Implementing a new format or a series of new formats of activities into your CME program could be considered one innovation. To meet the expectations for this criterion you would need to describe and demonstrate three additional innovations, as well as how each of the innovations contributes to your ability to meet your CME mission.
Yes. The innovation must be new to the provider’s CME program during the current accreditation term.
If meeting planning staff are part of your CME team, then education/training for them about how to be more effective meeting planners would fulfill the expectation of continuous professional development.
If some of your faculty are functioning as members of your CME team, then providing education and support for them on how to be more effective educators or educational leaders would be considered continuous professional development of your team.
The CME team does not have to take the lead on the management of the research project. However, the research must be related to the effectiveness of and/or best practices in CME.
The ACCME accredits an organization, not the CME department or unit. For this criterion, we are referring to the organization.
The results of the research from at least two distinct projects must be developed into a form that is suitable for sharing with the community, and have each been submitted to a peer reviewed forum. Acceptance for publication/presentation is not necessary to demonstrate compliance.
Yes, research can be qualitative, quantitative, or both.
When you enter participant completion records in PARS, you will need to indicate the number of total MOC points earned and the MOC credit type(s) for which the points were earned.
The ACCME will notify you if you are selected for an MOC audit and will ask you to complete a structured abstract for the activity that was selected for audit. Upon review of your submission, the ACCME will notify you if additional information is needed and/or the results of the audit in terms of compliance with the requirements.
No. The accredited provider defines a minimum participation threshold for MOC activities. Physician learners are likely to participate in one or more of the areas outlined in ABIM’s requirements for Practice Assessment activities, but participation in every step of the quality improvement process is not an ABIM requirement.
The National Academy of Medicine’s quality dimensions include six specific aims for improvement. More information can be found here: http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf
Yes, you can register an activity for only ABIM Practice Assessment points.
Typically, the number of MOC points will be equivalent to the number of CME credits designated for the activity. However, it is acceptable for the MOC points to be less than the number of CME credits available, if only a portion or limited number of sessions in a larger meeting meet the ABIM MOC Assessment Recognition Program requirements.
Providers are required to enter the typical activity-related fields in PARS, and if the activity is eligible to offer ABIM Practice Assessment Points, the provider must attest to meeting the ABIM’s requirements, indicate which ABIM specialty(ies) the activity is best designed for based on the content of the activity, and how many MOC points will be offered. Please note that activities can be registered for ABIM Medical Knowledge points, Practice Assessment points, and/or Patient Safety Credit in any combination.
The same learner information would be required as is currently collected for ABIM Medical Knowledge activities: The physician learner’s first and last name, date of birth (mm/dd), date of completion of the activity (mm/dd/yyyy), and the number of MOC points earned. In addition, providers must also indicate the MOC credit type(s) for which points were earned (i.e., Medical Knowledge, Practice Assessment, Patient Safety).
ABIM has extended the decision to not require Practice Assessment in its MOC program through December 31, 2018. However, ABIM Board Certified physicians must earn a total of 100 MOC points every 5 years and points earned for Practice Assessment activities can count toward the total.
It is up to the provider to determine the most appropriate interval or intervals for assessing the effectiveness of its support strategies. The ACCME expects that this assessment would occur at least once for each strategy during the accreditation term. The provider should additionally demonstrate how the support strategy evolved following the analysis.
The provider might evaluate how many learners are accessing support strategies, how many learners are using the reminders and/or patient education materials, or how many learners are logging into networking opportunities post-activity to engage with faculty or other learners. The provider might survey the learners to find out if the support strategies were helpful in reinforcing change, and if not, what might be more effective/helpful.
The spirit/intent of C31 is for the provider to develop—with the learner—a learning plan with individualized feedback that will help the learner to address their own personal practice gaps—those areas of knowledge, skill, or performance that need improvement. To that end, a tracking system related to credit or MOC requirements, while useful, would not meet the intent of this criterion. The provider should be able to demonstrate that the learning plan differs meaningfully between learners.
Each learner in an activity would be expected to have been observed and given feedback to meet the criterion.
Yes, if the skill is an observable psychomotor skill that requires expertise and practice.
Yes - the intent of this criterion is to have the content/format of the activity support the observation of, and feedback to, learners on their communication skills, so that each participant can derive personal value from the activity.
No. Feedback can be provided in person or virtually, in writing or orally – and can be provided to the individual learner or to a group (for example during a team simulation).
Individuals or groups of learners can self-report and/or self-assess their communication skills, but the accredited provider must also include external observation with feedback to the learner – for example with a faculty member, a peer observer, or a standardized patient.
No. Criterion 28 requires that the accredited provider work with outside organizations to more effectively address population health issues. Such internal collaborations, however, could support the provider’s compliance with other commendation criteria.
Yes. Criterion 28 requires that the accredited provider work with outside organizations to more effectively address population health issues.
No. For Criterion 28, the provider must demonstrate how collaborations augment its ability to address population health issues, but does not have to demonstrate these approaches with examples of CME activities.
The ACCME does not require providers to use a particular definition of public or population health. As one suggestion, a 1988 Institute of Medicine (IOM) report offered a condensed definition of public health as “fulfilling society’s interest in assuring conditions in which people can be healthy.” (Committee for the Study of the Future of Public Health, 1988, p.19) [Institute of Medicine (1988). The Future of Public Health. Washington, D.C.: National Academy Press.]
Yes. By teaching learners how to conduct community health education, you are teaching them a strategy they can use to achieve improvements in population health.
Yes. In the context of your organization and the learners you serve, patients who elect to have surgery could be the collective "population" referenced in Criterion 27.
Yes. The use of clinical registry data in your CME activities would be an example of compliance with Criterion 26, if the data in the registry are used to teach about healthcare improvement.
No. The ACCME does not expect or require providers to use identifiable patient health or practice data. Providers should seek appropriate guidance from institutional policies and practices concerning the protection of confidential and identifiable information when including health or practice data in CME activities.
No. Standard 3 of the ACCME Standards for Commercial Support: Standards to Ensure the Independence of CME Activities requires that all commercial support received by an accredited provider for a CME activity be controlled and disbursed solely by the accredited provider, including payments to planners, authors or faculty/speakers. In contrast, any payments from ACCME-defined commercial interests to persons outside of accredited CME would be subject to disclosure as financial relationships (with a commercial interest) per Standard 2.1.
Patients are often important contributors to educational activities and we encourage providers to engage patients as planners and faculty. Providers should seek appropriate guidance from institutional policies and practices concerning the protection of confidential and private information when including patients in CME activities. The Health Insurance Portability and Accountability Act (HIPAA) does not prohibit the use of patients as faculty, planners, or learners in accredited CME as long as their permission has been received.
The ACCME gives the provider broad latitude to design activities that optimally meet learners’ needs while engaging health professions students as planners and faculty for CME activities.
It depends. If the quality improvement project led by residents included accredited CME and physicians as learners, then yes. If the quality improvement project did not include accredited CME, then no.
No. The provider can involve students from any health profession as planners and faculty of CME activities for Criterion 25.
No. Criterion 24 requires that patients and/or public representatives are involved as planners and faculty of CME activities. The same people do not need to be involved as both planners and faculty.
Yes. Patients/families who serve as planners or faculty in CME would be in a position to control content and therefore the requirements for identifying and disclosing relevant financial relationships and resolving conflicts of interest apply.
Not necessarily. Interdisciplinary has a different meaning than interprofessional. Interdisciplinary refers to multiple specialties – for example, cardiologists, endocrinologists, and nephrologists. Our intent with Criterion 23 is for CME providers to include multiple professions —not only multiple disciplines of medicine. For example, including nurses, pharmacists, radiology techs, social workers, and physicians (or at least two of these professions) in the planning and delivery of education for the healthcare team would meet the expectations of Criterion 23.
No. Criterion 23 rewards interprofessional continuing education (IPCE), where representatives from at least two professions— representative of the target audience for the activity—are included as planners and faculty.
No. The accredited provider can define the role of faculty for their CME activities.
No. The accredited provider can define the role of planners for their CME activities.
Relevant financial relationships are financial relationships in any amount, which occurred in the twelve-month period preceding the time that an individual was asked to assume a role controlling content of the CME activity, and which relate to the content of the educational activity, causing a conflict of interest. The ACCME considers financial relationships to create conflicts of interest in CME when individuals have both a financial relationship with a commercial interest and the opportunity to affect the content of CME about the products or services of that commercial interest.
The provider can set its own goals and offer evidence for how achieving those goals has contributed to the improvement in health outcomes for the individuals and/or communities they serve.
Yes. Providers can measure patient or community health improvement using a variety of approaches that can include self-reporting by patients and other community members.
