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Cme relationships with stakeholders



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  • 1. Continuing Medical Education (CME)Relationships with StakeholdersImproving Patient Care Through Education:How do we get there?AMWA CME Study Group90% SolutionsBarbara Woldin
  • 2. Alignment Between BusinessGoalsand Effective EducationAreas of alignment:• Improving diagnosis• Optimizing treatment strategies andtherapies• Increasing medication adherence• Improving overall patient outcomes
  • 3. Communicating Value of CMEto Stakeholders1. Commercial supporters and providersneed the ability to communicate internallyand externally2. Commercial supporters and providersneed to develop a structuredcommunications plan
  • 4. Basic Elements of aCommunications Plan• DestinationWho is the recipient?• PurposeWhy are you communicating with this person/group?• ContentWhat is the message to be conveyed?• SourceWhere does the content originate?• FormWhat should the communication look like?• ChannelWhat method will be used to convey the message?
  • 5. Internal and External StakeholderIdentification and Assessment• Providers• Supporters• Learners• Faculty• Patients• Regulators• AccreditorsCollaboration and communication among CMEstakeholders: The core of the new patient-centered-care paradigm
  • 6. ACCME: Accreditation Council forContinuing Medical EducationSeven-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.
  • 7. ACCME: Role and Responsibility• Independent accreditation body for institutionsand organizations that sponsor CME forphysicians• Mission Statement:“The identification, development, and promotionof standards for quality continuing medicaleducation (CME) utilized by physicians in theirmaintenance of competence and incorporation ofnew knowledge to improve quality medical carefor patients and their communities”.
  • 8. ACCME: Role and Responsibility• Serves as the body for accrediting institutionsand organizations that offer CME• Serves as the body for recognizing institutionsand organizations that offer CME accreditation.• Develops criteria for use by ACCME or stateaccreditating bodies in granting accreditation toinstitutions and organizations that offer CME andfor use by the Council in evaluating theirrespective educational programs and activities• Ensures institutions and organizations that offerCME comply with these standards
  • 9. ACCME: Role and Responsibility• Develops/fosters development of methods formeasuring effectiveness of CME and itsaccreditation, particularly in terms of supportingquality patient care and the continuum of medicaleducation• Recommends and initiates studies for improvingthe organization and processes of CME and itsaccreditation• Reviews and assesses developments in CME’ssupport of quality health• Reviews periodically ACCME’s role in CME toensure it remains responsive to public andprofessional needs
  • 10. Purpose of Accreditation• Ensures quality and integrity of accreditedCME providers• Establishes criteria for evaluation ofeducational programs and their activities• Assesses whether accredited organizationsmeet and maintain standards• Promotes organizational self-assessmentand improvement• Recognizes excellence
  • 11. 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
  • 12. CME Providers• Institution or organization sponsoring CME andauthorized to award AMA PRA Category 1Credit™ to physicians• Institution or organization offering activitiesmust be accredited by either ACCME or ACCME-recognized state medical society• Joint Sponsors: Accredited provider has fullresponsibility for activity and works incollaboration with non-accredited provider• Co-sponsors: Two or more accredited providersinvolved in an activity, one of which must benamed as the responsible entity through anappropriate accreditation statement
  • 13. Organizations Eligible for CMEAccreditation• 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
  • 14. CME Providers:Role and Responsibility•Compliance with ACCME Essential Areas andElements•Compliance with ACCME Standards forCommercial SupportSM•Compliance with American MedicalAssociation(AMA) Requirements
  • 15. CME Providers:Role and ResponsibilityCompliance with AMA Requirements:• Conform to AMA definition of CME• Present content appropriate in depth andscope for physician audience• Conform to CEJA opinions and ACCMEStandards for Commercial Support• Present content non-promotional in nature• Address demonstrated educational needs(cont’d)
  • 16. CME Providers:Role and Responsibility• Communicate clearly identified educationalpurpose and/or objectives• Use learning methodologies/format(s)appropriate to activity’s educational purposeand/or objectives• Institute evaluation mechanisms to assessactivity’s quality and relevance to purposeand/or objectives• Have activity designated for AMA PRACategory 1 Credit™ in advance(cont’d)
  • 17. CME Providers:Role and Responsibility• Develop means of recording credits claimed byeach physician participant and methods ofpreserving such records (6 years)• Include Designation Statement* verbatim in allactivity materials that reference CME (except"save the date" notices)• Meet additional requirements for certain CMEactivities (eg, enduring materials, performanceimprovement)* Physicians: [Name of accredited provider] designates this educationalactivity for a maximum of [number of credits] AMA PRA Category 1Credit(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 wasdesignated for [number of credits] AMA PRA Category 1 Credit(s)™.
