The Accreditation Council for Continuing Medical Education (ACCME) continued along with a number of important activities, announcements and updates for continuing medical education (CME) providers and stakeholders, according to their monthly newsletter. As we previously noted, ACCME recognized that the Centers for Medicare & Medicaid Services (CMS) final rule implementing the Physician Payment Sunshine Act recognized the value of ACCME Standards for Commercial Support.
As a reminder, ACCME-Accredited Providers must complete their Year-End Reporting by March 29, 2013. So far, 488 ACCME-accredited providers have entered 32,039 activities into PARS for the 2012 reporting year. The Program and Activity Reporting System (PARS) is always open and ACCME encourages CME providers to start entering 2012 activity data now in anticipation of the year-end reporting deadline. Providers are welcome to enter basic information about an activity before it has taken place and complete the entry after the activity. ACCME also provided several tips to support data entry:
Enduring Material Activities: Who Counts as a Participant? When reporting the number of physician and nonphysician participants for an enduring material activity, whether it is Internet-based, printed, or another format, you should count all learners who completed all or a portion of the activity and whose participation can be verified in some manner. The ACCME would not consider individuals who only downloaded or received the activity but did not actually complete all or a portion of it to be participants.
Regularly Scheduled Series: Is This an RSS and — If so — How Do I Report it? First determine if your “series” is an RSS. The ACCME considers an RSS to be planned as a series with multiple sessions, planned to occur on an ongoing basis (offered weekly, monthly, or quarterly), and planned and presented primarily to the accredited organization’s professional staff. Examples of RSS activities include grand rounds and tumor boards. Organizations that provide RSS activities should report each series (not session) as one activity in PARS. Click here for more info on how to report RSS in PARS.
ACCME Reports on Strategic Discussions with Stakeholders about CME’s Future
The ACCME Board of Directors engaged in strategic planning in 2011 to discuss the future of the ACCME system and the role of accredited CME in supporting practice-based learning and health care quality improvement. Through this process, the Board identified three strategic imperatives:
- Foster ACCME Leadership and Engagement
- Evolve and Simplify the Accreditation Standards, Process, and System
- Explore and Build a More Diversified Portfolio of ACCME Products and Services
The Board incorporated feedback from stakeholders to identify these priorities, and then, throughout last year, the ACCME continued engaging with stakeholders about how to fulfill them. The ACCME convened more than 20 focused discussions about the strategic imperatives with more than 1,100 stakeholders including member organization liaisons, ACCME volunteers, Recognized Accreditors, ACCME-accredited providers, and intrastate providers. These discussions were held in a range of national, regional, and state forums, including accreditation workshops, town halls, volunteer meetings, Recognized Accreditor conferences, and events for intrastate CME providers. A summaryof Key Themes from Stakeholder Conversations included:
- Clarity: The ACCME should communicate its expectations clearly. It will be a lot easier for providers to do what the ACCME asks if they can easily understand the ACCME’s expectations. Commercial support requirements could be restructured to more easily apply to various scenarios such as activities that are commercially supported, those that are not commercially supported, and those that do not include advertising and exhibits.
- Fewer criteria may suffice: Some expectations are redundant (for example, Criterion 4, scope of practice); some are not readily measured (Criterion 5, choice of educational format); and some could be collapsed into one (Criteria 12-15, self-assessment and improvement).
- Criteria 16 and 22 are too easy: Stakeholders pointed out that providers were de facto in compliance with Criteria 16 and 22 by virtue of the organization existing and producing CME designed to change performance.
- Evolve the Commendation Criteria: Providers want to retain a criterion-referenced system for Accreditation with Commendation, but they want more attributes to be recognized as commendable. They like the concept of a menu of options, from which they could choose a certain number to fulfill in order to achieve Accreditation with Commendation.
- Maintain high expectations: Stakeholders do not want the ACCME to lower the bar. They value the Plan-Do-Study-Act approach combined with the Standards for Commercial Support.
- Push providers to higher level outcomes: Stakeholders feel that the ACCME should evaluate whether CME providers cause change—not just measure change—in learners. This should be an ACCME measurable, if not an actual requirement. Also, while stakeholders recognize that learners’ achievement of knowledge and competence are necessary steps in the change process, some stakeholders believe these objectives may no longer be adequate outcomes, if the accredited CME system is positioning itself as a strategic asset for initiatives to improve health care and public health.
