cme relationships with stakeholders

Continuing Medical Education (CME) Relationships with Stakeholders

Improving Patient Care Through Education:

How do we get there?

AMWA CME Study Group90% Solutions

Barbara Woldin

Alignment Between Business Goals

and Effective Education

Areas of alignment:

• Improving diagnosis

• Optimizing treatment strategies and

therapies

• Increasing medication adherence

• Improving overall patient outcomes

Communicating Value of CMEto Stakeholders

1. Commercial supporters and providers

need the ability to communicate internally

and externally

2. Commercial supporters and providers

need to develop a structured

communications plan

Basic Elements of a Communications Plan

• DestinationWho is the recipient?

• Purpose Why are you communicating with this

person/group?

• Content What is the message to be conveyed?

• Source Where does the content originate?

• Form What should the communication look like?

• Channel What method will be used to convey the message?

Internal and External Stakeholder

Identification and Assessment

• Providers

• Supporters

• Learners

• Faculty

• Patients

• Regulators

• Accreditors

Collaboration and communication among CME

stakeholders: The core of the new patient-centered-

care paradigm

ACCME: Accreditation Council for Continuing Medical Education

Seven-member umbrella organization:

• American Board of Medical Specialties

• American Hospital Association

• American Medical Association (AMA)

• Association of American Medical Colleges

• Association for Hospital Medical Education

• Council for Medical Specialty Societies

• Federation of State Medical Boards of the U.S.

ACCME: Role and Responsibility

• Independent accreditation body for institutions and organizations that sponsor CME for physicians

• Mission Statement:

“The identification, development, and promotion

of standards for quality continuing medical

education (CME) utilized by physicians in their

maintenance of competence and incorporation of

new knowledge to improve quality medical care

for patients and their communities”.


• Serves as the body for accrediting institutions and organizations that offer CME

• Serves as the body for recognizing institutions and organizations that offer CME accreditation.

• Develops criteria for use by ACCME or state accreditating bodies in granting accreditation to institutions and organizations that offer CME and for use by the Council in evaluating their respective educational programs and activities

• Ensures institutions and organizations that offer CME comply with these standards


• Develops/fosters development of methods for measuring effectiveness of CME and its accreditation, particularly in terms of supporting quality patient care and the continuum of medical education

• Recommends and initiates studies for improving the organization and processes of CME and its accreditation

• Reviews and assesses developments in CME’s support of quality health

• Reviews periodically ACCME’s role in CME to ensure it remains responsive to public and professional needs

Purpose of Accreditation

• Ensures quality and integrity of accredited CME providers

• Establishes criteria for evaluation of educational programs and their activities

• Assesses whether accredited organizations meet and maintain standards

• Promotes organizational self-assessment and improvement

• Recognizes excellence

CME Accreditors

• ACCME• American Board of Medical Specialties • American Hospital Association • American Medical Association • Association for Hospital Medical Education • Association of American Medical Colleges • Council of Medical Specialty Societies

(CMSS) • Federation of State Medical Boards • American Academy of Family Physicians • American Osteopathic Association

CME Providers

• Institution or organization sponsoring CME and authorized to award AMA PRA Category 1 Credit to physicians

• Institution or organization offering activities must be accredited by either ACCME or ACCME-recognized state medical society

• Joint Sponsors: Accredited provider has full responsibility for activity and works in collaboration with non-accredited provider

• Co-sponsors: Two or more accredited providers involved in an activity, one of which must be named as the responsible entity through an appropriate accreditation statement

Organizations Eligible for CME

Accreditation

• 501-C Non-profit organizations • Government organizations • Non-health care related companies • Liability insurance providers • Health insurance providers • Group medical practices • For-profit hospitals • For profit rehabilitation centers • For-profit nursing homes • Blood banks • Diagnostic laboratories

CME Providers:Role and Responsibility

•Compliance with ACCME Essential Areas and

Elements •Compliance with ACCME Standards for

Commercial SupportSM

•Compliance with American Medical Association

(AMA) Requirements


Compliance with AMA Requirements:

• Conform to AMA definition of CME

• Present content appropriate in depth and scope for physician audience

• Conform to CEJA opinions and ACCME Standards for Commercial Support

• Present content non-promotional in nature

• Address demonstrated educational needs

(cont’d)


• Communicate clearly identified educational purpose and/or objectives

• Use learning methodologies/format(s) appropriate to activity’s educational purpose and/or objectives

• Institute evaluation mechanisms to assess activity’s quality and relevance to purpose and/or objectives

• Have activity designated for AMA PRA Category 1 Credit™ in advance

(cont’d)


• Develop means of recording credits claimed by each physician participant and methods of preserving such records (6 years)

• Include Designation Statement* verbatim in all activity materials that reference CME (except "save the date" notices)

• Meet additional requirements for certain CME activities (eg, enduring materials, performance improvement)

* Physicians: [Name of accredited provider] designates this educational activity for a maximum of [number of credits] AMA PRA Category 1 Credit(s)™; Non-physicians: [Name of accredited provider] certifies that [name of participant] has participated in the educational activity titled [title of activity] at [location, if applicable] on [date]. The activity was designated for [number of credits] AMA PRA Category 1 Credit(s)™.