Patient or community health are the health characteristics or outcomes related to individuals or to groups of individuals within a geographic location, service area, or other grouping. Health and health outcomes can include incidence and/or prevalence of disease, mortality, vaccinations, nutrition, and social determinants (for example, healthy behaviors, safe environment).
No, collaboration is not limited to a single institution. Collaboration can occur within, or in connection with, a healthcare institution such as a hospital or health system, but it can also occur more broadly across systems of care. The ACCME interprets "system performance" broadly and the CME provider can choose how, and with whom, it collaborates in the processes of healthcare quality improvement.
Criterion 37 is an opportunity for ACCME to recognize and reward the contribution of a provider’s CME program to improving care processes and system performance. The provider can use quality measures that are validated by outside sources and/or measures that are appropriate and important to their own setting.
Healthcare quality improvement refers to improvements in clinical care processes or systems.
Healthcare quality improvement refers to improvements in clinical care processes or systems. The provider would be expected to describe and provide data that demonstrates the healthcare quality improvement achieved with the support of its collaboration.
Yes. You would need to show that, through your CME activities, you are collaborating in the process of healthcare quality improvement and demonstrate that the activity/activities resulted in healthcare quality improvement at least twice during the accreditation term.
No. The expectation of Criterion 36 is that the provider measures and demonstrates performance improvement for any learners (physicians or other learners) who participate in the accredited educational activities.
No. Providers can meet the Critical Elements and Standard for Criterion 36 without measuring performance change in every learner.
Yes, provided that the simulation includes assessment of the learner’s or learners’ actions, behaviors, and skills.
Yes. Providers can demonstrate that CME activities improve the performance of individuals or groups of learners—including teams—to meet the expectations of Criterion 36.
For Criterion 36, the majority of learners whose performance has improved would be calculated based on those learners who respond to the follow-up survey. The provider should ensure there are appropriate mechanisms in place to optimize the response rate. Note that providers can use follow-up surveys or a variety of methods to obtain this data.
Yes. Providers can measure changes in the performance of individuals or groups of learners based on self-reports of changes in practice.
In Criterion 36, change in performance refers to measured changes in a learner’s or learners' behavior (e.g., higher patient communication ratings, fewer coding errors, greater participation in team meetings, more appropriate prescribing, etc.). Providers can set their own specific goals and targets for the performance improvement objective. The provider can also choose the most appropriate mechanisms to measure performance change, and how much change in learners is acceptable.
Not necessarily. Strategies to meet the expectations of Criterion 37 do not necessarily include the demonstration of improved learner performance (Criterion 36).
Yes. If your goal was to get your learners to decrease or stop a practice, for example, prescribing a certain drug or ordering a test, and they do make those changes – then, that would meet the expectations of "improvement" for Criterion 36.
Yes, the total number of activities you've provided across the term of accreditation (four or six years) includes both directly provided and jointly provided activities. It may be helpful to consider how some of your collaborations with joint providers could help you achieve some of the goals of the new commendation criteria.
Yes, activities outside of pediatrics may be registered for ABP MOC credit provided that the activity is relevant to physicians certified by the ABP, as demonstrated by the professional practice gap(s) and content of the activity.
If requested by the participant, the provider must provide the participant with written documentation (eg, that could be downloaded or provided in hard copy), to include the name of the activity and the provider; the participant name; the participant’s ABP ID number; the date of completion of the activity; and the PARS activity identifier; in addition to a statement that the activity has been approved for ABP MOC Part 2 credit along with the number of MOC points awarded.
ABP diplomates must meet yearly reporting requirements related to completion of activities, as such accredited providers are asked to submit learner completion data to the ACCME within 30 days of the completion date and no later than December 1 of the calendar year. Activities completed after December 1 must be entered immediately into PARS.
Diplomates’ ABA ID numbers are eight digits that begin with the number three (for example, 3555-5555). They are not the same number that is printed on diplomates’ certificates, nor is it their membership number with a specialty society. If you do not have a diplomate’s ABA ID, you will need to get it from the physician. Diplomates can locate their ID number by logging into their personal portal account on the ABA website at www.theABA.org or by calling the ABA’s Communications Center at (866) 999-7501 Monday through Friday from 8 a.m. to 5 p.m. ET.
The ABA’s MOCA 2.0 Part 2 requirement is 250 credits of CME activities over a 10-year cycle that meet the following criteria:
All credits must be Category 1 CME activities:
Board certified physicians should see MOC points/credits reflected in their physician portal within 24 hours of the providers submitting the participant records in PARS.
For most CME activities that are registered for ABIM MOC points, the number of CME credits will be the same as the number of MOC points. However, it is possible that a large activity might only have certain sessions that qualify for MOC points. In that case, the number of MOC points will be less than the number of CME credits that could be earned.
No, the ACCME has the expectation that accredited providers evaluate the impact of their activities on learners’ knowledge, strategies/skills, performance, and/or patient outcomes. Different assessment approaches can be found in Appendix A of the ABP’s Lifelong Learning and Self-assessment for MOC Part 2 CME Provider Program Manual.
The ABP will verify the participant’s ABP ID number , as well as First & Last Name. If the First & Last Name do not match, the participant’s date of birth (mm/dd) will be used to verify the participant’s information. Additionally, the ABP will ensure that credit has not been previously awarded to the participant for this specific activity.
Please see Table 2 in the ABP Lifelong Learning and Self-Assessment for MOC Part 2 CME Provider Program Manual for a detailed list of materials you will need to submit if your activity is audited. Accredited Providers should complete the ABP’s audit checklist (see Appendix B of the ABP MOC Program Manual) for each activity registered for MOC credit and retain this document along with any other relevant materials in the event the activity is selected for audit.
No. Partial credit will not be awarded to participants.
Participant completion should only be reported when the maximum number of MOC points have been achieved as determined by the provider.
MOC points are equivalent to the number of CME credits awarded. All MOC points awarded must be rounded to the nearest whole number.
Any CME provider accredited directly by the ACCME, by a Recognized State Accreditor, or by Joint Accreditation for Interprofessional Continuing Education can register a CME activity for the ABP Lifelong Learning and Self-assessment for MOC Part 2 CME Provider Program in PARS by attesting that the activity meets the requirements and policies of the program. See the Program Manual for further information
The ABA will verify that the participant’s ABA ID is valid.
There are three options available to you for registering an activity for MOC in PARS.
You will need to report two records for ABA Diplomates that have earned Patient Safety credit as well as MOCA points for their participation in a CME activity. These two types of credit cannot be reported in a single record. Rather, the first record will contain the number of non-Patient Safety MOCA credits earned, and the second record will contain the number of Patient Safety credits earned. The total of the two lines will equal the total number of CME granted to the diplomate for that activity.
The number of ABA MOCA credits is equal to the number of AMA PRA Category 1 Credits designated for the activity. For example, if your activity is designated for 5 AMA PRA Category 1 Credits, then it would count for 5 ABA MOCA credits.
Any CME provider accredited directly by the ACCME, by a Recognized State Accreditor, or by Joint Accreditation for Interprofessional Continuing Education can register a CME activity for the Part 2 (Lifelong Learning and Self-Assessment) component of the ABA’s MOCA 2.0 program in PARS by attesting that the activity meets the requirements for ABA. The CME activity must:
The ABA’s MOCA content outline provides a framework for categorizing medical education content relevant to practicing anesthesiologists. For each registered activity for MOCA 2.0, you will select at least one or a maximum of two content areas that best describe the content of your activity. The ABA can answer questions about its MOCA content outline. Contact the ABA at cme@theABA.org.
The term “health professions students” refers to students of any of the health professions (e.g, medicine, nursing, pharmacy, physician assistants, and others), across the continuum of healthcare education, including professional schools (e.g., nursing, medical, pharmacy schools) and graduate education (e.g., residency and fellowship programs).
Criterion 24 encourages the accredited provider to utilize patients, their families, and other members of the public as planners and faculty members in accredited CME. Providers have broad latitude in how they define the roles of planners and faculty – as appropriate to their CME program and activities. For example, a patient or public representative could serve on a planning committee to advise the provider, could be a speaker, or could be a participant in a case-based discussion during an accredited CME activity.
An interprofessional team is comprised of team members from two or more different professions (e.g., nurses and physicians, physicians and community health workers, social workers and psychologists, pharmacists and respiratory therapists) who learn with, from, and about each other to enable effective collaboration and improve health outcomes.
Yes. There are no limitations on the provider using data/information from their CME activities to support compliance with appropriate Critical Elements and Standards for criteria in the menu approach.
Providers that will receive accreditation decisions after November 2019 must use the Menu of New Criteria for Accreditation with Commendation (C23-C38) to seek Accreditation with Commendation.
