AOE Compliance Connection

Welcome to AOE’s April 2024 edition of AOE Compliance Connection, our monthly newsletter. This month, we bring you news about the role of AI in healthcare, a helpful compliance check from the ACCME VP, and the fourth installment in our series on the trickiest ACCME commendation criteria and how to avoid the pitfalls!

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ACCME President and CEO, Graham McMahon, MD, MMSc recently discussed the rise of artificial intelligence in the realm of medicine and medical education on the “Coffee with Graham” podcast. McMahon, with a background in endocrinology, was joined by two current Google employees, Dr. Peter Clardy (pulmonary and critical care physician by training) and Dr. Paul Jhun (emergency medicine physician by training). Both of the guests currently work with Google at the intersection of new technology development in the health care space.

The conversation began with a working definition of AI as “a field of computer science [that] refers to computer systems doing or performing tasks that normally would require human intelligence” and branched into generative language models, as opposed to traditional machine learning concepts. Dr. Clardy walked the audience through the historical context of the integration of AI into clinical practice, to provide a framework and landed in the problematic (in terms of AI capacity) field of individual patient transaction and the current climate of prioritizing the teaching of providers: ‘shaping your tools before your tools shape you’.

Dr. McMahon reassured listeners that clinicians will not be out of a job, but will instead be stepping into an increasingly complicated field: “Technology is only going to make our jobs both more complicated, but also more interesting and allow us to do things we’ve never been able to do before … these [AI] systems are here to stay and fighting them is pointless. We have to find ways … of engaging with them, controlling them, understanding them, utilizing them in a way that helps patients and actually improves efficiency.”

To hear (or read) the entire conversation, click here.

Recently, Dion Richetti, ACCME Vice President of Accreditation and Recognition, published a helpful Compliance Check for accredited providers.  He focused on Standard 3 and how understanding the exceptions can ease the administration burden of your CE team.

He reminds providers that “with non-clinical education, you do not need to identify, mitigate, or disclose financial relationships”.

Some good examples of non-clinical education are leadership, communication, and mindfulness training.  They are considered non-clinical because there isn’t a chance for anyone in control of content to include any commercial bias regarding products of an ineligible company (like medical devices, medications, etc.).

The ACCME provides a helpful list of what constitutes an eligible and ineligible company in case clarification is needed.

Richetti concludes with a reminder: “When there’s no possibility for someone to insert commercial bias toward the products of an ineligible company, you can skip Standard 3.  That means, you do not have to collect disclosures from the planners, reviewers, speakers, faculty, and facilitators controlling the content of your non-clinical education activities.  Similarly, there is nothing you need to disclose to learners, either.”

More ACCME Compliance Check posts can be found here!

During accreditation and reaccreditation processes, AOE has assisted many providers in going above and beyond and demonstrating compliance not only with the Core Accreditation Criteria, but also with the Commendation Criteria set forth by the ACCME. All CE providers have the option to seek commendation (a six-year term) and become eligible for this status by compliance with Core Accreditation Criteria and any seven criteria of their choice from any category of the Menu of Commendation Criteria plus one criterion from the Achieves Outcomes category (a total of eight criteria).

Over these months, we’re taking a deep-dive into each of the five categories to highlight specific criteria that historically are most likely to trip up providers during the accreditation process.

In January, we covered the “Promotes Team-Based Education” category with a focus on IPCE. In February, we discussed “Addresses Public Health Priorities”, and focused on the sometimes-nebulous term “population health”. Last month, we continued with “Uses Support Strategies”, one of four criteria in the “Enhances Skills” category.

This month, we move into our fourth installment of the series with “Demonstrates Educational Leadership”, which is best summarized as advancing the CME enterprise both within organizations and more broadly. Of the three criteria in this category, we’re going to focus on the one that can be trickiest for providers: “Demonstrates Creativity/Innovation”.

Previously Criterion 35, this criterion was designed for those CME providers that implement innovations in their CME program to help meet the evolving needs of learners. Specifically, this criterion asks the questions:

• Can the CME provider show change and evolution of the program?
• Is the CME program improving?
• Is the CME program/provider doing “cool new stuff” that can be highlighted and learned from?

When addressing this criterion, it’s important to ensure that creativity and innovation is tied with meeting a CME provider’s CME mission statement; it’s not creativity for creativity’s sake.

One of the required elements is that the provider “Implements an innovation that is new for the CME program.” The ACCME has indicated that “new” means new for the current accreditation term. Additionally, the ACCME has clarified that implementation of a new format or a series of new formats into a CME program could be considered one innovation. Each new format would NOT count as its own innovation – the series would count as a single, new innovation.

Providers must submit descriptions of four examples from the accreditation term in order to achieve compliance with this criterion.

What are some other ways providers can demonstrate compliance?

AOE has worked with many providers who have successfully achieved compliance in this category. Two examples of compliance we have seen are below:

Compliance:

• The provider improved its educational reach and impact by partnering with state medical societies to deliver education and track impact regarding screening and brief intervention (SBI) for alcohol abuse. In addition, the provider developed educational SBI reminder cards and emails that were distributed to emergency medicine and primary care physicians and allied care professionals in specific states. As a result, the provider was able to show that proper diagnosis and treatment increased from 5% to more than 15% across three states.
• The provider augmented its conference-based activities regarding surgical tube thoracostomy (chest tube insertion) with a virtual reality workshop that allowed interventional radiologists to practice surgery on virtual patients of varying ages and body types. These interventions allowed participants to compare their skills with other physicians and to document specific practice changes associated with the educational interventions.

Additionally, the ACCME has posted many examples of compliance and non-compliance which are helpful to providers aiming to design a program worthy of commendation. A few examples of non-compliance are below:

Non-Compliance:

• A provider described a new website that is in the process of being developed for the future. The example is not compliant because the innovation has not been implemented during the current accreditation term.
• Providers have described updates to existing series or programs that reflect contemporary terminology and/or best practices. While positive developments, these changes did not qualify as truly innovative or creative and therefore were not compliance (for this criterion).

The ACCME has a number of resources available on their website including FAQs and Examples of Compliance. If you are interested in training and/or strategic planning as related to Accreditation with Commendation, please contact AOE Consulting at inquire@aoeconsulting.com.

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