AOE Compliance Connection

Welcome to the July edition of AOE Compliance Connection, AOE’s monthly newsletter. In this month’s newsletter, you can expect a feature on “Respecting Diversity in Healthcare”, ACCME President and CEO Graham McMahon’s article exploring the difficulties he has faced in healthcare as a two-dad family, a deep dive look at Standard 4 of the Standards for Integrity and Independence in Accredited Continuing Education, and a recap of AOE’s presentations at last week’s Alliance for Continuing Education in the Health Professions, Alliance Connect, Conference in Orlando, Florida. As we move through summer, AOE remains committed to equipping you and your team with the latest CE news and updates, including helpful weekly compliance tips. Reach out to us at inquire@aoeconsulting.com to see how we can best support you!

Last month, ACCME President and CEO Graham McMahon published a heartfelt and poignant article that addresses the difficulties in navigating the healthcare system for a family that doesn’t fit into a traditional structure. In “Beyond Pride: Respecting Diversity in Healthcare”, McMahon speaks frankly as one of two parents in his two-dad family, and the lack of education and accommodation he has encountered in such mundane activities as completing child camp registration forms, arranging doctor visits for his daughters, and navigating outdated and restrictive language on all fronts. His compelling article outlines his professional journey in light of these obstacles and argues that both the “heteronormative lack of social awareness and understanding is outdated and unacceptable in the healthcare environment” and that when ignorant comments or assumptions are made by members of the healthcare team, “the trusting relationship with patients is put at risk and the quality of care may suffer as a result”.

McMahon doesn’t just point out the flaws in the system, however; he offers suggestions for clinicians and healthcare professionals looking to build trust with LGBTQ+ patients based on his own experience as a gay clinician, patient, and father:

1. Allow patients to self-designate on health forms in a way that feels right to them. Keeping in mind that gender identity and sexual orientation exist on a spectrum, McMahon encourages offices to reevaluate all intake forms for outdated language and prepopulated options.
2. Ask about your patient’s personal life. Ask respectful questions that demonstrate interest in your patient’s wellbeing outside of the clinical setting. McMahon explains that some clinicians may unconsciously show more interest in a heterosexual patient’s life events and neglect to express the same curiosity in an LGBTQ+ patient’s life.
3. Seek out continuing medical education (CME) to address your own implicit biases. McMahon points to accredited CME as a way for your healthcare team to receive training on a wide variety of topics including health disparities and health equity for marginalized communities.

McMahon’s overall message to the CE community is that, by embracing the diversity around us, we can build a stronger, more compassionate community and set an example for generations of healthcare leaders to come.

The full article can be read here.

Released in December 2020, the Standards for Integrity and Independence in Accredited Continuing Education replace the established Standards for Commercial Support. As providers will be required to comply with the new Standards by January 1, 2022, now, in 2021, is an advantageous time for a deep dive into each of the 5 new Standards. As part of AOE’s efforts on behalf of our clients, we are featuring one standard per newsletter, to offer readers insight and tools beyond a surface level. Previous AOE newsletters feature in-depth information about Standard 1, Standard 2, and Standard 3.

Standard 4 clarifies the appropriate management of commercial support. This standard only applies to accredited CE that receives financial (or in-kind) support from ineligible companies (previously known as commercial interests).

Any accredited provider that does choose to solicit and accept commercial support is responsible for “ensuring that the education remains independent of the ineligible company and that the support does not result in commercial bias or commercial influence in the education.” As a reminder, the ACCME defines commercial support as financial or in-kind support from ineligible companies. Standard 4 confirms that the support provided should not establish a financial relationship between the ineligible company and anyone in control of content of the education.

Standard 4 contains four subsections, as summarized below:

1. Decision-making and disbursement: All decisions regarding the receipt and disbursement of the commercial support must be made by the provider only. This section details what the providers are (and are not) allowed to cover pay for; for example, commercial support may be used to fund honoraria and travel expenses for planners and faculty members, but not for any individual learners in the education. Further, the accredited provider may use commercial support to defray or eliminate the cost of the education for all learners.
2. Agreement: A documented agreement between the ineligible company and the accredited provider must contain the terms, conditions, and purposes of the commercial support, prior to the start of the education itself. An accredited provider can sign onto an existing agreement between an accredited provider and a commercial supporter by indicating its acceptance of the terms, conditions, and amount of commercial support it will receive.
3. Accountability: A record must be kept by the provider detailing the amounts of support received and how it was used.  This record (i.e., expense/income record) must be made available, upon request.
4. Disclosure to learners: Prior to the education, accredited providers have to disclosure to learners the 1) names of ineligible companies, and 2) nature of support (without including the corporate logos or trade names).

The ACCME clarifies a few different points about Standard 4, including the option to provide scholarships to residents and fellows. While not directly addressed in the standards (4.1c), commercial support funds to support scholarships for residents and fellows is permitted. Additionally, ineligible companies can require (via the written agreement required in 4.2) that any unspent commercial support funds be returned by the accredited provider to the ineligible company.

More information about the new Standards can be found here.