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.
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.
In order to ensure that accredited CME activities meet the ABP’s requirements for MOC credit, audits may be performed by the ACCME and/or by the ABP at any time. As a requirement of participating in the ABP CME Provider Program, accredited providers agree to participate in an audit of their activity(ies), and if selected, to allow the ACCME to share the results of the audit with the ABP. The ABP will review activities entered into PARS by the provider to ensure that accurate and appropriate data is submitted by the provider.
You will start reporting activities that are available as of Nov. 1, 2016 through the PARS system and any diplomate participation information associated with those activities. If you are a registered provider with the ABA, you will report activities and diplomate participation information that was completed prior to Nov. 1, 2016 directly to the ABA. Any questions for the ABA can be sent to cme@theABA.org.
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.
ACCME publishes information about accredited CME activities that have been registered for MOC via its CME Finder website (www.cmefinder.org). CME Finder is a publicly available on-line search tool that provides a one-stop resource for physicians seeking to earn Maintenance of Certification (MOC) points by participating in accredited CME. The following information is published about each CME activity registered for ABIM MOC that is currently available, or will be available in the future:
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.
As a service to accredited providers and the American Board of Internal Medicine (ABIM) and the American Board of Pediatrics (ABP), the ACCME will conduct audits on the activities registered for the ABIM and ABP Maintenance of Certification (MOC) programs in the Program and Activity Reporting System (PARS). The activities will be selected using a specific method approved by the ABIM. Providers will be asked to submit information that demonstrates compliance with the ABIM and ABP Program Requirements.
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.
Providers will receive a warning for the first violation and will not be permitted to submit participant completion information for an activity that fails the audit. The ABP will not revoke MOC points or patient safety credit that has already been issued to physicians who participated in an activity that fails the audit. Future noncompliance with ABP's policies and requirements may result in a change in the provider’s ability to offer ABP MOC credit.
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 relies on the ACCME’s standards and processes for evaluating providers’ compliance with these standards as assurance that the CME activities registered for ABA’s MOCA program are high quality, unbiased educational activities that contain valid content and are relevant to the learners’ needs. Patient Safety activities are subject to audit by the ABA.
The ABA will verify that the participant’s ABA ID is valid.
CME providers that have previously worked with a specialty board to have their CME activity(ies) approved, should contact that specialty board to determine the preferred method for reporting learner data. For those providers that have web services data transfer already established with the specialty board, that data transfer mechanism can continue until the specialty board requests that it be moved into PARS.
There are three options available to you for registering an activity for MOC in PARS.
No, there is no fee at this time to register CME activities for ABA, ABIM, or ABP MOC programs.
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.
"Population health” refers to the health of a population as measured by health status indicators and as influenced by factors such as the social, economic and physical environments, personal health practices, individual capacity and coping skills, and health services (Dunn and Hayes's, 1999). Population health issues are the specific illnesses or health problems prevalent within a specific community or group of individuals.
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:
Yes. To achieve Accreditation with Commendation using the menu of new criteria, CME providers will 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. The Menu of New Criteria for Accreditation with Commendation includes 16 criteria divided into five categories (i.e. Promotes Team-based Education, Addresses Public Health Priorities, Enhances Skills, Demonstrates Educational Leadership, Achieves Outcomes).
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™.
CME Providers: No. There are no new requirements for reporting REMS-compliant activities in PARS. With the introduction of CME Finder, ACCME gives you the option to have your REMS-compliant activities appear in search results for physicians and other healthcare professionals who are seeking REMS-compliant educational activities that meet their needs. If you would like your REMS-compliant CME activity to appear in CME Finder, complete the “CME Finder” fields when you enter your activity into PARS.
There are a number of ways you can get help using CME Finder. Within CME Finder, you can click on the “Help/FAQs” link at the top of each page to link to frequently asked questions on the ACCME website.
You can also use the question mark icons that are found on each CME Finder page. If you place your mouse over the question mark next to a particular item, you will either see a tip appear, or, your mouse cursor will change from an arrow into a pointing hand, indicating that you can click on this item to open a window displaying more information.
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 a CME activity with limited registration, please contact the accredited provider directly.
Currently, only activities that are also registered for American Board of Internal Medicine’s Maintenance of Certification program (ABIM 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 the American Board of Internal Medicine's (ABIM's) Medical Knowledge Assessment Recognition Program. Activities are searchable by provider name, date, location, subspecialty, and MOC points and/or CME credits available.
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 MOC audit is not part of the reaccreditation process. 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.
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.