- Keep pushing stakeholders: Stakeholders expect and want the ACCME requirements for the accredited CME enterprise to be drivers for their organizations’ change and improvement–—so that their CME programs are in fact relevant and serve as strategic assets to initiatives to improve health care and public health.
- Require organizational competence and-buy-in: It may be time to reintroduce requirements that organizations explicitly demonstrate their commitment to CME. (This expectation was specified in previous ACCME requirements.) Examples could include expecting CME staff to meet certain qualifications, evidence of direct, hands-on oversight by CME leadership, explicit involvement of senior organizational leadership.
- Retain three-part reaccreditation process: Providers see the triad of self-study report plus performance-in-practice review plus interview as a valuable process that should be retained, although they offered suggestions for improvement. One suggestion was to make interviews optional. To ease documentation requirements, providers suggested that the ACCME develop a structured abstract for providers to use when verifying performance-in-practice, which would take the place of labels and facilitate the process of submitting activity files.
- Retain verification by documentation: Providers feel that creating and maintaining adequate documentation of compliance is a lot of work—but that the ACCME’s random selection of activities for performance-in-practice verification is critical to the credibility and overall validity of the accredited CME enterprise in the eyes of our customers. The providers have asked that the ACCME examine how documentation requirements can be reduced while maintaining the important benefits of performance-in-practice verification.
- Templates: Providers want the ACCME to develop (optional) tools, instruments, and resources for providers to use in order to streamline the reaccreditation process and to promote compliance findings.
- Formative feedback: Providers want information about their compliance during their term of accreditation, as opposed to every four or six years. They want to know how they are doing in real-time and they want the opportunity to make mid-course adjustments, so as to avoid noncompliance findings.
- Engage leadership: Stakeholders believe that their institutional leadership and the leadership of the health care system in general is not engaged with continuing professional education—and this engagement must be developed in order to realize the full value of CME. They want the ACCME’s help in achieving this engagement.
- Regulatory alignment: Stakeholders believe that it is critical to achieve a congruence of values and expectations across regulatory systems.
- Validation by MOC and MOL: Stakeholders believe that the accredited CME enterprise needs explicit validation from the emerging systems of Maintenance of Certification® (MOC) and Maintenance of Licensure (MOL) in equal measure.
- Support MOC and MOL: Stakeholders believe that the accredited CME enterprise must fulfill the needs and expectations of the emerging systems of MOC and MOL. In addition, and perhaps more important, the accredited CME enterprise must fulfill the needs and expectations of those directly involved in improving health care or population health.
Video Interview Series: ACGME’s Next Accreditation System
In a four-part video interview series, Timothy P. Brigham, MDiv, PhD, Chief of Staff and Senior Vice-President, Department of Education, Accreditation Council for Graduate Medical Education, (ACGME), discusses how the ACGME’s Next Accreditation System (NAS), supports physicians’ continuous professional development and explores opportunities for medical education accreditors and hospital leaders to collaborate to improve health care safety and quality. This series is part of ACCME’s efforts to support alignment across the medical education continuum.
- An Introduction to the ACGME’s Next Accreditation System (NAS) (Part 1 of 4)
- Understanding the ACGME Milestones: Applications and Opportunities for Accredited CME (Part 2 of 4)
- Clinical Learning Environment Review (CLER) Visits: A Meeting Point for GME and CME (Part 3 of 4)
- Knitting the Continuum Together: Seizing the Opportunity to Improve Medical Education (Part 4 of 4)
The ACCME has also produced the following video interviews focusing on the strategic value CME brings to graduate medical education.
- Case Study: Integrating CME and GME—Jane Nester, DrPH, Executive Director for Medical Education/AHEC at Moses Cone Hospital, describes how she demonstrates the strategic value of CME to graduate medical education.
- Using CME to Engage Community Physicians in Quality and Teaching—Rani Gereige, MD, Director of Medical Education, Miami Children’s Hospital, discusses CME as a bridge between practice improvement, graduate medical education faculty development, and institutional goals.
