STRATEGIC OPPORTUNITIES · MSMS CME CONFERENCE FOR PROVIDERS Dr. Steve Singer 8/14/2017 ©ACCME 2017 FOR EDUCATIONAL USE ONLY 1 MSMS CME CONFERENCE FOR PROVIDERS AUGUST 11, 2017 STEVE

MSMS CME CONFERENCE FOR PROVIDERSDr. Steve Singer

8/14/2017

©ACCME 2017 FOR EDUCATIONAL USE ONLY 1

MSMS CME CONFERENCEFOR PROVIDERSAUGUST 11, 2017

STEVE SINGER, PHDVP EDUCATION & OUTREACH

STRATEGIC OPPORTUNITIES

Current and EmergingCollaborations to

Enhance the Value ofAccreditation


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Are any of these statements true?

Learners’ needs arechanging fast.

Although we’repracticing in teams,education is largelysiloed.

It’s hard to engageclinicians in qualityand safety initiatives.

Clinicians primarilyattend to get thecredit, rather thanlearn.

Health professionalburnout threatensour mission.

Educators areunder-appreciatedand continuingeducation is under-funded.

AMA CollaborationALIGNMENT AND EVOLUTION

Evolving AMA PRA system to:• Simplify expectations• Harmonize with ACCME requirements• Shared glossary• Facilitate and encourage innovation and flexibility


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Examples of Designating an Activity as “Other”ACTIVITY FORMATS

• Bedside learning• Virtual reality• Social media• Blended quality improvement

and skills-based activities• Gamification in learning

Visit www.accme.org for more information.

• Providers can designatecredits on an hour-per-creditbasis, using their bestreasonable estimate of the timerequired to complete the activity

• ACCME will modify PARS toenable providers to enter “other”as an activity type.

Centers for Medicare and Medicaid Services

• Proposes to recognize accreditedCME as a mechanism to meetclinical practice improvementactivity expectations ofMIPS/MACRA legislation

• Pursuing opportunities to allowproviders to report required datathrough PARS


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ACGME CollaborationINTEGRATION WITH THE CLINICAL LEARNING ENVIRONMENT

• Using CLER (Clinical LearningEnvironment Review)Feedback

• Faculty Development• Share milestone data• Wellness curriculum• Educational leadership/Chief

Learning Officer• Operational alignment

Building the Value of CME

Leadership valuesaccredited CME Educational leaders

C-SuiteLeaders in Quality and Safety

The output is recognized

American Board of Medical Specialties boardsCenter for Medicare and Medicaid Services

Credentialing authoritiesState Licensing

Providers have flexibility American Medical Association

Food and Drug Administration


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CME can connect…

• The continuing education professional with the learner• Across the medical education continuum

Medical School, Graduate Medical Education

• Interprofessional teams• With quality improvement• With public health

Making ConnectionsEducational

Expertise

Quality & SafetyPriorities

Public HealthPriorities

LocalGaps & Needs

LicensureCertification

Credentialing

LearnerCommunity You


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Overview

• Encourage and reward best practices in pedagogy,evaluation, change management and generatingmeaningful outcomes

• Community asked us to… Recognize provider best practices Create flexibility for different types of organizations Balance rigor and attainability

• Commendation remains optional.

Implementation

• ACCME-accredited providers receiving accreditationdecisions between November 2017 and November 2019have the option to demonstrate compliance with: OPTION A: Current Commendation Criteria (C16-C22) or OPTION B: New Commendation Menu (C23-C38)

• All providers receiving accreditation decisions afterNovember 2019 must use Option B (new commendationmenu C23-C38) to seek Accreditation with Commendation


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The Menu Approach

• 16 Criteria in five categories• Choose 7 from any category• Choose (at least) 1 from

“Achieves Outcomes”category

Why Require Outcomes?

There was widespread consensus that it is important todemonstrate the relevance, value and impact of CME.