No. Individual participant data is collected and shared exclusively with the specialty board with which that activity has been registered for the purpose of reporting MOC points/credits for board-certified diplomates. ACCME will not share individual participant data with any other organizations.
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 table below illustrates which activity types are eligible for the specialty board’s that rely on PARS for MOC activity registration and diplomate completion reporting for their MOC program:
See FAQ’s for individual boards regarding board-specific instructions on activity reporting.
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.
Any CME provider accredited by the ACCME, by a Recognized State Accreditor, or by Joint Accreditation for Interprofessional Continuing Education can register CME activities for the American Board of Anesthesiology (ABA), American Board of Internal Medicine (ABIM), and/or American Board of Pediatrics (ABP) Maintenance of Certification (MOC) programs in PARS by attesting that those activities meet the requirements of those programs.
As a service to accredited providers and the American Board of Internal Medicine (ABIM), the ACCME conducts audits on the activities registered for ABIM Maintenance of Certification (MOC) program in the Program and Activity Reporting System (PARS).
Yes. If you save an activity using the “Save and quit” button in the activity record in PARS before completing all the required information to register an activity for Maintenance of Certification (MOC), you will see a message that notifies you that there are missing MOC requirements and gives you the option to go back to the activity or save and finish later. As with entering data for any activity in PARS, you must use the Save buttons provided in PARS to retain the information entered; closing your web browser without saving will not retain your data.
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).
No. CME providers in the ACCME System have the option but are not required to offer accredited CME that meets the ABIM, ABA and/or ABP program requirements.
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 CME 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 ACCME's Program and Activity Reporting System (PARS). This ensures that their RPC-supported CME 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 q
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.
Effective February 2014, no organization will be evaluated for compliance for ACCME requirements or policies that were removed as a result of the ACCME’s 2014 simplification of its accreditation requirements and processes. This applies to organizations regardless of what stage of the accreditation process they are in. Specific scenarios are summarized below:
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.
A summary, explanation, and supporting documents describing the simplifications that ACCME made in February 2014 to its accreditation requirements and processes can be found on the ACCME Web site here.
This question will produce information that supports Accreditation Criterion 6, which says that the provider develops activities in the context of desirable physician attributes. The ACCME added this data element in response to requests from stakeholders including the American Board of Medical Specialties (ABMS).
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 the Campbell Alliance, Ltd. to manage the commercial support. So, in this complicated case, for simplicity, the ACCME is allowing providers to specify the “RPC/Campbell Alliance, 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. ACCME will report this data, in aggregate, to the stakeholder community.
In order to provide an equitable process for all accredited CME providers within the ACCME system, the ACCME is assessing a per activity fee from accredited CME providers that receive commercial support from the REMS Program Companies (RPC) to develop ER/LA Opioid Analgesic REMS-compliant CE activities; this fee will enable ACCME to develop, implement, and maintain the systems required to support the data collection, reporting, and auditing process stipulated by the FDA. As of January 1, 2015, the per activity service fee is $500.
No. The ACCME does not require accredited providers to offer REMS-compliant or REMS-related CE activities. There are no new or special accreditation requirements for accredited providers within the ACCME system that provide REMS activities. The REMS CE reporting requirements are mandated by the Food and Drug Administration (FDA) and the REMS Program Companies (RPC); they are not ACCME requirements.
Yes. You can download a report of the REMS-specific data associated with your REMS activities, by clicking on the Activities tab, and then clicking on Download REMS Activities from the left-hand navigation menu. Note that this report will only appear if you have entered a REMS activity.
At the bottom of the Add an Activity screen, you will see a section called Food and Drug Administration (FDA) Risk Evaluation and Mitigation Strategy (REMS). Follow the instructions to enter data about REMS-compliant and REMS-related activities.
Providers accredited by the ACCME or an ACCME Recognized Accreditor can participate in the data collection process by entering REMS data in the REMS section of the web-based interface in PARS for each REMS activity they provide.
The ACCME has modified PARS to accept the data mandated by the FDA, including how many REMS CME activity participants prescribed ER/LA opioids within the last year, and a breakdown of these individuals by profession. Accredited CME providers may also submit information on the number of participants that were registered with the DEA to prescribe Schedule 2 and 3 drugs, as well as participants by practice type (primary care, pain specialist, non-pain specialist).
As a service to the CME community and to the FDA, the ACCME has agreed to contribute to fulfilling the data collection and auditing requirements for the ER/LA Opioid Analgesics REMS. The ACCME has modified its Program and Activity Reporting System (PARS) to enable accredited providers to submit information about REMS CME activities and has a process for generating reports containing data about those activities.