CME Supporters

Professional Development:

• Alliance for Continuing Medical Education (ACME)

• Society for Academic CME (SACME)• North American Association of Medical

Education and Communication Companies, Inc. (NAAMECC)

• National Commission for Certification of CME Professionals (NC-CME)

• Alliance of Independent Academic Medical Centers

• CMSS CME Directors’ Component Group

CME Supporters

Primary Funders of CME:

• Pharmaceutical and biotech companies

• For-profit medical education and communications companies (MECCs)

• Hospitals

• Not-for-profit trade associations

CME Supporters

Other Funding Sources:

• Foundations

• Government

• Non–health care commercial interest

• Payers

• Health care organizations

CME Supporters:Role and Responsibility

Accreditating Organizations:

• Enhance coherence and alignment between ACCME and other accreditation systems

• Foster equivalency between national and state medical society systems

• Implement Updated Accreditation Criteria• Minimize cost burden to providers• Address issues relating to new formats of CME• Provide activity reporting system

(cont’d)


• Meeting operational challenges of updated criteria

• Aligning CME to maintenance of certification and licensure

• Communicating CME's value to broader health care system


Communicating With External Stakeholders

• Understanding the grant submission and approval processes

• Ability to demonstrate differentiation among peers

• Educational effectiveness• Facility in demonstrating evidence of a

quality provider/partner


Barriers to Communications

• Under recognition of value of CME• Change in internal policies• Lack of funds/resources• Lack of participation


Meeting the Challenges

• Educate providers about company’s grant submission and RFP process

• Communicate aspects of industry- independent education

• Inform providers of individual best practices

• Be available as a compliant resource


How to overcome challenges and maintain compliance in the funding of educational programs that attain high-level outcomes:

•Develop a clear, concise CME value proposition•Examine transparency measures and compliant reporting of grant funding•Make considerations for grant reconciliation•Apply CME cost containment measures


Channels for Communication:

• Convene online meeting and video conferencing (Web-ex)

• Participate in speakers bureaus

• Exhibit at the ACME annual conference


Expected Outcomes of Communication:

•Mutual understanding

•Compliant partnering

•Support system for providing quality, innovative, and effective education


Communicating with Internal Stakeholders:

• Identify appropriate internal stakeholders of interest

• Gage receptivity and review policies of CME department

• Determine if communication plan for stakeholders exists

• Conduct needs assessments and define outcomes

• Provide regularly scheduled updates(cont’d)

CME SupportersRole and Responsibility

Salient Points:

• Develop a structured communication plan as the first step in building a successful working relationship

• Incorporate messages, audiences, interventions and metrics into the communication plan

• Promote communication plan and assess feedback from stakeholders

CME Learners

Eligibility:

• CME providers award AMA PRA Category 1 Credit to physician learners

• Physicians may apply for the PRA if they hold a valid and current license issued by one of the U.S., Canadian, or Mexican licensing jurisdictions or are engaged in an ACCME accredited residency training program in the United States

CME Physician Learners:Role and Responsibility

• Ethically obligated to only claim credit consistent with the extent of their participation in CME activities

• Entirely responsible for self-claiming and self-documenting AMA PRA Category 2 Credit™ activities

• Apply learning experience to improve patient communication

• Utilize learning experience to engage patient and/or caregiver into shared decision making, information therapy, and patient self-management

CME Physician Learners*: Role and Responsibility

• Complete educational activity and submit time spent in ¼ hour intervals

• Request documentation by submitting complete journal activity or evaluation of enduring material activity

• Know requirements of particular credentialing/ qualifying agency for which credit is being earned

*Non-physician learners (ie, all other health professionals) receive Attendance Certificates


Physicians may claim these AMA PRA Category 1 CreditTM directly from the AMA:

• Publishing articles• Poster presentations• Medically related advanced degrees• ABMS member board certification and

Maintenance of Certification (MoC©) • Accreditation Council for Graduate Medical

Education accredited education• Independent learning• International Conference Recognition program


Physicians may claim these AMA PRA Category 2 CreditTM activities directly from the AMA:

• Consultation with peers and medical experts• Small group discussions• Self assessment activities• Medical writing• Preceptorships• Research

Faculty

• Academia• Teacher of learners• Expert in subject germane to activity• May also be learner

Faculty:Role and Responsibility

• Can earn AMA PRA Category 1 Credits™ for learning that occurs in preparation of presentation for activity

• Formula for granting credit: 2 AMA PRA Category 1 Credits™ per participant credit (2:1 ratio)

• Cannot receive credits for repeat presentations of same material

• Can only receive credits for teaching at live activities designated for AMA PRA Category 1 Credit™

• Disclose all conflicts of interest

StakeholderRelationships

ACCME Standards

for

Commercial SupportSM

Standards to Ensure Independence in CME Activities


Compliance with ACCME Standardsfor Commercial SupportSM

• STANDARD 1: Independence

• STANDARD 2: Resolution of personal conflicts ofinterest

• STANDARD 3: Appropriate use of commercialsupport

(cont’d)