No. Providers have the choice of using either Option A: Commendation Criteria (C16-C22) or Option B: Menu of New Criteria for Accreditation with Commendation (C23-C38) to seek Accreditation with Commendation. However, providers need to select one option and cannot combine criteria from the two different options during the reaccreditation process.
Providers that will receive accreditation decisions between November 2017 and November 2019 will have the choice of using either Option A: Commendation Criteria (C16-C22) or Option B: Menu of New Commendation Criteria (C23-C38) to seek Accreditation with Commendation. Providers that will receive accreditation decisions after November 2019 must use Option B if they wish to seek Accreditation with Commendation.
The standard describes the ways providers will be expected to demonstrate compliance with each criterion in the menu of new criteria:
Accredited CME providers asked, through their feedback and comments, the ACCME to include additional information – in terms of explanation and measurement expectations – in support of any new commendation criteria. In order to be responsive to that feedback, the ACCME is including rationale for each criterion, the critical elements required to demonstrate compliance, and the standards for measuring compliance.
The Menu of New Criteria for Accreditation with Commendation includes 16 criteria divided into five categories (Promotes Team-based Education, Addresses Public Health Priorities, Enhances Skills, Demonstrates Educational Leadership, Achieves Outcomes). To achieve Accreditation with Commendation using this menu, CME providers need to demonstrate compliance with any seven criteria of their choice, from any category—plus one criterion from the Achieves Outcomes category—for a total of eight criteria.
No. As with the existing commendation criteria (16-22), achieving compliance with the menu of new commendation criteria is optional for CME providers and is not required to achieve Accreditation. Providers will continue to achieve and retain Accreditation by demonstrating compliance with Accreditation Criteria 1-13.
The Menu of New Criteria for Accreditation with Commendation can be used by any ACCME-accredited and state-accredited providers that are eligible to apply for Accreditation with Commendation. There is no change to requirements for Joint Accreditation for Interprofessional Continuing Education™.
There are two ways you can get more information about an activity that you find through CME Finder: 1) click on the activity URL provided in the search response; and/or 2) contact the accredited provider that is offering the activity. Contact information for all accredited providers can be found on the Find a CME Provider page of ACCME's website.
Registration is “limited” for activities that are designed primarily for the accredited provider’s faculty, staff, membership, or another specific audience. For information about whether you may register for an activity with limited registration, please contact the accredited provider directly.
Currently, only activities that are registered for American Board of Anesthesiology’s Maintenance of Certification program (ABA MOCA), American Board of Internal Medicine’s Maintenance of Certification program (ABIM MOC), American Board of Pediatrics Maintenance of Certification program (ABP MOC), or are compliant with the FDA’s ER/LA Opioid Analgesics REMS are included in CME Finder.
As a benefit of registering CME activities for MOC using ACCME’s Program and Activity Reporting System (PARS), accredited providers agree to have information about their activities made available to the public via ACCME’s CME Finder search tool (www.cmefinder.org). CME Finder is a resource for board certified physicians to search for accredited CME activities that are available for MOC through the collaboration between ACCME and several specialty boards, including the ABA, ABIM, and ABP.
ACCME’s CME Finder is a web-based search tool designed to help health care professionals find accredited CME activities that meet their needs. Users can search for information about currently available CME activities that have been registered for American Board of Anesthesiology’s Maintenance of Certification program (ABA MOCA), American Board of Internal Medicine’s Maintenance of Certification program (ABIM MOC), American Board of Pediatrics Maintenance of Certification program (ABP MOC), or are compliant with the FDA’s ER/LA Opioid Analgesics REMS.
Each specialty board has its own guidance for calculating the number of MOC points/credits available for an activity. See “Ask ACCME” pages for specific boards to determine the number of MOC points/credits for the activity that you are registering for MOC.
The ACCME and ABIM have developed a resource, Evaluation Tool: CME that Counts for ABIM MOC, which includes examples of evaluation approaches that CME providers can use in activities that count for ABIM MOC.
No. If you are creating a journal-based CME activity, the ACCME does not expect you to identify and disclose to learners the relevant financial relationships of the article’s authors and editors or to resolve their conflicts of interest. That process is handled by the journal editors. Disclosure by authors is a standard component of published articles, and the editorial review process manages the resolution of any conflicts of interest.
When you submit participant completion data, PARS will verify the participant's information against simple validation rules, and if verified, will transmit the record to the specialty board(s) for further validation. After the specialty board(s) completes its validation of the data, the participant record status will change to "accepted" or "rejected" within 24 hours. If a record is rejected, you will be notified via email, and the reason for rejection will appear in PARS. Depending on the reason for rejection, you may be able to correct the data and resubmit.
Reporting Maintenance of Certification (MOC) points for an accredited CME activity is a straightforward two-step process.
You should collect the following information for each board-certified physician (diplomate) in order to report their participant completion data in PARS:
If the participant data submitted via PARS does not match the information in a diplomate's specialty board record, PARS will not be able to confirm the participant’s identity and will not accept the completion record. The provider will be notified immediately via a validation error message in the PARS interface or in the batch upload report, depending on what data submission method is being used. The provider will subsequently need to enter corrected data to submit the record successfully.
Feedback can be provided in several ways. Evaluation results can be used as feedback. This is best achieved by correcting misconceptions and incorrect responses, showing learners the correct or optimal response, and providing an explanation as to why the correct answer is the best. This can be done live and at the same time as the activity, or asynchronously. During a live activity, a case conversation where faculty share with learners the appropriateness of the decisions they made and the appropriateness of the case outcome can be considered feedback to participants.
A passing standard can be set according to the intent of the evaluation. The passing standard is determined by the provider. When using a post-test as part of evaluation, the activity planners and/or faculty can determine the minimum number of items that the learners would need to answer correctly to demonstrate that they have adequately absorbed the content of the activity.
Shared responses refer to the dialogue that is shared among participants in a discussion group. For example, this might be an appropriate assessment method when learners work collaboratively through a case, or come to a shared resolution to an ethical problem. The accredited provider should be attentive to what is said and by whom, and observe for individual learner participation, engagement, and contributions.
Written responses can be responses to a variety of prompts. The questions can be as broad as "What would you do differently as a result of what you learned?" and "What will you keep doing or stop doing as a result of the learning that has occurred?" to more narrowly focused questions such as "What would you do next for this patient in this situation?" Those written responses can be evaluated for concordance to an ideal response. When appropriate, it may be adequate to have the learner write a meaningfully reflective statement.
Longer form tests refer to assessment instruments that comprise several different testing modalities, such as multiple-choice items, items that require the learner to draw a process, and/or fill-in-the-blank written or spoken responses. An answer key is essential in order to use this modality effectively.
Fill-in-the-blank questions refer to items that are completed by the learner(s). The format includes a leading statement with a missing word or words that are then completed by the learner(s). These responses can be collected using a variety of methods, including audience response systems or evaluation forms.
Multiple-choice questions can be used in a variety of ways. They are typically used as mini-case simulations that present a clinical vignette and a question (the "lead in") followed by a discrete range of possible responses, one of which is correct. These can be readily scored using audience response systems, computer score sheets, or manually. Instructions for writing effective multiple-choice items can be found at http://www.nbme.org/publications/item-writing-manual.html.
The American Board of Internal Medicine (ABIM) Medical Knowledge Assessment Recognition Program Guide notes that in order for a course (or other live activity) to be registered for ABIM Maintenance of Certification (MOC) points in the ACCME’s Program and Activity Reporting System (PARS), the provider must include a comprehensive evaluation component that measures learners change.
The process of peer review means that the educational materials are reviewed by other clinicians who are sufficiently familiar with the material to be able to render an opinion as to whether the materials are fair, accurate, and free of commercial bias.
Once you have attested that your activity meets the American Board of Internal Medicine’s (ABIM) Medical Knowledge Assessment Recognition Program requirements, ACCME’s Program and Activity Reporting System (PARS) will prompt you to indicate whether or not you are seeking the optional patient safety Maintenance
Yes. Once you have attested that your activity meets the American Board of Internal Medicine (ABIM) Medical Knowledge Assessment Recognition Program requirements, the Program and Activity Reporting System (PARS) will prompt you to indicate one or more specialties represented by ABIM for which the activity is relevant.
No. As has always been the case, accredited providers should report any multi-session annual meeting as a single CME activity in ACCME Program and Activity Reporting System (PARS). When registering an annual meeting activity for the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) program, you can adjust the number of MOC points to accurately reflect only the sessions that meet the requirement.
Per ACCME data reporting instructions, accredited providers should report multi-session regularly scheduled series (RSS) for example, grand rounds, tumor boards, and morbidity and mortality conferences as a single activity in the Program and Activity Reporting System (PARS). If the entire RSS or a portion of the series meets the American Board of Internal Medicine (ABIM) requirements, it can be registered for Maintenance of Certification (MOC).