Assessing outcomes will help the CME community identifymore effective ways of delivering CME that contributes tohealthcare improvement.


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Supporting Documentation

On the ACCME websitewww.accme.org/commendation

Wheel graphic is available at www.accme.org.

Determining ComplianceACCME.ORG/COMMENDATION

Criterion requirement

see page 36


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Rationale for each Criterion’s inclusion

see page 36


Critical Elements required to demonstrate Compliance

see page 36


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The Standard for measuring Compliance

see page 36

Determining Compliance (cont)ACCME.ORG/COMMENDATION

• Activity-based vs program-based standards• Sliding scale to accommodate CME programs of different

sizes• Approaches for demonstrating compliance include:

o Attestationso Submitting evidence at review (It may be possible to meet multiple

Criteria with one CME activity.)o Examples and descriptions


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Educational ResourcesWWW.ACCME.ORG

• Explanatory videos

• Ask ACCME FAQs

• Examples of Compliance

• ACCME 2018 MeetingApril 16-19, 2018 in Chicago

PromotesTeam-BasedEducationwww.accme.org/teambasededucation

Members of inter-professional teams areengaged in the planning anddelivery of interprofessionalContinuing education (IPCE).

C23

Patient/publicrepresentativesare engaged inthe planning anddelivery of CME.

C25

Students of the healthprofessions are engagedin the planning anddelivery of CME.C24


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Compliance with Criterion 24EXAMPLES

Due to the rise in awareness about sports concussions in recentyears, a medical specialty society began holding an annual conferencededicated to prevention and treatment. The planning committeeincluded experts in clinical neurology research, athletes who hadexperienced sports concussions, and coaches from all levels ofcompetition from youth to professional athletes. During theconference, one of the professional athletes and several coachesparticipated in a panel sharing their first-hand experience about thelifelong effects of concussions on athletes’ physical, mental, andemotional health.

Addresses PublicHealth Prioritieswww.accme.org/publichealthpriorities

The provider advancesthe use of health and

practice data forhealthcare improvement.

C26

The provider addressesfactors beyond clinical care

that affect the health ofpopulations.

C27

The providercollaborates withother organizationsto more effectivelyaddress populationhealth issues.

C28


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The Director of Nutrition Services recognized the barriers facing many patientswho are referred for nutrition counseling. The patients had limited access toaffordable fresh fruits and vegetables, were not well educated on how to makegood choices at the grocery store, and had limited insight on healthy cooking.The CME department, along with nutrition services, the medical library, and alocal community Seed-to-Feed program, collaborated to start three regularprograms for clinicians and their patients to participate in together: tours of alocal vegetable garden; grocery store tours with a nutritionist; and accessingdatabases, books, journals, and websites containing evidence-based resourcesand recipes.

Enhances Skillswww.accme.org/enhancesskills

The provider designsCME to optimizecommunication skillsof learners.

C29

The providerdesigns CME tooptimize technicaland proceduralskills of learners.

C30

The providercreatesindividualizedlearning plans forlearners.

C31

The provider utilizessupport strategies to

enhance change as anadjunct to its CME.

C32


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The provider delivered a CME course that seeks to improveskills in scientific writing as it applies to publishing clear andeffective scientific papers. The coursework included severalhours of online instruction and writing assignments, followedby an onsite workshop where healthcare publishing expertsreview assignments and provided feedback to each learner.


A provider holds a monthly CME online webinar series on “Hot Topicsin Psychiatry.” After each webinar, participants are invited to participatein an online discussion about the topic of the month utilizing a mobileapp. The provider analyzes the participation during the discussion andincludes questions to the learners about how to improve the onlinediscussion to gain greater participation and engagement. The providershows what improvements were made to the questions and cases tofacilitate easier engagement and follow-up with the learners.


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DemonstratesEducationalLeadershipwww.accme.org/educationalleadership

The provider engagesin CME research andscholarship.

