While continuing medical education (CME) remains essential for closing knowledge and competence gaps, many in our field are actively exploring how CME can better support learners in applying evidence within real-world systems and workflows. When striving to extend learning outcomes toward measurable improvements in care, there is an opportunity for CME to more intentionally connect education with implementation.

At the 2025 Alliance Industry Summit (AIS), I presented on how CME can be paired with electronic medical record (EMR) tools, quality improvement (QI) methods and learning collaboratives to bridge the gap between learning and practice. Three themes stood out from that session and the conversations it sparked: education is most effective when connected to system-level support; learning collaboratives offer a practical structure for combining CME and QI over time; and EMR tools are most valuable when introduced alongside education and adapted to local workflows. This article expands on those themes and highlights practical directions for CE teams seeking to support learners beyond the point of instruction.

When Motivation Meets System Barriers: A Learner Perspective

Well before I put together the AIS session, I conducted learner interviews after a series of CME activities delivered to clinicians practicing in a federally qualified health center (FQHC), and noticed this same desire to increase the connection between learning and implementation. One clinician, reflecting on the CME activities, shared: “The education was excellent — I learned so much. But afterward, I felt awful, because I didn’t have the tools in my practice to actually do what I had just learned.”

The comment was not a critique of the education itself. Rather, it reflected a common and understandable tension: high-quality CME can clarify evidence, reinforce best practices and motivate change, while simultaneously exposing gaps in workflows, resources or system-level support that sit outside the control of individual clinicians, particularly in resource-constrained settings.

For CE professionals, this tension highlighted an important opportunity. When education illuminates what should be done without pathways for how it can be done, learners may feel inspired yet limited. When CME is paired with implementation-oriented support, such as exposure to EMR tools, examples of workflow redesign or participation in a learning collaborative, it can help convert that discomfort into productive momentum.

Importantly, in my experience, learners in implementation-focused educational settings are often well-positioned to identify where system changes are needed. With appropriate educational framing and implementation resources, CME can support clinicians in becoming advocates for improvement and equipping them to initiate conversations, engage internal stakeholders and participate meaningfully in practice transformation within their organizations.

CME and System Design: A Shared Opportunity

A recurring question from attendees of my AIS session was how CME fits alongside EMR-based interventions, such as order sets, dashboards or clinical decision support. The discussion underscored a growing recognition that education and system design are interdependent.

My answer to these questions: EMR tools shape clinical behavior at the point of care, while CME provides the context, clinical reasoning and shared understanding needed to use those tools effectively. When developed in parallel, education helps clinicians understand not only what is changing within the EMR, but also why those changes matter and how they can be applied safely within local workflows.

It is also important to acknowledge that EMR changes beyond documentation, such as building order sets, best practice advisories, referral workflows or reporting dashboards, are often costly and time intensive. These efforts typically require governance approval, informatics resources and sustained maintenance, as well as a champion within the clinical environment to move them forward. In many cases, the CME learner can be well positioned to serve as that champion to use education to build alignment, articulate the clinical rationale and initiate conversations with informatics, quality and leadership teams.

Many CE programs already incorporate implementation considerations through case-based learning, discussion of barriers and practical examples. Making EMR artifacts, including draft order sets, note templates or sample metrics, an explicit part of CME offers one way to further support learners who are interested in advancing change within their organizations, without positioning education as prescriptive or burdensome.

Structuring Education to Support Ongoing Change

Another theme from the AIS discussion was the importance of how educational programs are structured over time. In the examples shared, foundational CME was delivered live, with asynchronous options to ensure accessibility. Opportunities to participate in follow-on QI activities were introduced immediately after the educational activity, allowing learners to translate insight into action while momentum remained high.

This work can take shape through learning collaboratives, where CME is intentionally paired with QI support over a defined period. Learning collaboratives provide a structured yet flexible environment in which learners can test changes, share experiences and learn from peers while earning CME credit. For many CE teams, this model represents a natural evolution by combining education with guided application rather than expecting change to occur in isolation.

Learning collaboratives have shown promise in chronic disease management and access-to-care initiatives, where improvements often depend on workflow redesign, team-based care and coordination across settings. In Ohio, for example, participation in a statewide CME- and QI-supported learning collaborative focused on diabetes care was associated with a 15% increase in access to diabetes services over one year, reflecting expanded referrals, improved care coordination and greater utilization of evidence-based programs. In these contexts, CME establishes a shared evidence base, while QI methods and peer learning help translate that knowledge into measurable practice change.

Integrating EMR Tools Within CME and Collaboratives

CE teams are also exploring how EMR-enabled tools can be more intentionally integrated into both educational activities and learning collaboratives. One emerging example for my team in 2026 involves emergency preparedness education focused on patient engagement. Rather than presenting recommendations alone, the course encourages faculty to discuss where patient education fits within visit workflows, how it might be supported by documentation tools and how EMR prompts could reinforce best practices.

Within learning collaboratives, EMR tools can serve as optional resources that teams adapt to local needs, such as smart phrases, referral workflows, or data dashboards. CME provides the clinical and conceptual foundation, while the collaborative structure supports iterative testing and shared learning. This approach allows education to remain flexible and learner-centered while still engaging with the realities of system-level change.

Where This Approach Has Been Most Useful

Experience to date suggests that combining CME, EMR tools and learning collaboratives may be especially effective in certain areas.

Programs focused on defined patient populations, such as Diabetes Self-Management Education and Support (DSMES), offer clear opportunities to align education, workflows and measurement. Similarly, guideline-driven care areas, where evidence-based pathways are well established, lend themselves to this integrated approach, as teams can focus on implementation rather than consensus-building.

Across these settings, quality improvement methods provide a common framework for assessing progress, identifying barriers and refining interventions over time. For CE professionals already committed to outcomes-based education, QI offers a familiar and practical extension of existing work.

CME as a Partner in Ongoing Improvement

A key insight from the AIS discussion was that clinicians often look to CME not only for information, but for guidance on how to navigate increasingly complex systems of care. High-quality education can motivate change, but sustained improvement typically requires additional support.

By pairing CME with EMR tools, QI methods and learning collaboratives, CE teams can offer learners a pathway from understanding to action — without positioning education as the sole driver of change. Instead, CME becomes a trusted partner in a broader improvement process, supporting clinicians as they adapt evidence to local contexts and, in some cases, step into the role of change champion within their organizations.

Key Takeaways for CE Professionals

As CME continues to evolve, several themes emerge:

• CME plays a critical role in preparing learners to engage with system-level change.
• Learning collaboratives offer a practical model for combining CME and QI.
• EMR tools are most effective when paired with education and local adaptation.
• Chronic disease and access-to-care initiatives are strong starting points.

The future of CME lies in supporting learners to learn and to implement.

By continuing to experiment, collaborate and learn from one another, the CME community has an opportunity to further strengthen its impact — supporting meaningful improvements in care while remaining responsive to the needs of learners and patients alike.

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Zarah Mayewski, PharmD, is senior vice president of care solutions at Innovation Horizons, where she leads initiatives integrating continuing education, quality improvement and system-level implementation. A pharmacist by training, she works with public health agencies, health systems and care teams to design education that supports measurable improvements in care delivery.