A diagnostic laboratory is not considered an ACCME-defined commercial interest if its business is limited to the provision of diagnostic services that provide clinical results or information to healthcare professionals for their treatment of patients.
The REMS Program Companies (RPC) assigns an ID (RPC ID) to each activity for which it provides commercial support. Accredited providers that offer RPC- supported REMS activities are responsible for entering the RPC ID in the designated field in the REMS section of the activity web-fill form in the Program and Activity Reporting System (PARS). This ensures that their RPC-supported activities can be identified and reported to the RPC and, ultimately, to the FDA. If you are an accredited provider that has received commercial support from the RPC for REMS activities and you have questions abo
The use of employees of ACCME-defined commercial interests as faculty and planners or in other roles where they are in a position to control the content of accredited CME is prohibited, except in the specific situations specified here. The ACCME has identified 3 special-use cases where employees of ACCME-defined commercial interests can have a specific, limited role in accredited CME activities.
Yes. Effective April 2015, providers can use tabs, links, or other electronic mechanisms to make disclosure information available to learners, just as they have always been able to make disclosure available via a tabbed section in a printed syllabus. Regardless of the method of disclosure, all required ACCME information specified in Standard for Commercial Support 6: Disclosures Relevant to Potential Commercial Bias must be transmitted to the learner prior to the learner beginning the CME activity and should be clearly marked, accessible, and useful for learners.
No. Standard 2.1 requires the provider to identify relevant financial relationships of those who control the content of a CME activity in order to identify conflicts of interest. Two things must be present for there to be a conflict of interest: financial relationship(s) with an ACCME-defined commercial interest(s) and the ability to control content related to products/services of the commercial interest(s).
Yes. The Structured Abstract is intended to streamline, clarify and make more explicit ACCME’s expectations for verifying Performance-in-Practice. Using the fill-form fields on the structured abstract, the provider should state information representative of the entire series. It is permissible for the provider to summarize, or abstract, information from multiple sessions into brief statements on the abstract document.
No. The Structured Abstract is intended to streamline, clarify and make more explicit ACCME’s expectations for verifying Performance-in-Practice. A single Structured Abstract can be used to for complex activities, however, you can also prepare separate structured abstracts for different tracks of a large annual meeting. Providers taking this approach should be sure that each structured abstract includes the required information and attachments.
No. Providers may now submit evidence of performance-in-practice using one of two methods:
The 2006 Accreditation Criteria are founded on Shewhart and Deming’s “Plan, Do, Study, Act” model for continuous improvement. This is reflected both in those accreditation criteria that are concerned with the improvement of a provider’s overall CME program, as well as criteria that guide the provider in planning and implementing CME activities to support continuous improvement of their learners’ practice and/or patient outcomes.
You are correct that the 2014 modifications to the ACCME Standards for Commercial SupportSM: Standards to Ensure Independence in CME Activities are focused on prohibiting the corporate logos of ACCME-defined commercial interests when making disclosure of commercial support to learners or in educational materials.
The ACCME has no policy regarding the wearing of a corporate logo of an ACCME-defined commercial interest by an employee (of an ACCME-defined commercial interest) who is demonstrating a device to the CME activity participants inside the CME activity teaching/learning space.
Yes. The 2014 modifications to the ACCME Standards for Commercial SupportSM: Standards to Ensure Independence in CME Activities are about the separation of promotion and education. Standard 4 outlines the expectations of how that separation is maintained.
No. Logos of ACCME-defined commercial interests are not permitted in the disclosure of commercial support. The ACCME considers the disclosure of commercial support, as well as other information required by the ACCME such as disclosure of relevant financial relationships, to be part of the educational materials.
Educational materials are those materials used by the accredited provider in the transfer of education to learners, as well as information required by the ACCME to be made known to the learner, such as disclosure of relevant financial relationships and/or disclosure of commercial support. Examples include handouts, slides, educational content, abstracts (if part of the education itself).
The ACCME made these modifications in March 2014 because it determined that the logos of ACCME-defined commercial interests —as a form of corporate branding —are not appropriate in either educational materials or in the disclosure of commercial support of accredited continuing medical education.
Criteria 14 and 15 were eliminated in February 2014 as part of the changes to simplify the accreditation requirements and process because they were redundant to Criteria 11-13. This change streamlines the Accreditation Criteria while retaining the Plan-Do-Study-Act cycle, which is integral to the ACCME’s expectations.
Criterion 4 was eliminated in February 2014 as part of the changes to simplify the accreditation requirements and process because it was redundant to Criterion 2, which requires providers to design activities based on educational needs that underlie professional practice gaps. If education reflects professional practice gaps it will, in turn, have to match the scope of practice.
Yes. Accredited providers can choose to include components in their CME mission statements in addition to those specified in Criterion 1. However, during the accreditation process, providers’ mission statements will be evaluated only to ensure that the mission statement includes “expected results articulated in terms of changes in competence, performance, or patient outcomes that will be the result of the program.”
Some of the special requirements for journal-based CME were eliminated as part of the February 2014 changes to simplify the accreditation requirements and process. The requirements that support the Standards for Commercial Support were incorporated into Standard 4.2.
Some of the special requirements for Internet CME were eliminated as part of the February 2014 changes to simplify the accreditation requirements and process. The requirements that support the Standards for Commercial Support were incorporated into Standard 4.2.
Some of the special requirements for enduring materials were eliminated as part of the February 2014 changes to simplify the accreditation requirements and process. The requirements that support content validity are retained and are now described in the Content Validity of Enduring Materials Policy.
Yes. Providers may choose any quality assurance method that works for them in order to ensure that their regularly scheduled series (RSS), and all their activities, are planned and presented in compliance with accreditation requirements. However, the ACCME does not require providers to use a monitoring system for RSS–or for any of their activities.
No. There are no special requirements for regularly scheduled series (RSS). For RSS, as with any activity type, providers are expected to demonstrate compliance with all applicable ACCME accreditation requirements and policies, including the ACCME Standards for Commercial SupportSM: Standards to Ensure the Independence of CME Activities.
No. Organizations applying for Provisional Accreditation are not required to have an on-site survey. Surveys are required; conference calls are the standard interview format the ACCME currently uses. Initial applicants and accreditors have the option of using other survey formats including televideo and face-to-face, if circumstances warrant it.
The ACCME expects accredited providers to discontinue the use of the term “sponsor” (e.g., jointly sponsored, joint sponsorship, directly sponsored, direct sponsorship) for new materials published after January 1, 2015. Please note that this change in terminology applies to accreditation statements for directly and jointly provided activities, as well as other materials.
Yes. The February 2014 changes to ACCME’s accreditation requirements and processes apply to all accredited providers within the ACCME accreditation system. ACCME Recognized Accreditors are responsible for implementing these changes for intrastate providers. Please check with your accreditor about the implementation process.
Accredited CME providers that are interested in conducting the long-term evaluations might provide service in support of the ER/LA Opioid Analgesics REMS in the following ways:
The RPC has hired inVentiv Health, Ltd. to manage the commercial support. So, in this complicated case, for simplicity, the accreditor is allowing providers to specify the “RPC/inVentiv Health, Ltd.” as the commercial supporter.
The FDA has provided the following description of the REMS Long-Term Evaluations in its ER/LA Opioid Analgesics REMS Supporting Document:
The REMS Program Companies (RPC) are responsible to the FDA for fulfilling the requirements for long-term evaluations. The RPC will provide funding to organizations that will conduct the long-term evaluations in accordance with FDA specifications.
The FDA has required long-term evaluations of the ER/LA prescribers who complete REMS-compliant CE activities. Specifically, the FDA is requiring the evaluation of knowledge retention and practice change in ER/LA opioid prescribers 6-12 months after completing the REMS-compliant CE activity. The long-term evaluations will be separate and different from any post-tests that might be conducted by accredited CE providers immediately after all REMS-compliant CE activities.
The CE community addresses prescription drug abuse in many ways. One way is by developing and presenting education that is explicitly part of the RPC-funded ER/LA Opioid Analgesics REMS that meets all the specific REMS requirements. Another way is through the activities offered by accredited CE providers on a wide range of important topics to educate healthcare professionals about prescription drug safety, and drug abuse prevention, intervention, and treatment.
The Food and Drug Administration Amendments Act of 2007 gave the FDA the authority to require manufacturers of drugs and biological products to put in place special programs if the FDA determines that safety measures are needed beyond the professional labeling to ensure that the benefits of products outweigh their risks. The manufacturers then implement FDA-monitored actions to address those risks. The FDA calls each of these a Risk Evaluation and Mitigation
No. The ACCME cannot control what a commercial interest asks of an accredited provider but there is no CME reason for the provider to share the names of speakers/authors with commercial supporters. An accredited provider that submits to the requirement of a commercial supporter to supply the names of speakers and authors could be participating in a process whereby the commercial supporter is controlling the selection of speakers and authors in accredited CME.