C33

The provider supportsthe continuousprofessionaldevelopment of its CMEteam.C34

The providerdemonstratescreativity and

innovation in theevolution of itsCME program.

C35


A recent survey of learners revealed that many appeared to prefer toengage in asynchronous learning (using recorded webinars) ratherthan live activities. One of the faculty from the provider’s CMECommittee began a research study to characterize the basis of theseapparent changes in learning preference and describe how learningresources could be better deployed to meet their educational needs.The result of the study was submitted and accepted as a presentationat the annual conference for CME providers in the state.


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Achieves Outcomeswww.accme.org/achievesoutcomes

The providerdemonstratesimprovement in theperformance of learners.C36

The providerdemonstrates

healthcare qualityimprovement.

C37

The providerdemonstrates the impact

of the CME program onpatients or their

communities.C38


The provider describes that it has participants complete a self-directedperformance inventory before each course begins and then again 3-monthsafter the course has taken place. The inventory is comprised of a web-basedsurvey that asks the learner to estimate how often they perform specificpractice-based behaviors. For example, the inventory for a course addressingthe diagnosis of Post-Traumatic Stress Disorder (PTSD) asks learners to reporthow many veterans they see in their practice each month and how often theyscreen for PTSD using a written inventory. The provider shares data thatdemonstrate that the regular use of the screening inventory increased from20% to 40% among the majority of learners who completed the course andresponded to the follow-up survey.


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Reflect on Your Best-PracticeMark it up! (5 mins)

Circle Criteria that your CME Program is likelyalready meeting

Star the Criteria that you could seeincorporating into your CME Program☆

○

CME FOR MOC


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Evolving MOC to…MAINTENANCE OF CERTIFICATION (MOC) COLLABORATION

• Align educational requirements with medical specialtyboardso Internal Medicine, Pediatrics, Anesthesia, Pathology

• Blend quality improvement (QI) and self-assessmentactivities

• Provide a seamless data transfer service for creditmanagement (via ACCME’s Program and Activity ReportingSystem - PARS)

ACCME is working with Boards to…

Make it easy for accredited providers to offer a variety of MOC points for existing and new activities Shared view of what counts Maximize flexibility by adopting

trust-and-verify Centralized data management Pilot QI programs through accredited providers


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“By collaborating with ACCME, ABIM will open the doorto even more options for physicians engaged in MOCand will allow them to get MOC credit for high-qualityCME activities they are already doing.”

- Richard J. Baron MDPresident and CEO, ABIM

“This collaboration will generate many moreopportunities for accredited CME providers to serve asa strategic resource by delivering relevant, effective,independent, practice-based education that counts forMOC.”

- Graham McMahon MD MMScPresident and CEO, ACCME

“This collaboration is designed to create a centralrepository that will help our diplomates easily locatecourses that are most relevant to their practice needs.”

- James P. Rathmell MDSecretary, ABA

“This agreement will allow pediatricians toautomatically get lifelong learning and self-assessmentcredit for qualifying CME activities. It is one of severalchanges the ABP is making to simplify the MOCprocess and remove barriers to getting credit forprojects and learning activities that pediatriciansalready are doing.”

- Virginia A. Moyer MDVice President, MOC and Quality, ABP

A Simpler, Unified Process

• Search for ABIM MOC or REMS• Search by provider• Search for ABIM MOC or REMS• Search by provider

Filter results by:• Keyword• Activity

Type

• Specialty• Number of

Credits

• Location• Fee• Date

• Type of registration (i.e. limited vs open)

www.CMEfinder.orgACCME’S CME FINDER


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CME for MOC EducationTUTORIALS

Website ResourcesACCME.ORG/CMEFORMOC


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“Ask Your Questions” WebinarsCME FOR MOC

Wednesday, September 13 – 2 pm CentralWednesday, November 15 – 2 pm Central

MOC HANDOUTS


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USING ACCME’SFLOWCHART FOR THEIDENTIFICATION ANDRESOLUTION OF PERSONALCONFLICTS OF INTEREST

A TUTORIAL AND FLOWCHART TO HELPYOU NAVIGATE THE IDENTIFICATION OFRELEVANT FINANCIAL RELATIONSHIPS ANDTHE RESOLUTION OF CONFLICTS OFINTERESTS IN CME ACTIVITIES.