The FDA has mandated that the REMS Program Companies (RPC) report to the FDA on the progress of implementing the ER/LA Opioid Analgesic REMS and that there be an independent audit of REMS-compliant accredited CE activities to confirm that the education has met the FDA requirements. The FDA has agreed that accrediting bodies can serve as the independent auditors.
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 in PARS on the “Organization Profile” tab in PARS. Contact information for individual users may be edited on the “User Management” tab.
ACCME recognizes all individuals that are associated with your organization in the ACCME’s Program and Activity Reporting System (“PARS”) as authorized representatives who may ask questions and receive information related to your organization’s ACCME accreditation. This includes users that are assigned to the role(s) of Primary Contact, Billing Contact, and Chief Executive Officer, as well as those listed as “Other Users” in PARS.
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, the ACCME collects, summarizes, and publishes information about the CME enterprise on its website as a service to accredited providers, other members of the CME community, and the public via the ACCME’s 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 CME Program.
You are required to complete the following fields regarding commercial support at the individual CME 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 ACCME 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 physician 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 a CME activity that involves a physician 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 CME.
Test Item Writing CME 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 a CME 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 CME is based on a learner’s participation in the pre-publication review process of a manuscript.
A journal-based CME 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 physician participant 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 CME 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)
A course is a live CME 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 CME activity. (The identification of activity types by the ACCME serves to allow the ACCME to report data and information on the range of educational formats offered by the national CME enterprise. This helps provide an accurate description of the CME enterprise and dispels the myth that accredited CME is mostly lecture, or didactic, in format.) The ACCME does not have special requirements for this activity type.
The ACCME requires accredited providers 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.
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.
The ACCME delivers a "CME as a Bridge to Quality" Accreditation Workshop two to three times each year to provide training and support regarding the expectations of the ACCME Accreditation Criteria. To see dates for upcoming workshops or to register, please visit this page.
In addition, the ACCME also provides educational resources and tools via the Education section of the ACCME website.
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."
Yes, evaluation of learners' change in competence, performance or patient outcomes is required.
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.
Through self-assessment or self-audit, the physicians in an ACCME accredited group practice might identify the following professional practice gap:
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.
This allows the learners to distinguish between missing disclosure information and the circumstances where there is nothing to disclose.
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).
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.
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.
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.
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.
What follows is an example of how several tactics can be tied together by the Provider into a mechanism to resolve conflicts of interest that could demonstrate the Provider's compliance with the ACCME requirements, and preserve participation of experts with financial relationships.
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.
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.
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.
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. Please keep in mind that these are only suggested mechanisms. Each provider will want to design and adopt a mechanism that works best for its structure and type of activities. The intent of the Updated Standards is that any content about products is aligned with the best interest of the physician learners and their patients.
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, 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. 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.
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 , 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.
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.
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. 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.
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. 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.
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.
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 longer than three years. The ACCME policy on enduring materials requires both an original release date and an expiration date. In addition, the ACCME policy requires that you review each enduring material at least once every three years or more frequently if indicated by new scientific developments.
Yes. The ACCME publishes a library of Examples of Compliance and Noncompliance gathered during the course of the accreditation review process. Additionally, the Education section of the ACCME website provides a number of multimedia vignettes in which ACCME staff, accredited providers, and system stakeholders discuss practical issues regarding the implementation of the ACCME Criteria and policies. Lastly, the ACCME offers a number of educational workshops focused on training that is informed by provider best-practices.
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.
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.
Yes. Non-US based organizations are encouraged to apply for accreditation.
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).
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.
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."
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 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. 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.
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.
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
“Description of Content” is an optional field for a description of the information and topics that were discussed during the CME activity. There is no specified format for this field, although it is limited to 2500 characters. If your organization produced an abstract for the activity, we encourage you to copy and paste it into the Content field. If you did not produce an abstract, you may include the written objectives of the activity, or simply describe the content in your own words. In the future, this information may
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.
Physician participants are activity participants who are MDs or DOs. Through the 2014 reporting year, residents are not included in this category, but are included under nonphysician participants. Effective with the 2015 reporting year, residents are included as physician participants.
Nonphysicians are called “other learners.” This category includes activity participants other than MDs and DOs. Beginning with the 2015 reporting year, residents are no longer included in this category and are instead counted as physician participants. The terminology change has been made in response to feedback from the CME community that “other learners” is a more appropriate term for describing the range of learners.
