2010-05-06

Meeting Information

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Attending:  Linda Casebeer and Francis Kwakwa, co-chairs; Valerie Smothers, staff; Ed Kennedy, Jack Kues, Jackie Mayhew.

Agenda Items

1 Implementation updates

Valerie reviewed news since the last call. The MEMS specification was approved as an American National standard in August 2009. She congratulated the group on their hard work. In addition, the ACCME developed a Program Activity Reporting System (PARS) that allows CME providers to send data to the ACCME using the MEMS format. Valerie asked Ed to comment further.

Ed explained that the ACCME has published two upload formats for batch reporting. One is tab delimited for ease of transition. It is a simple, spreadsheet friendly approach, consistent with previous data collection efforts. The other is a MEMS-based XML format. Both are published. They are not getting a lot of feedback about how providers have progressed with the new reporting system. They have found several fields they didn’t need, but to preserve conformance to the standard, the application requires providers to include fields from mems that are required. The ACCME added a wrapper element so providers can upload multiple activities at once. One file can report 30 activities. There are a few odds and ends they needed that they put in Xtensible info in PARS. These are requirements they identified late in the process, after mems progressed to the ansi approval process. Most relate to in kind support. They wanted to have the ability to track in kind support. Also, there are some additional fields related to commercial support. He is happy to send around a copy of their spec. The documentation describes the additions in detail.

Jack commented he would like to see the spec. Ed sent it to Valerie for distribution to the group.

Jackie asked if technology companies like CME tracker have piloted electronic reporting. Ed replied that CECity had participated in the pilot, but he had not had dialogue with other vendors.

Francis asked if any providers reported using mems. Ed replied not date; they are currently in the exhibition and education phase. The production period will begin in June. They did test the mems format during the pilot. There have only been minor revisions since then, and it seemed straightforward to those involved in the pilot.

Valerie asked Francis if the tech people at RSN they were aware of the opportunity to send XML to the pars system. Francis offered to ask them. He added that he thought we should make it easier for providers and provide training for them to do the export.

Jackie commented this was a good opportunity for MedBiquitous. We want educators to share data with each other, the ACCME system could be the motivation needed to get the data in a common format and enable sharing. We do need for technical people to be involved along with the CME office. She questioned how we could get that across.

Jack commented that we should identify providers who institutions they can bring IT people to the table. He agreed that you need both IT and CME together.

Francis commented that RSNA could be one implementer. He can get the IT group together fairly quickly.

Ed commented that will drive adoption of the entities collecting data in this format. If providers need to report to multiple entities, it will become efficient way of reporting.

Linda commented that for the providers they work with, it’s a pretty big leap to transfer the data. That’s the main issue. Valerie asked if training would be helpful.  Linda replied that it depends on the motivation and need driving motivation. It is great that the ACCME is working with us, but it can’t just be that.

Francis commented that if the accme is giving other options for data submission, the likelihood of using those options is high. It is hard to understand mems, and some training would help.

Linda commented that we would need to define the target audience for training. It is technical people.

Jack commented that what would really change culture is if you can distribute inexpensive tools that people can use that implement the standards. Then people can start using the tools.

Linda commented that we had discussed that last year. One issue was that there is no consensus on what kind of evaluation tools to use.

Jack agreed that was a factor. But if a couple were developed and put out, and seen as a universal way of comparing data, we could see what kind of traction they get. We won’t fit every need for everybody.

Valerie asked whether any of the joint CME projects had used MEMS for data collection and evaluation.

Jackie commented that CECity has been the data aggregator for all that she knows about. She asked if we could engage other companies that provide solutions. Could medbiq reach out to that community?

Valerie replied that it often works better if the provider community demands these changes from the vendors.

Francis commented that reporting will come from the education department, not IT. The education department has to understand the benefits to implement the standard.

Jack commented that dissemination & adoption falls in between providers and technologiest. It is not squarely in either camp, but at the intersection.  He added that several pockets of data are collected by providers. He can conceive of a generic tool that could be rolled out and adopted for simple things like Conflict of Interest (COI) disclosure. A tool could be developed. A Registration or activity area tool could be rolled out and adopted. Evaluation will remain muddy; other areas are clear. Big vendors like cecity are the closest to having this capability. But the vendors capable of the type of development needed are developing big suites of products not affordable by the majority of providers. We need disruptive technology that is small and easily transportable. He recommended looking at a group like the Alliance. Even though they don’t have a technologists in house, they have the biggest influence and might have the best shot at brokering development of a tool.  But it has to be a tool that you can use for little or no price.

Jack added that there has been discussion over the years regarding the development of a single database or format by which conflict disclosures could be gathered and updated. This could be used by all providers, and could solve lots of headaches tracking faculty on regular basis. If there were a single tool, this could improve small area where there are problems. It would be seen as valuable to all providers. He would be willing to pay for that.

Jackie agreed. Providers have to share info with each other. Then pass data to the accme. A common format makes sense.

Linda commented that the group has been focused on evaluation, an area where there is no complete agreement. But it would be great if there was an app for a little piece of that.

Valerie asked if the alliance would be interested in developing that kind of an application. Jack replied that he would be happy to forward the suggestion to the Alliance board.

Linda agreed that it was a compelling idea. The way things get adopted is if they make someone’s job easier. Francis agreed a tool could be a springboard.

Jack agreed to take the proposal to the alliance. He added that this may be a good focus of the group for a while: to work with tool developers to solve our common problems. Francis and Linda agreed that it was a great idea.

Jackie commented that where money is a barrier, we should think about a block grant. She questioned whether MedBiquitous or the Alliance could make money available for implementing MedBiquitous standards.

Jack commented that first we must get the standards implemented through simple tools. Standards allow for the collection of large data sets and analysis at a much higher level. This provides the opportunity to generate new knowledge. He questioned whether that was a place to consider putting new funds. He added that there is much more data available than what the ACCME collects. He added that he had written a proposal for a new entity to do just that and e-mailed the proposal to the group.

2 Specification maintenance discussion

3 Education needs assessment

4 Open discussion

Valerie commented that she would get Jody to schedule subsequent calls.

Linda suggested that next time we discuss ways to bring the IT people together from other organizations.

Decisions

Action Items

• Valerie will get Jody to schedule another call.
• Jack will get in touch with the alliance to propose development of a tool to solve some of the practical problems related to tracking and evaluation.
• Francis & Valerie will talk to RSNA IT people