1. Continuing Medical Education (CME)
Relationships with Stakeholders
Improving Patient Care Through Education:
How do we get there?
AMWA CME Study Group
90% Solutions
Barbara Woldin
2. Alignment Between Business
Goals
and Effective Education
Areas of alignment:
• Improving diagnosis
• Optimizing treatment strategies and
therapies
• Increasing medication adherence
• Improving overall patient outcomes
3. Communicating Value of CME
to 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
4. Basic Elements of a
Communications Plan
• Destination
Who 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?
5. 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
6. 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.
7. 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”.
8. ACCME: Role and Responsibility
• 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
9. ACCME: Role and Responsibility
• 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
10. 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
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 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
13. 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
14. 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
15. CME Providers:
Role and Responsibility
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)
16. CME Providers:
Role and Responsibility
• 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)
17. CME Providers:
Role and Responsibility
• 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)™.
18. 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
19. CME Supporters
Primary Funders of CME:
• Pharmaceutical and biotech companies
• For-profit medical education and
communications companies (MECCs)
• Hospitals
• Not-for-profit trade associations
20. CME Supporters
Other Funding Sources:
• Foundations
• Government
• Non–health care commercial interest
• Payers
• Health care organizations
21. 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)
22. CME Supporters:
Role and Responsibility
• Meeting operational challenges of updated
criteria
• Aligning CME to maintenance of certification and
licensure
• Communicating CME's value to broader health
care system
23. CME Supporters:
Role and Responsibility
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
24. CME Supporters:
Role and Responsibility
Barriers to Communications
• Under recognition of value of CME
• Change in internal policies
• Lack of funds/resources
• Lack of participation
25. CME Supporters:
Role and Responsibility
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
26. CME Supporters:
Role and Responsibility
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
27. CME Supporters:
Role and Responsibility
Channels for Communication:
• Convene online meeting and video
conferencing (Web-ex)
• Participate in speakers bureaus
• Exhibit at the ACME annual conference
28. CME Supporters:
Role and Responsibility
Expected Outcomes of Communication:
•Mutual understanding
•Compliant partnering
•Support system for providing quality,
innovative, and effective education
29. CME Supporters:
Role and Responsibility
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)
30. CME Supporters
Role 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
31. 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
32. 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
33. 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
35. CME Physician Learners:
Role and Responsibility
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
37. 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
39. Stakeholder
Relationships
Compliance with ACCME Standards
for Commercial SupportSM
• STANDARD 1: Independence
• STANDARD 2: Resolution of personal conflicts of
interest
• STANDARD 3: Appropriate use of commercial
support
(cont’d)
40. Stakeholder
Relationships
• STANDARD 5: Content and format
without commercial bias
• STANDARD 6: Disclosures relevant to
potential commercial bias
• STANDARD 4. Appropriate management
of associated commercial
promotion
41. CME Supporters:
Role and Responsibility
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
42. CME Supporters
Role 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
46. 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, ELS
2009-2010 AMWA
Publications Administrator
AMWA JOURNAL • VOL. 25, NO. 1, 2010
