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Meeting Information

Date:

October 10, 2008

Time:

11:00 AM EDT


Attending: Francis Kwakwa, Linda Casebeer, Co-chairs; Sean Hayes, Tao Le, Rachel Makleff, Valerie Smothers, Missy Wozetek

Agenda Items

1. Review minutes of last meeting

Francis informed the group of Valerie's pregnancy and asked her to talk about her plan for maternity leave. Valerie explained to the group that she was expecting and due on February 2. She plans to be out for 11 weeks and returned shortly before the annual conference. She added that the timing may be such that the specification would be in standards committee review during the time of her maternity leave, in which case working group meetings would not be necessary. Nancy Davis would be providing some guidance to several working groups should assistance be necessary. When to emphasize that the group does plan to move forward quickly so that the review can take place during Valerie's leave.

The minutes were accepted.

2. Review changes to specification*and* schema

Valerie summarized that changes had been made to the specification based on input from the ACCME. She and Peter had met with the ACCME in July. At that meeting, the ACCME reviewed a monitoring and surveillance document that had been publicly released and reviewed a set of data points that they wish to capture, saying that they would like to use MedBiquitous standards for data collection. Valerie mapped the ACCME's data requirements to existing MedBiquitous standards including healthcare LOM and MEMS. After presenting this to the working group, she then incorporated the data requirements into the metric specification. The new elements were placed under activity description and have been highlighted.

Sean questioned the element on commercial bias saying that bias is much broader than that. He is currently researching a review paper on this topic. The broader question is how much of what's presented to the learner is discordant with evidence and best practice. Will the bias contort or distract from the learning experience? The group agreed to be aware of this issue for the future but to stick with the accme's current requirements.

Tao  asked how the questions on designed to change competence relate to knowledge assessment. Valerie commented that there's no clear connection within the schema or specification, but a system could certainly automatically indicate that an activity is designed to take change competence if there is knowledge assessment data. Knowledge assessment instruments and items can be tied to specific competencies within a framework using the classification element. That would be more of an issue for an implementation guide.

Rachel asked how we are distinguishing between competency and competence. There may be different sets of data to measure each.

Linda acknowledged that that was true but added that the accme is trying to create database to address what people are currently doing. They currently have very little data and are in the beginning stages of data collection.

Tao commented that one could address the specific issue and competency such as appropriate end-of-life care, and tie that to an IOM or ACGME competency such as communication skills. There is nothing restricting them from adding multiple layers of competency references. The important thing is to see how people use the specification. In future versions, we may have different layers of competencies.

Rachel suggested proposing several questions on bias to the ACCME.  Linda commented that it would be good to wait for Sean's evidence. At this time, we don't have valid and reliable bias questions.

3. Identifying pharmaceutical companies

Francis asked Valerie to describe the links that were forwarded. Valerie stated that they were provided by Murray Kopelow loud as possible references for lists defining commercial supporters. Unfortunately, each of the lists cited is either out of date or incomplete. Currently, the approaches to have a free text field for defining commercial supporters. Tao and Rachel agreed that was a good approach.

4. Implementers update

Missy stated that Andy has reached out to Jack, but has not heard back from him. Linda commented that an ACCME trial might be a good next step. The group could move forward based on that. Valerie added that she could contact Kate Regnier and Ed Kennedy and see how they are doing with their implementation. She would let them know our plans for financing the standard and ask if they have a timeline for testing the specification that she could share with the group. Linda stated that the group should try to make a decision about next steps that the next call.

Francis asked Linda about her implementation results. Linda replied that they had applied the standard to set up a common database for a group of providers. Valerie's conversations with developers were able to resolve all of the issues encountered. In addition, the CME Qual survey instrument will be aligned with the standard and go into a database where data can be shared. The alliance for CME has announced its CMExchange site, which leverages the standard. She hopes it will drive CME providers to MedBiquitous.

Francis asked about the smoking cessation program out of Wisconsin. Valerie commented that she had e-mailed Jann Balmer but had not heard back. Sean offered to provide faculty information. Missy commented that all of the smoking cessation program participants are using CE city's CME 360 program, so all evaluation data is going into a common database. She will talk to the project leaders about using the standard for data exchange.

Linda commented that the group will continue to promote the use and testing of the standard but will continue to move the standards process forward.

Valerie added that we should that the new elements with the ACCME and make sure that it meets their needs. The group concurred.

5. Open discussion

Francis asked Valerie to recap Nancy Davis's role in the working group. Valerie explains that Nancy would mainly be providing support for the MedBiquitous annual conference during her leave, but that she would also be providing some support to the working groups, mainly guidance. Jody will be running calls and taking minutes. Linda added that it was her hope that we could submit the standard to the standards committee before Valerie leaves on maternity leave and then wait for feedback, not needing any working group calls during the time Valerie is out. Rachel added that we may want to plan earlier since Valerie could deliver as early as three weeks before her due date. Linda agreed that we should shoot for mid-December. She added that everyone has made wonderful contributions and that it is important to stick with the process and continue to move forward. Francis agreed the group should shoot for pilot feedback by mid-December.

Decisions

Action Items

1.       Valerie will contact the ACCME and make sure that the specification meets their needs.

2.       Valerie will ask the accme about their implementation timeline to see how that fits with our standards development timeline.

3.       Valerie will begin the editing process to prepare the manuscript for standards committee review.

4.       The group will assist in reviewing edits and proofreading.

5.       The group will make a decision as to standards committee review on the next call.

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