Yes. Accredited CME providers can base their activities on the FDA blueprint and be in compliance with the ACCME Standards for Commercial SupportSM: Standards to Ensure Independence in CME Activities. As with any CME activity, accredited providers within the ACCME system must comply with the ACCME accreditation requirements.
No. ACCME considers relationships of the person involved in the CME activity to include financial relationships of a spouse or partner. The ACCME expects that providers will communicate to everyone who is in a position to control of content of an educational activity that the individual’s disclosure of relevant financial relationships must include:
No. The ACCME does not require that providers use a disclosure form to gather information about relevant financial relationships of all persons in control of the content of an educational activity. A disclosure form is one mechanism that providers may use to obtain (and show that they possess) this information. Other examples could include:
SCS 2.1 requires that the accredited provider “must be able to show that everyone who is in a position to control the content of an education activity has disclosed all relevant financial relationships with any commercial interest to the provider.” If someone in connection to the activity has the opportunity to affect the content, they are “in control of content.” Those individuals in a position to control the content of an e
First it is important to understand how the ACCME defines a financial relationship. Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit.
Financial relationships are those relationships in which the individual benefits by receiving, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit.
SCS 2.1 says that providers “must be able to show that everyone who is in a position to control the content of an education activity has disclosed all relevant financial relationships with any commercial interest to the provider.” Therefore, the provider must do both of the following:
All of the users associated with your organization in PARS have the ability to edit organizational contact information on the “Profile” tab in PARS. Contact information for individual users may be edited within the "Profile" tab under "Contacts".
All funds that originate from ACCME-defined commercial interests and are paid to reserve space to hold accredited CME activities (sometimes called satellite symposia) in conjunction with other organizations’ meetings are considered commercial support. As with all commercial support, these funds must be paid directly to the accredited provider responsible for the activity or to a designated nonaccredited joint provider.
Yes. There is no ACCME prohibition against including product-specific content in accredited CME. Accredited providers can develop and distribute product-specific content for activities based on the FDA blueprint for the Extended-Release and Long-Acting (ER/LA) Opioid Analgesics Risk Evaluation and Mitigation Strategy (REMS) because the blueprint was developed and issued independent of the control of any ACCME-defined commercial interest. As with any CME activity, accredited providers must comply with the ACCME accreditation requirements.
No. An accredited CME provider cannot use content developed by an ACCME-defined commercial interest in CME activities because that would be noncompliant with Standard for Commercial Support 1: Independence.
No. The ACCME information applies only to the ER/LA Opioid Analgesics REMS. The ACCME appreciates that the FDA recognizes the value of accredited education and believes that accredited CME should be considered as a strategic asset to all those trying to improve drug safety. Since 2009, the ACCME has supported the role of accredited CME as a strategic asset to REMS FDA-approved products, provided the proper controls are in place to ensure independence. The ACCME will be ready to respond if the government calls on accredited CE to support implementation of other REMS.
The ACCME views the FDA ER/LA Opioid Analgesic REMS as an important initiative for addressing a critical public health and patient safety concern. The ACCME believes that accredited CME can be an important factor in the success of this REMS and all REMS that involve continuing professional education.
The ACCME appreciates that the FDA recognizes the value of accredited education and chose to leverage the CE system to carry out this important public health initiative. The ACCME has a long-standing commitment to supporting the role of accredited CME as a strategic partner in public health and safety initiatives.
In the Extended-Release and Long-Acting Opioid Analgesics REMS, one of the elements to assure safe use is an education program for prescribers about the risks of opioid medications as well as safe prescribing and safe use practices. The ER/LA Opioid Analgesics REMS requires the manufacturers to provide commercial support to accredited CME so that it is available free of charge or at nominal cost to prescribers. However, the participation of accredited providers is completely voluntary – as is the participation of prescribers in REMS education.
The FDA delivered its Risk Evaluation and Mitigation Strategy (REMS) for extended-release and long-acting (ER/LA) opioid analgesics to the manufacturers in 2012. According to the FDA news release the REMS "is designed to ensure that healthcare professionals are trained in how to properly prescribe these medicines and how to instruct their patients about using them safely." It has two components: a medication guide and elements to assure safe use.
No. For CME activities in which the learner participates electronically (e.g., via the Internet), all required ACCME information specified in Standard for Commercial Support 6: Disclosures Relevant to Potential Commercial Bias must be transmitted to the learner prior to the learner beginning the CME activity.
The ACCME defines a commercial interest as “any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
Each year, information is collected, summarized, and published as a service to accredited providers, other members of the community, and the public via the Program and Activity Reporting System (PARS). At the conclusion of each Reporting Year, a provider is required to submit information about their activities that took place during the year as well as financial data about their overall Program.
You are required to complete the following fields regarding commercial support at the individual activity level.
Internet searching and learning activities are based on a learner identifying a problem in practice and then accessing content in search of an answer from sources on the Internet that are facilitated by a provider. For the purpose of data collection, the ACCME includes AMA-defined point of care CME as a form of internet searching and learning.
Performance improvement activities are based on a learner’s participation in a project established and/or guided by a provider in which a learner identifies an educational need through a measure of his/her performance in practice, engages in educational experiences to meet the need, integrates learning into patient care and then re-evaluates his/her performance.
Committee learning is an activity that involves a learner’s participation in a committee process where the subject of which, if taught/learned in another format would be considered within the definition of continuing education.
What kind of activity types can be reported in PARS?
Test Item Writing activities may consist of either of the following processes:
When questions are written for an ‘item pool’ from which they are later drawn to build a variety of ‘tests’, then building the questions for a single pool is one activity (ex. the Pediatric Item Writing Committee of the National Board of Medical Examiners; or the Second Year Clerkship exams at your medical school); or
Test item writing is an activity based on a learner’s participation in the pre-publication development and review of any type of test-item (e.g., multiple choice questions, standardized patient cases).
Manuscript review is based on a learner’s participation in the pre-publication review process of a manuscript.
A journal-based activity includes the reading of an article (or adapted formats for special needs), a provider stipulated/learner directed phase (that may include reflection, discussion, or debate about the material contained in the article(s)) and a requirement for the completion by the learner of a pre-determined set of questions or tasks relating to the content of the material as part of the learning process.
An internet enduring material activity is available when the learner chooses to complete it. It is “enduring,” meaning that there is not just one time on one day to participate in it. Rather, the participant determines when he/she participates. (Examples: online interactive educational module, recorded presentation, podcast).
An enduring material is a printed, recorded, or computer-presented activity that may be used over time at various locations and which, in itself, constitutes a planned activity. In an enduring material the provider creates the content.
An internet live course is an online course available at a certain time on a certain date and is only available in real-time, just as if it were a course held in an auditorium. Once the event has taken place, learners may no longer participate in that activity. (Example: webcast)
What kind of activity types can be reported in PARS?
A course is a live activity where the learner participates in person. A course is planned as an individual event. Examples: annual meeting, conference, seminar.
Learning from teaching is a descriptive label for a type of activity. (The identification of activity types allows the reporting of data and information on the range of educational formats offered nationally. This helps dispel the myth that accredited CE is mostly lecture, or didactic, in format.)
Accredited providers are required to understand the issues with knowledge or competence or performance that underlie a professional practice gap. Problems with knowledge, competence or performance that underlie a professional practice gap — and design an educational activity to intervene — and to design and to measure — in terms of changes in competence, performance or patient outcomes. The patient outcome or the outcome is like the professional practice gap, those are analogous.
Through self-assessment or self-audit, the physicians in an ACCME accredited group practice might identify the following professional practice gap:
Yes... at this point an assessment of change is required for each CME activity. The information is then analyzed by the CME provider in the context of the overall program's effectiveness. Criteria 11 and 12 require the provider to have knowledge of the effectiveness of their Program of CME in the context of changes in competence, performance, or patient outcomes.
Yes, evaluation of learners' change in competence, performance or patient outcomes is required.
Let us say a CME provider set its mission so that the expected result of its program of CME was to change competence and was, "To enable learners to develop strategies for the identification of patients with drug addiction."
Examples of a sample of the type of data that would be acceptable in meeting Criterion 12 would be:
"When we started, none of our learners could ask the right screening questions, did ask the right screening questions, or identified a patient with drug dependence in their practice."