• STANDARD 5: Content and format without commercial bias• STANDARD 6: Disclosures relevant to potential commercial bias

• STANDARD 4. Appropriate management of associated commercial

promotion


Standard 1: Independence

1.1 Commercial interests can have no decision-making or control over planning, execution or evaluation of CME activity

1.2 Commercial interests cannot be non-accredited partners in joint sponsorship

CME SupportersRole and Responsibility

Standard 2: Resolution of Personal Conflicts of Interest

Provider must verify that everyone controlling the content of an education activity has disclosed all relevant financial relationships with any commercial interest to the provider

CME Stakeholder Resources

• http://www.accme.org/dir_docs/doc_upload/68b2902a-fb73-44d1-8725-80a1504e520c_uploaddocument.pdf

• http://www.sacme.org/site/sacme/assets/pdf/accme_roundtable_2010.pdf

• http://www.naamecc.org/downloads/code_of_conduct.pdf• http://www.accme.org/dir_docs/doc_upload/e2843247-7cae-

40fe-a0eb-27a982b8fcc0_uploaddocument.pdf• http://www.edmeasures.com/newsletter/cc.php• http://www.acme-assn.org/home/compreport/CompRprt_1.p

df• http://www.gwumc.edu/cehp/pdf/CMEPolicies/FDAguidance.pdf• http://www.fda.gov/downloads/RegulatoryInformation/Guidances/U

CM125602.pdf

(cont’d)

http://www.sacme.org/site/sacme/assets/pdf/accme_roundtable_2010.pdf

http://www.sacme.org/site/sacme/assets/pdf/accme_roundtable_2010.pdf

http://www.naamecc.org/downloads/code_of_conduct.pdf

http://www.accme.org/dir_docs/doc_upload/e2843247-7cae-40fe-a0eb-27a982b8fcc0_uploaddocument.pdf

http://www.accme.org/dir_docs/doc_upload/e2843247-7cae-40fe-a0eb-27a982b8fcc0_uploaddocument.pdf

http://www.edmeasures.com/newsletter/cc.php

http://www.acme-assn.org/home/compreport/CompRprt_1.pdf

http://www.acme-assn.org/home/compreport/CompRprt_1.pdf

http://www.gwumc.edu/cehp/pdf/CMEPolicies/FDAguidance.pdf

http://www.fda.gov/downloads/RegulatoryInformation/Guidances/UCM125602.pdf

http://www.fda.gov/downloads/RegulatoryInformation/Guidances/UCM125602.pdf


• www.acme-assn.org/advocacy_pg/ceja1.doc • http://www.ama-assn.org/ama1/pub/upload/mm/377/lea

rning-environment-report.pdf• http://www.sacme.org/site/sacme/assets/pdf/LOA_positi

on_paper_Final_for_release_REVISED_3-19-2008.pdf• http://www.naamecc.org/downloads/collaboration.pdf• http://www.phrma.org/files/attachments/PhRMA

%20Marketing%20Code%202008.pdf• http://www.accme.org/dir_docs/doc_upload/3c2bd2bd-

431d-4459-b081-f46e1071c30b_uploaddocument.pdf

(cont’d)

http://www.ama-assn.org/ama1/pub/upload/mm/377/learning-environment-report.pdf

http://www.ama-assn.org/ama1/pub/upload/mm/377/learning-environment-report.pdf

http://www.sacme.org/site/sacme/assets/pdf/LOA_position_paper_Final_for_release_REVISED_3-19-2008.pdf

http://www.sacme.org/site/sacme/assets/pdf/LOA_position_paper_Final_for_release_REVISED_3-19-2008.pdf

http://www.naamecc.org/downloads/collaboration.pdf


• http://www.accme.org/dir_docs/doc_upload/19312604-d5af-4196-a7fb-ae890e04d996_uploaddocument.pdf

• http://www.accme.org/dir_docs/doc_upload/dc0e76c4-16bd-4b78-819b-912ff57ca936_uploaddocument.pdf

• http://www.iom.edu/~/media/Files/Report%20Files/2009/Redesigning-Continuing-Education-in-the-Health-Professions/CE_release_v3.pdf

• http://www.sacme.org/site/sacme/assets/pdf/accme_roundtable_2010.pdf

• http://www.accme.org/dir_docs/doc_upload/68b2902a-fb73-44d1-8725-80a1504e520c_uploaddocument.pdf

• http://eo2.commpartners.com/users/acme/downloads/Report_of_Commercial_Support_and_Bias_1.pdf

AMWA Champions CME

“Following a long-term planning effort, the AMWA Executive Committee has begun to work toward greater collaboration with allied organizations in order to advance the profession of medical communication. To explore the diversity of medical communication—and the “hot topics” that AMWA is facing along with other groups—the AMWA Journal is publishing a series of articles based on interviews with leaders in continuing medical education, publication planning, regulatory document and manuscript writing, and health and medical journalism. We welcome input from readers about what other fields and organizations should be covered.”

– Faith Reidenbach, ELS2009-2010 AMWA

Publications AdministratorAMWA JOURNAL • VOL. 25, NO. 1, 2010

cme relationships with stakeholders

Health & Medicine