Annually, ACCME aggregates the activity data that is reported by providers and publishes an Annual Report that provides information to the CME community about the size and scope of the CME enterprise. The “Reporting Year” tells ACCME 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).
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.
Commercial Support for a CME activity 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. The definition of roles and requirements when commercial support is received are outlined in the ACCME Standards for Commercial Support (SM).
A course is identified as a regularly scheduled series (RSS) when it is planned to have
Below is a list of the different CME activity types that can be reported in the PARS System. You can click on the name of any of these activity types for a definition and additional information:
Yes. PARS replaces the Excel spreadsheets ACCME used to collect activity data during the reaccreditation process, as well as the online Annual Reporting System that ACCME accredited providers used to submit their ACCME Annual Reports. PARS streamlines these two data reporting mechanisms into one central location.
Providers may determine when and with how much frequency to enter their activity data. ACCME encourages providers to begin inputting data as soon as possible. You can enter basic information about an activity before it has taken place and complete the entry after the activity occurs. You must enter all of your organization's program and activity data for a completed Reporting Year and complete the Attestation by the last business day of the following March to allow for the calculation of the ACCME
Yes. Providers have the ability to download a file that contains all of their activity data by clicking on the "Download All Activities" link on the Activities tab in PARS. By clicking on this link, the data that your organization has reported will be downloaded into a .csv file, which you can then save as a .xls or other spreadsheet file format for easy reference and analysis.
Providers also have two options for uploading data in batches (you can click on the link below to learn more about each of these options):
The tab-delimited batch upload enables providers to export multiple activity records at one time into PARS. The tab-delimited batch upload process originates with the use of an MS Excel template which closely mirrors the CME Activity List used previously by ACCME accredited providers to report activities for reaccreditation purposes.
XML File Export: XML stands for eXtensible Markup Language, a Web standard that makes it easier for computer systems to exchange data over the Internet. In order to collect information in a manner that is consistent with the data communications standards being adopted by medical education content providers, PARS includes a data upload tool that accepts XML files formatted to conform with the Medical Education Metrics (MEMS) XML standard created by Medbiquitous. Providers that have CME activity tracking systems that support exports to XML files may wish to explore this op
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.
By default, the Activities page of PARS displays “open” activities that occur during the current Reporting Year. If you enter all required activity information, but no longer see the activity listed in the default view, first make sure that the “Reporting Year” is set to the appropriate year for the activity, and then click on the “closed” tab on the Activities page. Activities that contain all required information are considered “closed.”
The Program Summary is a summary of financial data attributable to your entire CME Program for the year. For Reporting Years up to and including 2014, the Program Summary reflects two kinds of data:
If your organization is the accredited provider for a jointly provided activity, ACCME requires you to report the same financial data that you do for directly provided activities, even if the joint provider was the recipient of the funds.
When you report Performance Improvement CME in PARS, count each learning project as one Performance Improvement CME activity, regardless of whether or not it is created for an individual physician, or group of physicians. For hours of instruction, specify the amount of time you believe a learner would take to complete the Performance Improvement CME activity. The number of participants should equal the total number of learners who participated in the learning project.
When you report Internet Searching and Learning CME in PARS, aggregate and report all your data for Internet Searching and Learning CME 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 CME activity. The number of participants should equal to the total number of persons who participated in Internet Searching and Learning as a CME activity.
When you report Learning from Teaching CME in PARS, aggregate your data for Learning from Teaching CME 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 CME activity. The number of participants should equal the number of individuals who participated in this CME activity.
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.
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:
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.
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.
When you report Manuscript Review CME 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 as CME. For hours of instruction, specify the amount of time you believe a learner would take to complete the Manuscript Review CME activity. The number of participants should reflect the total number of learners engaged in reviewing manuscripts as CME.
When you report Journal-Based CME 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.
When an organization first applies for ACCME accreditation, it self-selects its organization type. ACCME uses this information for reporting and analysis purposes. Providers may not change their organization type unless the nature of their organization has changed significantly. If you would like ACCME to change your organization type, please contact us with an explanation of the reason for the request.
If your organization assigns an internal code or identifier to each of its CME activities, you may enter it into this field.
PARS data will not be accessible to the public. Accredited providers will have secure logins and their information will only be shared in accordance with ACCME's Information and Confidentiality Policies.
There are three (3) components of your organization’s year-end reporting to the ACCME:
The primary purpose of PARS is to provide a centralized system for the ACCME’s collection and management of activity and program data from its accredited CME providers. PARS will help the ACCME and providers demonstrate the size, scope and value of the CME enterprise.