Examples of a "non-educational strategy to enhance or facilitate change as an adjunct to activities or educational interventions" would be, 1) implementing a mechanism to send reminders to participants following CME activities (e.g., "Don't forget to..." or "Have you incorporated...?"), or 2) working with others to facilitate a peer to peer feedback system to reinforce new practices, or 3) incorporating new questions about the new practices into patient satisfaction questionnaires.
The ACCME is committed to ensuring that accredited providers have tools and resources to help them meet ACCME policies and standards. Educational opportunities include resources available through the ACCME website (www.accme.org) and training-focused workshops and other meetings. For more information, visit the Education section on our website.
No. Criterion 21 requires that the provider, "participates within a institutional or system framework for quality improvement", but does not specify the manner in which this is achieved. Criterion 21 is required to achieve Accreditation with Commendation (Level 3), however noncompliance with Criterion 21 is not held against providers seeking Full Accreditation (Level 2). For examples of provider practices that achieve compliance with Criterion 21, see the ACCME's Provider Examples of Compliance and Noncompliance.
It is expected that CME providers will enhance the impact of CME in their system, or micro system, when they are in collaborative or cooperative alliances with other stakeholders in quality.
Perfectly. The ACCME Accreditation Criteria require that all CME activities planned and implemented by an accredited provider address educational needs derived from a professional practice gap of the provider's own leaner(s) and are designed and evaluated with regard to changes in competence, performance, or patient outcomes.
No, you do not. Some Criteria address your overall CME program, while others relate to CME activities. For each CME activity, you need to demonstrate compliance with Criteria 2 - 6, which address educational planning and delivery. In addition, you need to demonstrate compliance with the ACCME Standards for Commercial Support SM (Criteria 7 - 10). Criterion 11 requires that providers evaluate changes in learners' competence or performance or patient outcomes, in order to be able to analyze those changes achieved as a result of the overall program's activities.
Criterion 1 says, "expected results articulated in terms of changes in competence, performance, or patient outcomes that will be the result of the program." What definition of "competence" is ACCME using? Does it mean knowledge and skill, or does it mean the application of knowledge or skill in practice? If the later is true, how does it differ from performance?
This is an ACCME adaptation of an Agency for Healthcare Research and Quality (AHRQ) definition of a gap in the quality of patient care where the gap is "the difference between health care processes or outcomes observed in practice, and those potentially achievable on the basis of current professional knowledge."
Yes. CME providers can offer activities designed to change knowledge. The emphasis now is on the CME provider knowing the "educational needs that underlie the professional practice gaps of their own learners." ACCME believes that the path to closing the gap will be through modifications to one, or more, of physicians' knowledge, competence, or performance. ACCME expects that CME providers and learners will analyze the gaps in order to understand the causes so as to determine what might be the best or most appropriate educational intervention.
Criterion 2 requires that the educational needs that underlie the professional practice gaps of learners be incorporated into the CME activities. However, the CME provider does not have to collect that needs data. There are many, many sources of needs data that relate to professional practice gaps. Determining if that data is relevant to the actual learners is a task for the CME provider. The ACCME's announcement of the Updated Criteria included some references that might be a place for the CME provider to start.
No. Previous activity evaluations may contain expressions of need that underlie professional practice gaps.
Needs assessment is about understanding the basis for a 'professional practice gap' - in terms of an underlying problem with knowledge, competence or performance-in-practice. A provider may want to further understand the underlying problem in the context of one or more of the competencies - so an educational need may be grounded in one or more of ABMS' core competencies. There are other competencies that have been promulgated that might be useful for the CME provider to consider, e.g., the IOM competencies, specialty - specific competencies.
CME must be free of commercial bias. CME must not promote products or services. CME must promote improvements in healthcare. A "balanced view" means that recommendations or emphasis must fairly represent, and be based on, a reasonable and valid interpretation of the information available on the subject (e.g., "On balance the data support the following..."). A "balanced view of therapeutic options" also means that no single product or service is over represented in the education activity when other equal but competing products or services are available for inclusion.
Informed learners are the final safeguards in assuring that a CME activity is independent from commercial influence. Regarding personal conflicts of interest, CME providers are to have in place mechanisms to identify and resolve conflicts of interest. While these mechanisms should greatly reduce the potential for conflicts of interest to affect CME content, a potential for influence remains. Disclosing to learners the relevant financial relationships that were present and resolved assists learners in assessing the potential for bias in information that is presented.
The nature of the relationship means the role they play or service they provide in exchange for some form of compensation (e.g., independent contractor including contracted research, consulting, promotional speaking and teaching, membership on advisory committees or review panels and board membership). ACCME has not set a minimum dollar amount for relationships to be relevant.
Yes. Commercial support is financial, or in-kind, contributions given by a commercial interest, which is used to pay all or part of the costs of a CME activity. This is money given to the provider to support the activity. In contrast, financial relationships are between an individual being asked to assume a role controlling content of the CME activity and a commercial interest and occur outside of the CME activity (e.g. a teacher or author of participating in a CME activity is paid by a commercial interest to speak).
This allows the learners to distinguish between missing disclosure information and the circumstances where there is nothing to disclose.
Yes. Please see the Rule Making Policy at ACCME for information about this process.
ACCME insists on the separation of education from all promotional activities, materials and messages. Many providers create a print or text based document that goes along with an activity and provides information that is supplementary to the education content - like reproductions of slides, graphics or other handouts. These documents, in print or electronic, are an integral part of the education and as such cannot have any advertising, corporate logo, trade name or a product-group message of an ACCME-defined commercial interest associated with them.
It would depend on what the program book, with abstracts, is used for in relation to the CME activity. If the abstracts are referenced during the activity or serve as a component of the content, then there can be no advertising in the program book. If the abstracts are not referenced as part of the CME content, and appear in the program book with all other logistical information about the activity, then there can be advertising.
Yes. It contains logistical and organizational information and not education materials. It contains maps and floor plans but not slides and not abstracts.
In SCS 4.5, the ACCME requires that accredited providers to use their own distribution channels for CME activities. To that extent, having a CME enduring material created for the exclusive purpose of use in promotional visits to physicians' offices, for example, would not be in keeping with the concept of separating CME from promotion.
Yes. A Provider would not be out of compliance with the Standards for Commercial Support.
No. Communication or distribution mechanisms that are owned or controlled by a commercial interest cannot be used to transmit or distribute continuing medical education activities to learners (e.g., a cable TV network or website owned and controlled by a commercial interest).
CME exists to support the physician change and learning -- so as to increase their ability to participate in providing quality healthcare or improved healthcare. ACCME expects that providers will always be able to demonstrate how each activity contributes to quality and/or improvement in healthcare, and is, therefore, aligned with what is in the best interest of the public.
Discussion of off-label uses are certainly allowed in CME activities. However, providers are no longer required to have a mechanism in place to ensure that off-label or investigational uses are disclosed as such. The ACCME adopted content validation statements in 2002 that are expectations of providers with regard to any recommendations for clinical care.
ACCME expects to be able to review income and expense statements for all CME activities. These statements must reflect:
Significant sources of income: Including income from commercial support, advertising and exhibit fees, tuition and registration fees, internal budget allocations and any other source that represents greater than 20% of total income.
No. The ACCME has no specific policy on this matter. The decision is an organizational one for the provider.
No, in this scenario the commercial interest is giving commercial support and buying promotional and sales opportunities. The commercial interest should buy advertising and promotion opportunities with resources designated for that purpose. If an agreement for advertising or promotion is struck between the two parties it must be outside the written agreement for commercial support described in Standard 3 of the SCS.
No. The Provider is not accountable to the ACCME for the content of advertising and exhibits. The information transferred in an advertisement or exhibit is not part of the Provider's program of continuing medical education activities.
This is a more detailed description of the requirements that must be followed if there is advertising in enduring materials. There can be advertising before and after the CME content of an enduring material but those advertisements cannot be related to the content of the CME and cannot have been paid for by the commercial supporter.
Twenty years ago, most CME occurred in a lecture hall. Now, learning activities occur in many different environments including electronic media, and ACCME intends that all of these places and spaces of CME activity need to be protected from encroachment by advertising, sales or promotional activity.
The ACCME intends for the CME Provider to be the one to decide how much people are paid for their services as planners, faculty, and authors in CME activities.
No. All commercial support must be stipulated by a written agreement and must flow through the Provider and/or its educational partner. Only the Provider and/or its educational partner can make payments to people for their role(s) in the activity.
Yes - but CME providers need to be sure that these people have bona fide teaching roles. In the United States, physician learners are not to be given compensation or reimbursement for attending CME activities (see Opinion 8.061 of the Council on Ethical and Judicial Affairs of the American Medical Association). It is unacceptable for anyone other than the Provider, or its agents, to receive direct financial benefit from commercial support.