About This Tool

ACCME requirements are designed to ensure that accredited continuing medical education (CME)provides a safe place for learning—independent of commercial interests and commercial influence. Weprepared this tutorial and flowchart to help you navigate the identification of relevant financial relationshipsand the resolution of conflicts of interests in CME activities.

It’s optional: Use of these resources is optional. Please note that the tutorial and flowchart do notaddress all of the expectations of ACCME requirements for independence from commercial interests.

Get the flowchart and step-by-step tutorial on the ACCME website at www.accme.org/coiflowchart.


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Ensuring Independence

ACCME expects accredited organizations to ensure independence by:1. Identifying relevant financial relationships between commercial interests and those

who plan, teach, and implement CME2. Resolving conflicts of interest that arise when those with relevant financial

relationships with commercial interests have the opportunity to control CME contentrelated to the products or services of those commercial interests

3. Disclosing to learners the (identified) relevant financial relationships for those incontrol of CME content prior to the educational activity or disclosing that there wereno relevant financial relationships.

Key TermsCommercial InterestACCME defines a commercial interest as any entity producing, marketing, re-selling, or distributinghealth care goods or services consumed by, or used on, patients. The ACCME does not considerproviders of clinical service directly to patients to be commercial interests - unless the provider of clinicalservice is owned, or controlled by, an ACCME-defined commercial interest.

Relevant Financial RelationshipRelevant financial relationships are financial relationships in any amount, which occurred in the twelve-month period preceding the time that the individual was asked to assume a role controlling content of theCME activity, and which relate to the content of the educational activity, causing a conflict of interest. TheACCME considers financial relationships to create conflicts of interest in CME when individuals have botha financial relationship with a commercial interest and the opportunity to affect the content of CME aboutthe products or services of that commercial interest.


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Key Terms (Cont)

Who is “in control of content”?If someone in connection to the activity has the opportunity to affect thecontent, they are “in control of content.”

Those individuals in a position to control the content of an educational activitymight include (but are not limited to) planners, faculty, authors, committeemembers, content reviewers, editors, and staff depending on the accreditedprovider’s processes for developing educational activities.

Let’s Get Started

Start early! Use this flowchart early in yourplanning process to make sure you canimplement your approaches to ensureindependence during the planning process andbefore the educational activity occurs.


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Start at A

A

NoBefore the activity, disclose to learners

that there are no relevant financialrelationships with ACCME-defined

commercial interests for anyone whowas in control of the content of the

activity. (SCS 6.2)

Is the content relatedto products or business lines of

an ACCME-definedcommercial interest?

Done!

A Disclosure to Learners

Yes

Employees of ACCME-definedcommercial interests can have

no role in the planning or implementationof CME activities related to theirproducts/services.1 (SCS 1)

Yes

Is theperson an

employee/owner of anACCME-defined commercial

interest?(SCS 1)



Done!

A

B

For each person incontrol of content forthe CME activity…

B


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CFinancial relationship between person in control of content (or theirspouse/partner) and an ACCME-defined commercial interest

Products/services of the ACCME-defined commercial interest (with whichthey have the financial relationship) are related to the content of the CMEactivity

In the past 12 months

Any amount ($)

Yes

No

Does theperson have arelevant financial

relationship with an ACCME-defined commercial

interest?(SCS 2.1)

Is theperson an

employee/owner of anACCME-defined

commercialinterest?(SCS 1)

No



Before the activity, disclose tolearners that the person(s) have norelevant financial relationship(s) with

ACCME-defined commercialinterests to disclose. (SCS 6.2)

Done!