  • 18. CME SupportersProfessional Development:• Alliance for Continuing Medical Education(ACME)• Society for Academic CME (SACME)• North American Association of MedicalEducation and Communication Companies, Inc.(NAAMECC)• National Commission for Certification of CMEProfessionals (NC-CME)• Alliance of Independent Academic MedicalCenters• CMSS CME Directors’ Component Group
  • 19. CME SupportersPrimary Funders of CME:• Pharmaceutical and biotech companies• For-profit medical education andcommunications companies (MECCs)• Hospitals• Not-for-profit trade associations
  • 20. CME SupportersOther Funding Sources:• Foundations• Government• Non–health care commercial interest• Payers• Health care organizations
  • 21. CME Supporters:Role and ResponsibilityAccreditating Organizations:• Enhance coherence and alignment betweenACCME and other accreditation systems• Foster equivalency between national and statemedical 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)
  • 22. CME Supporters:Role and Responsibility• Meeting operational challenges of updatedcriteria• Aligning CME to maintenance of certification andlicensure• Communicating CMEs value to broader healthcare system
  • 23. CME Supporters:Role and ResponsibilityCommunicating With External Stakeholders• Understanding the grant submission andapproval processes• Ability to demonstrate differentiationamong peers• Educational effectiveness• Facility in demonstrating evidence of aquality provider/partner
  • 24. CME Supporters:Role and ResponsibilityBarriers to Communications• Under recognition of value of CME• Change in internal policies• Lack of funds/resources• Lack of participation
  • 25. CME Supporters:Role and ResponsibilityMeeting the Challenges• Educate providers about company’s grantsubmission and RFP process• Communicate aspects of industry-independent education• Inform providers of individual bestpractices• Be available as a compliant resource
  • 26. CME Supporters:Role and ResponsibilityHow to overcome challenges and maintaincompliance in the funding of educationalprograms that attain high-level outcomes:•Develop a clear, concise CME valueproposition•Examine transparency measures andcompliant reporting of grant funding•Make considerations for grantreconciliation•Apply CME cost containment measures
  • 27. CME Supporters:Role and ResponsibilityChannels for Communication:• Convene online meeting and videoconferencing (Web-ex)• Participate in speakers bureaus• Exhibit at the ACME annual conference
  • 28. CME Supporters:Role and ResponsibilityExpected Outcomes of Communication:•Mutual understanding•Compliant partnering•Support system for providing quality,innovative, and effective education
  • 29. CME Supporters:Role and ResponsibilityCommunicating with Internal Stakeholders:• Identify appropriate internal stakeholders ofinterest• Gage receptivity and review policies of CMEdepartment• Determine if communication plan forstakeholders exists• Conduct needs assessments and defineoutcomes• Provide regularly scheduled updates(cont’d)
  • 30. CME SupportersRole and ResponsibilitySalient Points:• Develop a structuredcommunication plan as the firststep in building a successfulworking relationship• Incorporate messages, audiences,interventions and metrics into thecommunication plan• Promote communication plan andassess feedback from stakeholders
  • 31. CME LearnersEligibility:• CME providers award AMA PRA Category 1Credit™ to physician learners• Physicians may apply for the PRA if theyhold a valid and current license issued byone of the U.S., Canadian, or Mexicanlicensing jurisdictions or are engaged in anACCME accredited residency trainingprogram in the United States
  • 32. CME Physician Learners:Role and Responsibility• Ethically obligated to only claim creditconsistent with the extent of theirparticipation in CME activities• Entirely responsible for self-claiming andself-documenting AMA PRA Category 2Credit™ activities• Apply learning experience to improvepatient communication• Utilize learning experience to engagepatient and/or caregiver into shareddecision making, information therapy, andpatient self-management