Meals or social events compete with educational events when they happen at the same time in a different location or when they are the main attraction at the educational activity.
No they are not prohibited. Working and learning through meal time is an efficiency often included in bona fide CME activities.
Using commercial support to pay for modest meals and social events at CME activities has been allowed for years. However, providers must avoid making meals or social events longer or more important or more costly than the educational activity, for example.
Commercial support underwrites the provider's expenses for developing and presenting an activity. Commercial support can be used to pay for the expenses of teachers and authors as well others who are working for the provider on the activity.
Yes. ACCME considers meals arranged by the Provider in conjunction with an activity to be an appropriate part of the expenses of a meeting and can be paid for out of the commercial support.
Yes. The ACCME accepts electronic signatures as evidence that written agreements are signed.
No - commercial support does not have to be in a single payment or grant.
When there is commercial support there must be a written agreement that,
Yes. The agreement must describe the terms, conditions and purposes of the commercial support grant and be signed by the commercial supporter and the accredited provider.
The ACCME expects that written agreements for commercial support will:
The ACCME expects that the provider makes decisions related to the planning and implementation of CME activities without being directed or influenced by commercial interests.
A provider will be found in Noncompliance with SCS 1.1 and SCS 3.2 if the provider enters into a commercial support agreement where the commercial supporter specifies the manner in which the provider will fulfill the requirements of the ACCME's Elements, Policies and Standards. (Applicable to all electronically, digitally or manually signed written agreements executed after January 1, 2008.)
Yes. An accredited provider can fulfill the expectations of SCS 3.4 to 3.6 by adopting a previously executed agreement between an accredited provider and a commercial supporter and indicating in writing their acceptance of the terms and conditions specified and the amount of commercial support they will receive.
ACCME has never recommended withholding CME credit at the last minute as an alternative to producing CME that is in compliance with accreditation requirements. It does not seem fair to the physician learners. Assuming that in this scenario there is financial relationship information to disclose to the learners, a mechanism to resolve conflicts of interest could still be put in place.
Yes . Resolving conflicts of interest means individuals taking explicit actions prior to the educational activity to create CME content that is valid and free of commercial bias -- even in the presence of relevant financial relationships. In the construct of the current CME system, the development and presentation of CME content is most often the responsibility of teachers/authors. Therefore, the ACCME considers teachers/authors to be a part of the accredited provider.
No . "We read the content of each presentation, looking for commercial bias and content that is not supported by evidence" is a mechanism to identify commercial bias and invalid content but it does nothing to change the content so that the bias is gone and the content is valid. As described, it is a monitoring or screening process. If used before the activity it is a screening process -- and action needs to be taken to revise the content if commercial bias or invalid content are identified.
Commercial support is financial, or in-kind, contributions given by a commercial interest, which is used to pay all or part of the costs of a CME activity.
No. The commercial support must go first to the provider or a provider's joint provider or a provider's educational partner.
No. The provider must ensure that the content of the CME truly remains beyond the control of the commercial supporter. The process to develop the CME must be independent of the commercial interest. Providers must not allow commercial supporters to directly (SCS 1.1) or indirectly (SCS 3.2) control the content of CME.
There is no CME reason for commercial supporters to review and comment on CME content prior to its delivery to learners. An accredited provider would be out of compliance with SCS 1.1 and 3.2 if it were obligated to allow a content review by a commercial supporter as a condition of its contributing funds or services.
No. The Provider or its agents (e.g., staff, managers, educational partners or joint providers) must decide what commercial support will be accepted and how it will be spent or used.
You must not carry on with the activity under these circumstances. The person cannot participate if they refuse to disclose because conflicts of interest can neither be identified nor resolved.
Yes. Refusal to disclose is not limited to the explicit act of saying "no" to a provider's request for such information. Unresponsiveness that precludes the provider from implementing a mechanism to identify and resolve COI is equivalent to a refusal.
No. The ACCME expects providers to disqualify all individuals each time they refuse to provide information on their relevant financial relationships.
No. The provider cannot delegate the responsibility for resolving the conflict of interest to the person with the conflict of interest. However, an individual who controls CME content can be involved in the mechanism by being expected to take specific actions to resolve his/her conflict (ex: removing bias, using an evidence-based approach) under the supervision of the provider.
The ACCME expects that this is a rare event and expects that providers would have plans to manage this contingency as part of their institutional mechanisms for resolving conflicts of interest. Each provider is free to develop the strategy that best suits their circumstances.
Yes. Verbal disclosure to the provider is acceptable as long as the provider can verify for the ACCME at accreditation what information was collected for the conflict of interest identification and resolution processes.
Yes, with specific limits and expectations. Education on devices is a special-use case in accredited CME. Some equipment contains labeling requirements set by the Food and Drug Administration (FDA). These may include requirements for instruction prior to use. Employees of ACCME-defined commercial interests can demonstrate the operational aspects of the safe and proper use of a medical device within accredited CME activities.
YES. The provider always has the option to exclude some presentations or abstracts from their accredited program of CME or present this content in a track that is outside of but in conjunction with accredited CME. This option also preserves the free flow of information.
Yes. That documentation would verify that the first step of a mechanism for identifying conflicts of interest is in place. That would document for ACCME that the Provider knew the relevant financial relationships of the Committee members. However, keep in mind that the provider would need to be able to show that there was an assessment of whether or not the information disclosed caused a conflict of interest and if so, what was done to resolve the conflict.
No. It is not necessary to collect disclosure information on relevant financial relationships from a speaker, planner, or author each and every time that individual has control over the content of a CME activity. SCS Element 2.1 requires that the provider be able to show the ACCME that everyone who has control of CME content has disclosed all relevant financial relationships with any commercial interest to the provider.
Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria for promotional speakers’ bureau, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit.
The ACCME considers financial relationships to create actual conflicts of interest in CME when individuals have both a financial relationship with a commercial interest and the opportunity to affect the content of CME about the products or services of that commercial interest.
In accredited CME, when an individual's interests are aligned with those of a commercial interest, the interests of the provider are in "conflict" with the interests of the public. The interests of the people controlling CME must always be aligned with what is in the best interests of the public.
No. Compliance with SCS 2.1 requires that disclosure is made. Disclosing the same information repeatedly to the same Provider is not necessary. With the original disclosure information, the Provider is able to implement its mechanism to resolve any conflicts of interest.
An accredited provider is required to retain activity files/records during the current accreditation term or for the last twelve months, whichever is longer. For more information, see the ACCME's policy on records retention.
Joint providers are expected to routinely have a role in making decisions about the elements of the planning process specified in SCS 1.1. Since these decisions must be "made free of the control of a commercial interest" as per SCS 1.1, the joint provider cannot be a commercial interest. For further information on this topic, please click here to view the ACCME policy on joint providership.
As of August 2007 the ACCME defined a commercial interest as "any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients." The ACCME worked individually with accredited providers that were affected by this definition as they transitioned to an independent corporate structure that is acceptable in the context of the ACCME's Standards for Commercial Support.
No. There is no reason for the CME provider to request suggestions for speakers or topics from commercial interests, since it is unacceptable to act upon their suggestions. CME providers can receive commercial support from indu
There is no CME reason for commercial supporters to review and comment on CME content prior to its delivery to learners. CME providers can receive commercial support from industry. CME providers cannot receive guidance, either nuanced or direct, on the content of the activity or on who should deliver that content.
The ACCME offered several alternatives for corporate restructuring that met its requirements. For example, the ACCME determined that an accredited CME provider can have a sister corporation that is a commercial interest, as well as a parent corporation that is not a commercial interest, as long as each corporation is a separate legal entity and there are proper firewalls in place. The corporation that is the CME provider:
No. The accredited provider is required to record learner participation and be able to verify learner participation for six years from the date of the CME activity. See ACCME's policies on Attendance Records Retention.
For brochures, the ACCME does not have any rules or requirements for name placement, brochure content, cover design, interior layout, font size, or formatting. Brochure design and associated content are left to the provider's discretion. The accredited provider has the right to set criteria for its own standards in relation to its CME publications (both directly and jointly provided). The only ACCME requirement is that the correct accreditation statement be used somewhere within the brochure.
The following institutions are eligible to seek accreditation directly from the ACCME:
No. The ACCME accredits organizations that produce CME activities. The accreditation process includes the review of CME activities for the demonstration of compliance with the ACCME's requirements. For more information, see ACCME's description of the accreditation process for first-time applicants.
The process of seeking first-time, or "initial" accreditation from the ACCME generally takes twelve to eighteen months. The reaccreditation process for providers that are already ACCME-accredited takes approximately fifteen months. Refer to the For CME Providers section of our website to see a description of the process and the steps involved.