A

B

C Disclosure to LearnersFor eachperson incontrol of content for

the CME activity…

Is there a relevant financial relationship? If you can check all 4 boxesbelow, you’ve identified a relevant financial relationship with an ACCME-definedcommercial interest that must be resolved before the activity occurs.

C

Financial relationship between person in control of content (or theirspouse/partner) and an ACCME-defined commercial interest



Any amount ($)



interest?(SCS 2.1)

C



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D

Financial relationship between person in control of content (or theirspouse/partner) and an ACCME-defined commercial interest



Any amount ($)

Yes

Implement your process2

to resolve the potentialconflict-of-interest arising

from their relevant financialrelationship.(SCS 2.3)

Before the activity, disclose to learners the name(s) ofthe individual(s), name of the ACCME-defined

commercial interest with which they have a relevantfinancial relationship(s) and the nature of the

relationship. (SCS 6.1)



interest?(SCS 2.1)

Is theperson an

employee/owner of anACCME-defined

commercialinterest?(SCS 1)

No



Yes, there is a relevant financial relationship.

Done!

Provider takes an active role to resolve conflicts by:ü recusing person from controlling aspects of planning and

content with which they have a conflict of interest and/orüusing peer-review of planning decisions (for planners) by

person(s) that do not have conflicts of interest related tothe content and/or

üusing peer-review of content (for authors/presenters) byperson(s) that do not have conflicts of interest related tothe content and/or

ümaking sure to ensure that clinical recommendations areevidence-based and free of commercial bias (e.g., peer-reviewed literature, adhering to evidence-based practiceguidelines) and/or

üusing other methods that meet ACCME’sexpectations2

D

Disclosure to Learners

For eachperson incontrol of content for

the CME activity…


D

Implement your process2

to resolve the potentialconflict-of-interest arising

from their relevant financialrelationship.(SCS 2.3)

Before the activity, disclose to learners the name(s) ofthe individual(s), name of the ACCME-defined

commercial interest with which they have a relevantfinancial relationship(s) and the nature of the

relationship. (SCS 6.1)

Done!

Provider takes an active role to resolve conflicts by:ü recusing person from controlling aspects of planning and

content with which they have a conflict of interest and/orüusing peer-review of planning decisions (for planners) by

person(s) that do not have conflicts of interest related tothe content and/or

üusing peer-review of content (for authors/presenters) byperson(s) that do not have conflicts of interest related tothe content and/or

ümaking sure to ensure that clinical recommendations areevidence-based and free of commercial bias (e.g., peer-reviewed literature, adhering to evidence-based practiceguidelines) and/or

üusing other methods that meet ACCME’sexpectations2

D

Disclosure to Learners


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Work at your table… Share the effort!CASE EXAMPLES

1. An employee of ABC Heart Medicine Company is a member of the planningcommittee for a CME activity about medications for heart disease.

2. Dr. Jones is a speaker for a CME activity focused on improving team communicationand coordination for chronic diseases.

3. Dr. Smith is the Chairwoman of the CME Planning Committee for the AnnualConference on Spinal Surgery. Her husband is employed by XYZ Spine SurgeryDevices, Inc.

4. CME Coordinator Joe sends an email to everyone who is planning, authoring, orpresenting in next year’s Tumor Board Case Conferences asking, “What significantfinancial relationships (e.g. >$5,000) have you had over the past year withmanufacturers of pharmaceuticals related to cancer/tumor treatment?”

QUESTIONS

[email protected]


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Documents

STRATEGIC OPPORTUNITIES · MSMS CME CONFERENCE FOR PROVIDERS Dr. Steve Singer 8/14/2017 ©ACCME 2017 FOR EDUCATIONAL USE ONLY 1 MSMS CME CONFERENCE FOR PROVIDERS AUGUST 11, 2017 STEVE