Rico.


A series of actions were undertaken: first, a needs assessment was performed and an action plan was developed. Initially the plan was pilot-tested and later deployed among all participating primary care providers, implementing a complex CME intervention, including face-to-face events, small-group learning and internet-based study. The main strategy of this educational model was to provide for a high interaction among peers with the coaching of experts. Later, it was fine-tuned, with more integration into clinical practice and into other quality improvement efforts. A long-term goal has been to create and nurture a community of practice.


Depression management was piloted in a group of 62 primary care physicians. Then it was offered to the population of primary care physician providers (3,462), where 457 of them registered and participated. Later, new topics were addressed, including prescription of radiologic studies in several common chronic conditions, hypertension management in the elderly and preventive services in the context of health care reform.


Close collaboration between distant countries for the design and deployment of complex CME interventions represents an opportunity to share clinical practice experiences in these diverse environments, analyze obstacles and challenges in common and develop strategies to face them.

Funding Sources

This initiative was funded by Triple-S Salud.


1. Martínez E, Margolis A, Joglar F, Alonso D, López Arredondo A, García S. From Uruguay to Puerto Rico: similarities and differences in CME and the context of health care. Continuous Medical Education Congress, Vancouver, Canada, May 2008.

2. Llambí L, Margolis A, Toews J, Dapueto J, Esteves E, Martínez E, Forster T, López Arredondo A, Lockyer J. Distance education for physicians: adaptation of a Canadian experience to Uruguay. J Contin Educ Health Prof. 2008 Spring; 28(2): 79-85.

3. Llambí L, Esteves E, Martinez E, Forster T, García S, Miranda N, Lopez Arredondo A, Margolis A. Teaching tobacco cessation skills to Uruguayan physicians using information and communication technologies. J Contin Educ Health Prof. 2011 Winter; 31(1): 43-48.