The ACCME provides detailed instructions for submitting a self-study report during the accreditation process in the ACCME's Guide to the Accreditation Process. The most recent version of this guide can be found here.
An accredited provider must have mechanisms in place to record and, when authorized by the participating physician, verify participation for six years from the date of the CME activity. For more information, see the ACCME's policy on records retention.
No. See ACCME's policy on joint providership for more information.
All CME activities developed and presented by an accredited provider, including those designated for credit, become part of that provider's program of CME . The program must be in compliance with all ACCME accreditation requirements. Therefore, all activities designated for, or awarded, credit will be subject to review by the ACCME accreditation process.
No, there is no requirement that the provider have a CME committee.
No. Nonphysicians can be faculty at a CME activity.
No, there are no special ACCME requirements for activities that ACCME-accredited providers hold overseas. All activities provided by ACCME-accredited providers must comply with ACCME's Accreditation Requirements, regardless of their location.
Yes. Non-US based organizations are encouraged to apply for accreditation.
This activity still needs to be available for review by the ACCME - even if it has been "retired." When an Internet CME activity is no longer available online, the accredited provider may submit the internet activity saved to CD ROM or provide access to the activity on an archived web site.
No. The ACCME has no requirements about issuing credit and/or certificates. All credit-related questions should be referred to the organization that manages the credit. For example, the American Medical Association manages AMA PRA Category 1 Credit™, and the American Academy of Family Physicians manages its own credit system.
No. The ACCME does not require post-tests for any type of CME activity. In journal CME, some sort of challenge must be presented to the learner that is based on the content of the educational activity but we do not call it a post test.
Yes, if educational material from a live activity is turned into an enduring material, the enduring material is considered a separate activity.
Yes. The new CME activity, must demonstrate compliance with all applicable ACCME accreditation requirements, including faculty disclosure and acknowledgement of any commercial support (SCS 6).
No. Typically these cards contain only initial, preliminary information like the activity date and location. If more specific information is included, such as faculty and objectives, the accreditation statement must be included.
The decision regarding how you acknowledge their involvement or what words to use is up to you. See the ACCME's policies regarding the accreditation statement for a copy of the accreditation statement.
The ACCME expects that providers will have policies or procedures in place to accommodate learners with disabilities. The ACCME's policy in this regard states, "The provider must operate the business and management policies and procedures of its CME program (as they relate to human resources, financial affairs and legal obligations), so that its obligations and commitments are met."
The ACCME has a multitiered accreditation process for evaluating CME providers’ compliance with the ACCME’s requirements. As an additional safeguard, the ACCME has a Process for Handling Complaints Regarding ACCME-Accredited Providers, which it uses to respond to complaints from the public and the CME community about ACCME-accredited providers’ compliance with accreditation requirements.
The ACCME will review the complaint to determine whether the complaint relates to the provider's compliance with the ACCME accreditation requirements, and then follow one of these courses of action:
No. The complaints process and findings are kept confidential by the ACCME, with the exception of the ACCME's response to a lawful subpoena or other legal process. The ACCME does reserve the right to make public blinded examples and summaries from the complaints process for the purpose of educating providers and other stakeholders. This public information will not identify providers.
No. The ACCME Process for Handling Complaints Regarding ACCME Accredited Providers requires that all complaints submitted "confirm the name, US Postal Service address and contact information of the person making the submission."
ACCME-accredited providers must provide CME that contains content which falls within the definition of CME. The content of such CME must not promote recommendations, treatment or manners of practicing medicine that are known to have risks or dangers that outweigh the benefits, or are known to be ineffective in the treatment of patients. Note that an organization whose program of CME is devoted to advocacy of unscientific modalities of diagnosis or therapy is not eligible to apply for ACCME accreditation.
No. ACCME accreditation is awarded to the organization that sought the accreditation and was able to demonstrate compliance with ACCME's Accreditation Requirements. See "Informing ACCME of Personnel or Organizational Changes" for more information.
Report any in-kind (non-monetary) commercial support received for an activity by indicating the nature of the in-kind support. You should not estimate the dollar value of in-kind support. The following are the options in PARS to describe the nature of in-kind support:
Yes, the accredited provider must report the full amount of commercial support received, even if the commercial support is distributed to other non-accredited joint providers.
The Program Summary is a summary of financial data attributable to your entire Program for the year. It includes the following data fields that the provider is required to manually complete:
1. Total advertising and exhibit income received in support of your Program
2. Total registration fees received (includes registration, subscription or publication fees received from activity participants)
If your organization is the accredited provider for a jointly provided activity, you are required to report the same financial data that you do for directly provided activities, even if the joint provider was the recipient of the funds.
Commercial Support for an activity is financial, or in-kind, contributions given by a commercial interest, which is used to pay all or part of the costs of an activity. The definition of roles and requirements when commercial support is received are outlined in the ACCME Standards for Commercial Support (SM).
Hours of instruction equals the total hours of educational instruction provided. For example, if a one-day course lasts eight (8) hours (not including breaks or meals), then total hours of instruction reported for that course is 8.
See the ACCME FAQs about regularly scheduled series, manuscript review and learning from teaching for additional specific examples regarding calculating hours of instruction for these types of activities.
A directly provided activity is one that is planned, implemented and evaluated by the accredited provider. Include co-provided activities (provided by two accredited providers) in this category if you are the accredited provider awarding the credit. In contrast, a jointly provided activity is one that is planned, implemented and evaluated by the accredited provider and a non-accredited entity.
Related link: ACCME's Policy on Joint Providership
Annually, the activity data that is reported by providers is aggregated and published as an Annual Report that provides information to the community. The “Reporting Year” indicates in which Annual Report the activity belongs. Most providers operate on a calendar year basis, and for these providers the Reporting Year is equivalent to the year of the Activity Date (For instance, Activity Date = September 1, 2016, and Reporting Year = 2016).
A course is identified as a regularly scheduled series (RSS) when it is planned to have
Below is a list of the different activity types that can be reported in PARS. You can click on the name of any of these activity types for a definition and additional information:
If your organization assigns an internal code or identifier to each of its activities, you may enter it into this field.
There is no specific "co-provided" accreditation statement. If two or more accredited providers are working in collaboration on a CME activity, one provider must take responsibility for the compliance of that activity, and therefore, use the directly provided accreditation statement with its name. See the ACCME's Accreditation Statement Policy for a copy of the directly provided accreditation statement.
An important concept in PARS is that of “open” and “closed” activities. Open activities are those that have a minimum set of data entered for them: specifically, activity name, activity type, activity date, and, if applicable, location. Once these data about an activity are entered, the activity is “open”, and is saved to the database.
If you provide the same activity in multiple locations (e.g., update course) or provide the same activity year after year (e.g., annual meeting), you can save time entering data about these activities by using the copy function in PARS. The copy function allows providers to select an existing activity and create a new activity that contains the same data for the following fields:
Activities that are offered over the course of multiple reporting years - such as Enduring Materials - should be reported in PARS for each year in which they are active, regardless of whether they are active for the entire year or just a part of it.
When you report Learning from Teaching in PARS, aggregate your data for Learning from Teaching for all learners into one activity. For hours of instruction, specify the amount of time you believe a learner would take to complete their Learning from Teaching activity. The number of participants should equal the number of individuals who participated in this activity.
When you report Internet Searching and Learning in PARS, aggregate and report all your data for Internet Searching and Learning for all learners into one activity. For hours of instruction, specify the amount of time you believe a learner would take to complete their Internet Searching and Learning activity. The number of participants should equal to the total number of persons who participated in Internet Searching and Learning as an activity.
When you report Performance Improvement in PARS, count each learning project as one Performance Improvement activity, regardless of whether or not it is created for an individual learner, or group of learners. For hours of instruction, specify the amount of time you believe a learner would take to complete the Performance Improvement activity. The number of participants should equal the total number of learners who participated in the learning project.
When you report Manuscript Review in PARS, report each journal for which the manuscript is being reviewed as an activity regardless of how many manuscripts there are and regardless of how many persons have reviewed manuscripts. For hours of instruction, specify the amount of time you believe a learner would take to complete the Manuscript Review activity. The number of participants should reflect the total number of learners engaged in reviewing manuscripts .
When you report Journal-Based activities in PARS, report each article as one activity. For hours of instruction, specify the amount of time required to complete the activity. The number of participants should equal the total number of individuals who completed the activity.
There are three (3) components of your organization’s year-end reporting:
If you need to delete more than one activity at a time from PARS, you may do so by visiting the View Activities screen and selecting the applicable Reporting Year. Expand the list of either closed and/or open activities, and click the Select for Deletion checkbox next to each activity that you want to delete. When you have selected the activities you want to delete from both the open and closed lists, click the Delete Selected Activities button that appears above the list of activities.