  • 33. CME Physician Learners*:Role and Responsibility• Complete educational activity and submittime spent in ¼ hour intervals• Request documentation by submittingcomplete journal activity or evaluation ofenduring material activity• Know requirements of particularcredentialing/ qualifying agency for whichcredit is being earned*Non-physician learners (ie, all other healthprofessionals) receive Attendance Certificates
  • 34. CME Physician Learners:Role and ResponsibilityPhysicians may claim these AMA PRA Category 1CreditTMdirectly from the AMA:• Publishing articles• Poster presentations• Medically related advanced degrees• ABMS member board certification andMaintenance of Certification (MoC©)• Accreditation Council for Graduate MedicalEducation accredited education• Independent learning• International Conference Recognition program
  • 35. CME Physician Learners:Role and ResponsibilityPhysicians may claim these AMA PRA Category 2CreditTMactivities directly from the AMA:• Consultation with peers and medical experts• Small group discussions• Self assessment activities• Medical writing• Preceptorships• Research
  • 36. Faculty• Academia• Teacher of learners• Expert in subject germane to activity• May also be learner
  • 37. Faculty:Role and Responsibility• Can earn AMA PRA Category 1 Credits™ forlearning that occurs in preparation ofpresentation for activity• Formula for granting credit: 2 AMA PRA Category1 Credits™ per participant credit (2:1 ratio)• Cannot receive credits for repeat presentations ofsame material• Can only receive credits for teaching at liveactivities designated for AMA PRA Category 1Credit™• Disclose all conflicts of interest
  • 38. StakeholderRelationshipsACCME StandardsforCommercial SupportSMStandards to Ensure Independencein CME Activities
  • 39. StakeholderRelationshipsCompliance with ACCME Standardsfor Commercial SupportSM• STANDARD 1: Independence• STANDARD 2: Resolution of personal conflicts ofinterest• STANDARD 3: Appropriate use of commercialsupport(cont’d)
  • 40. StakeholderRelationships• STANDARD 5: Content and formatwithout commercial bias• STANDARD 6: Disclosures relevant topotential commercial bias• STANDARD 4. Appropriate managementof associated commercialpromotion
  • 41. CME Supporters:Role and ResponsibilityStandard 1: Independence1.1 Commercial interests can have nodecision-making or control over planning,execution or evaluation of CME activity1.2 Commercial interests cannot be non-accredited partners in joint sponsorship
  • 42. CME SupportersRole and ResponsibilityStandard 2: Resolution of Personal Conflicts ofInterestProvider must verify that everyone controlling thecontent of an education activity has disclosed allrelevant financial relationships with anycommercial interest to the provider
  • 43. 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.pd• http://www.naamecc.org/downloads/code_of_conduct.pdf• http://www.accme.org/dir_docs/doc_upload/e2843247-7cae-40fe-a0eb-2• http://www.edmeasures.com/newsletter/cc.php• 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.pd(cont’d)
  • 44. CME Stakeholder Resources• www.acme-assn.org/advocacy_pg/ceja1.doc• http://www.ama-assn.org/ama1/pub/upload/mm/377/learning-environment• http://www.sacme.org/site/sacme/assets/pdf/LOA_position_paper_Final_fo• 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)
  • 45. CME Stakeholder Resources• 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
  • 46. AMWA Champions CME“Following a long-term planning effort, the AMWA ExecutiveCommittee has begun to work toward greater collaboration withallied organizations in order to advance the profession of medicalcommunication. 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 oninterviews with leaders in continuing medical education, publicationplanning, regulatory document and manuscript writing, and healthand medical journalism. We welcome input from readers about whatother fields and organizations should be covered.”– Faith Reidenbach, ELS2009-2010 AMWAPublications AdministratorAMWA JOURNAL • VOL. 25, NO. 1, 2010