How does the ACCME expect small providers to produce data on patient outcomes and evaluate the impact of CME on patient outcomes? This seems impossible.

The ACCME does not require accredited providers to measure patient outcomes -- neither in their CME Mission (Criterion 1), activity planning (Criterion 3), nor evaluation of CME activities (Criterion 11). The 2006 Criteria require providers to base their education activities on gaps in practice and to measure educational outcomes in terms of change -- in competence, and/or performance, and/or patient outcomes.