Registration Open for April 2013 CME as a Bridge to Quality™ Accreditation Workshop
Registration is now open for the ACCME’s 2013 CME as a Bridge to Quality™ Accreditation Workshop scheduled for April 24-26 in Chicago. A second workshop will be held July 31-August 2. ACCME has invited providers whose next accreditation decisions are scheduled for July 2014, November 2014, and March 2015.
ACCME Hosts Luncheon Discussion for Accreditation Surveyors
The ACCME hosted a luncheon and discussion for ACCME accreditation surveyors during the Alliance for Continuing Education in the Health Professions (ACEHP) Annual Meeting. The event was attended by more than 60 stakeholders, including ACCME accreditation surveyors; members of the ACCME Board of Directors, Accreditation Review Committee, and Committee for Review and Recognition; and staff and volunteers representing Recognized Accreditors.
Murray Kopelow, MD, President and CEO, ACCME, discussed the accomplishments surveyors made during the previous year. Thanks to surveyors’ contributions, the ACCME made 161 accreditation and reaccreditation decisions in 2012. To support this decision-making, 107 surveyors conducted accreditation interviews.
The ACCME asks providers to complete evaluations regarding their experience with the accreditation process and uses this feedback to analyze its current practices and make improvements. Kate Regnier, MA, MBA, Deputy Chief Executive and COO, ACCME, presented data reflecting feedback from each of the three 2012 cohorts, which showed that providers reported positive experiences with surveyors and the accreditation interviews. Dion Richetti, Director, Accreditation and Recognition Services, ACCME, reviewed the feedback, which showed that 95% or more of surveyors had a positive experience with the interview process. Mr. Richetti also presented surveyor feedback regarding the Accreditation Compliance Review System (ACRS), which was implemented last year in order to simplify and streamline the process for accredited providers and accreditation surveyors. The data shows that 97% of surveyors found the ACRS easy to use.
CE Accreditors Meeting Focuses on Interprofessional Education
The ACCME and its colleague accreditors, the Accreditation Council for Pharmacy Education (ACPE) and the American Nurses Credentialing Center (ANCC), hosted “Interprofessional Accreditation in Support of Interprofessional Education: An Exploratory Meeting of Accreditors” in February at the ACCME’s offices in Chicago. The inaugural meeting brought together continuing education accreditors from a variety of health professions to identify areas of alignment among the accreditation systems and opportunities to support interprofessional collaborative practice.
ACCME Hosts Commercial Supporters Forum
The ACCME hosted a commercial supporters forum in January at its Chicago offices. ACCME executive staff and commercial supporters discussed current and emerging issues related to the health care environment and accredited CME, including the Food and Drug Administration (FDA) Risk Evaluation and Mitigation Strategy (REMS) for extended-release and long-acting opioid analgesics. Participants discussed the importance of the ACCME Standards for Commercial Support: Standards to Ensure Independence in CME and explored strategies for supporting accredited CME that is independent from commercial influence.
The ACCME hosts commercial supporter forums on occasion to provide an opportunity for participants to address emerging issues related to the health care environment and accredited CME funding and to reinforce their commitment to ensuring that commercially supported CME advances public health and serves the public interest.
Genomics Medicine Conference Highlights Physician Education
The National Human Genome Research Institute, National Institutes of Health, convened “Genomic Medicine IV: Physician Education in Genomics” in January in Dallas. One of the goals of the conference was to identify ongoing efforts and needs related to physician education in genomics.
Mira Irons, MD, Associate Chief, Division of Genetics, Boston Children’s Hospital; and member, ACCME Board of Directors, gave a presentation explaining that genomics education must move beyond general rules and principles and focus on providing physicians with relevant, practical information about how genomics applies to their scope of practice and their patients.
The ACCME and the Accreditation Council for Graduate Medical Education (ACGME) were invited to discuss the roles of CME and GME in the medical education continuum. Thomas J. Nasca, MD, MACP, CEO, ACGME, addressed the importance of a multipronged approach to genomics education, which encompasses developing clinical proficiency in genomics in each specialty and includes practitioners and faculty. Murray Kopelow, MD, President and CEO, ACCME, described the scope of the ACCME accreditation system and the role of accredited CME as a strategic partner in efforts to advance physician education and practice related to genomics. He explained how information about physician practice informs the medical education continuum, including undergraduate, graduate, and continuing medical education. More information about the conference, including links to presentation slides and videos, is available here.