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Extracts from Professional Profile Workgroup Minutes

5-19-10            2 Review updates to specification

Valerie reviewed the changes highlighted in the document. She asked the group whether the specification should more clearly define the clinical status element. Toby commented that she is not sure we can define the clinical status element. The certifying boards need to determine their definition of practicing or not. Mike agreed. In certain specialties, there may be a requirement to do a certain volume of certain procedures. The definition may be different for each specialty.

The group then discussed the changes to certification data. Valerie added Participating in MOC and or OCC to certification duration. James commented that in surgery individuals participate in MoC  independent of lifetime and time limited certificate. The values are not mutually exclusive.

Purvi asked james how they are noting MoC. James replied that there is a separate field for MoC. Anyone certified after July 1 2005 is required to be in MoC.

Mike asked if there are there lifetime certificates in moc. James replied that there are. There are also diplomats with time limited certificates participating in MoC. Mike agreed we should take moc and occ out of certification duration. He asked if there is another category, like continuous, that could be used.

Purvi commented that since they are running a pilot, they are using moc for duration type. They’ve discussed having moc an participation element.James recommended making the field is optional at 0 to 2 occurences to allow them to indicate both lifetime and MoC or timelimited and MoC.

Valerie asked if certification occurrence addresses this issue. James replied that certification occurrence addresses a different issue. For pediatrics they may have an initial occurrence, but they are also immediately participating in MOC.

Mike asked if there should be a field that breaks down MoC and OCC requirements. Toby replied that individual requirements get tracked using the activity report. She recommended having a separate field to indicate involvement in MOC, separate from certification duration. James agreed.

Purvi commented that one board uses MoC for certificate duration and for occurrence uses recert or initial.

James proposed that we have separate conference call to clarify issues related to MoC and OCC. Having MoC under certification occurrence doesn’t make sense. Mike agreed it was a good idea.

Valerie agreed to coordinate a call with Purvi, James, and Annette.

James suggested that ABMS think about what information beyond certificate information they need – what are they trying to report to people independent of the certificate?

There were no comments on other changes in the document.

James added that he would like to discuss the name of reverificationdate. He understands purpose but thinks the name could be clearer. He suggested Verificationexpireddate. The group agreed to bring this up on the MoC/OCC call.

6-22-10            Certification Subcommittee Call

Certification Occurrence

Valerie asked if there would be instances where a physician enrolls in MOC but still has a certification occurrence of initial or recertification (perhaps the physician has enrolled but not yet completed any requirements). Brenda replied Yes, the physician could have an MoC record for an initial certification. Purvi agreed that initial and recertification were still valid values for certification occurrence. They do not use the Maintenance of Certification value for that element. Valerie proposed deleting that value if it was not in use.

 

6-24-10            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.

 

11-17-11          3. Discuss new requirement from ABMS - CertificationContinuousStatus.

Jennifer commented that they have talked about the concept of meeting MOC requirements. As they discussed certification duration, they found that there is a need to put the status of meeting requirements in the extensible section. They would like to add that to the standard and have started discussing alternate wording.

Purvi commented the new element would appear in the certificate issuance section, after certification status.

Jennifer explained that they want to get to the notion of whether or not the individual is meeting requirements of the MOC program. She spoke with James, and he is conceptually in agreement. James thought it might be helpful to use the term certificate maintenance type. James cautioned against a yes/no field, explaining that the type may expand beyond a simple binary option. He recommended maintained and not maintained to allow for expansion. He recommended it be a subelement of CertificateInfo as opposed to CertificateIssuance sinc the details are board specific.

Annette recommended “in compliance” as opposed to “maintained.”

Brenda asked what value would be used for a diplomate with a lifetime certificate.

James replied he would not send a certificate maintenance flag.

Jennifer commented there are boards that may have to put something in because of their chosen process.

Annette commented that in the case of AOA boards, DOs that opt into OCC will have their certificate changed to continuous; they can’t go back. If they did their status would change.

Mike commented that we should defer final action and put this out to the entire group again. He asked the group to send Valerie an updated wording. We will distribute, and we can make a decision on the next call.

1-27-12            5 Discuss wording of elementclarifying MOC/OCC compliance

Valerie commented that this was an item discussed on the last call. Jennifer Michael proposed alternate wording via email; Valerie had requested removing the word type since that is used to denote datatypes in the XML schema.

Mike clarified that the new element would be CertificationMaintenance. The AOA was in agreement on the proposed wording of the element name. The proposed valid values are maintained and not maintained. Annette had looked at this from the credentialer’s perspective and was concerned with not maintained because of ambiguity. That could mean failing to maintain or not required to maintain. She had suggested in compliance or not in compliance.

James asked to clarify how he was interpreting. For ABMS boards, one element says certificate type is life time, time limited, or continuous. If person has a lifetime certificate, they won’t have this flag. If their certificate is continuous, he will use this element. If not maintained, the individual is not in compliance. If it is maintained, then they are meeting requirements.

Don commented that he interprets it differently. They intend to use on any type of certificate.

Mike asked if maintained/not maintained would still work. Don agreed it would. The group agreed to adding CertificationMaintenance with a value of maintained/not maintained.

 

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