2010-06-24

Meeting Information

Attending: Mike Zarski, Chair; Valerie Smothers, Staff; James Fiore, Annette Gippe, David Hooper, Don Kooker, Kirke Lawton, Purvi Maniar, Brenda Ruff, Cyndi Streun, Toby Vandemark,

Agenda Items

1 Review minutes of last meeting

The minutes were approved.

2 Report from certification subcommittee

Valerie reviewed the report from the certification subcommittee call. Those who participated agreed the content was accurate.

Don introduced himself. He is from ABIM, and ABIM is also in the process of discontinuing end dates of certificates. The first certificates for MoC will be issued January 2011. Then they launch CMOC, continuous maintenance of certification, in 2012. At that time they will discontinue providing end dates on certificates. People will have to meet milestones as they go. Some people may miss them. The board has approved 5 year milestones, with 10 years for exams. Unlike the 5 year certification cycle, thngs will be expiring all the time.  Once a year, sometime in February, they will analyze everyone and see who is not up to date, and those who are not up to date will lose their certification. Certification can be reinstated. Even in the current system, people lose certification in the middle of the year through revocation and suspension. Don commented that he would favor a system that notifies credentialers and those with an interest in certification data when the certification status changes.

Don added that in discussing the Certification Occurrence element, he  would favor not tying the value to a specific named program. He recommended the language Maintained certificate. He added that at ABIM, anything without an end date will be a CMOC certificate, providing an additional flag that says if a certificate has to be maintained.

Annette questioned how physicians in time-limited certificate programs would be migrated to the new continuous certification. Don replied that anyone enrolled in MoC will be migrated to CMOC automatically. New diplomats will be enrolled automatically. In addition, they will auto-enroll anyone not currently enrolled and not yet expired.

Mike questioned whether ABMS could possibly get feedback on the data structure prior to May 2011.

Brenda commented that they have pilot program they will review quarterly from all perspectives. That will allow them to see if the new fields are meeting their needs. The pilot is due to end in May 2011. They can keep in touch before that point to let us know how the pilot is going and whether they are getting feedback or suggestions. There are similarities between the ABIM system Don described and  what they are doing in the pilot program.

Mike clarified that depending on the quarterly feedback, we could have points at which we could revist these issues prior to the completion of the pilot.

Brenda commented that she was not aware of the next call. She agreed she could provide an update then.

Purvi asked Don if ABIM is creating a new flag for certification duration.

Don commented that in terms of new fields, he would do things similarly to the way pediatrics is doing things.  Initially there will be time unlimited and time limited, then time unlimited must be maintained. Time limited will go away eventually. Eventually all certificates will be time unlimited, some of those must be maintained.

Purvi commented that they are also using an MoC participation status field. It is a Yes/No element that  tells them whether a physician is participating in MoC  and meeting MoC requirements.

James questioned whether certification duration, time limited vs lifetime, addressed the same issue.  If you have a time-limited maintained cert, doesn’t that say you are participating in MOC?

Purvi commented that two boards are moving away from time limited, but some are still issuing time limited and lifetime certificates. There will still be certificate dates. For those boards, additional fields are needed to distinguish physicians participating in MoC.  

Brenda added that lifetime certified physicians may enter the MoC process. They may not get a certificate with an MoC duration type. Each board has own policy as to who is participating and what constitutes MoC.

Don commented that ultimately if physicians do not meet requirements, they will lose certification. He added that ABIM will report what ABMS wants. Stating that a physician is active in MoC is like a feather in the cap. He added he is not sure whether the active in MoC concept means they are doing something or meeting milestones. For example, a physician may not pass the exam, of they may be doing things every year but not meeting their milestones. He is not sure how to distinguish those who are not meeting milestones from those who have lapsed.

Annette commented she will check with their bureau. Currently they have lifetime certificate holders who voluntarily recertify. These physcians don’t complete the modules, but they do take exams.

Don commented that physicians would have to complete the entire MoC program to be distinguished as participating in MoC.  Don asked how the MoC participation status field would be used.

Brenda replied that it would indicate that physicians are enrolled and meeting requirements. It is up to the board to determine if that is true.

Toby commented that you would need two fields. There is a difference between being enrolled and meeting requirements, and being enrolled and not meeting requirements.

Don commented that he would prefer a clear definition for a field that that they report rather than make up their own definition for a field.

Purvi agreed to discuss this as they are more aware of what other boards are doing.

Mike pointed out that some items are still underdiscussion, but there is one item where all are in agreement, and that is around deleting the Maintenance of Certification value from Certification Occurrence. The group agreed, and Valerie agreed to make that update in the next version of the specification.

He asked that Valerie change the Certification Subcommittee report to reflect that ABMS will have quarterly reviews and opportunities to update the working group on things that they encounter working with their stakeholders.

3 Report on Technical Steering Committee attachment recommendations

Mike asked Valerie for an update. She reported that the Technical Steering Committee continues to work on developing the guidelines for including attachments. Mike agreed that once the guidelines are complete, we can modify the standard to reflect them. Mike asked that Valerie put the guidelines back on the agenda when they are complete.

4 Implementation updates

Kirke commented that several schools are reporting unsuccessful or incomplete medical education but are not willing to state whether the student withdrawn voluntarily or involuntarily. It is sensitive information. He asked that the specification include a no longer active status for educational program. They are working with the NBME to exchange data.  He conceded that the new term would introduce some ambiguity but that it was pragmatically necessary. The group agreed this should be included in the next point release.

5 Open discussion 

The next call will be Sep 9, 12 pm EDT.

Decisions

The group will revisit the attachment guidelines discussion when the guidelines are complete.

Action Items

• Valerie will delete the Maintenance of Certification value from the Certification Occurrence element for the next point release of the specification.
• Valerie will update the Certification Subcommittee report to reflect that ABMS will have quarterly reviews and opportunities to update the working group on things that they encounter working with their stakeholders.
• Valerie will add no longer active as a value to the Education Status element.