Accreditation Council for CME Announces Simplification of Accreditation Requirements and Process

ACCME streamlines and improves the continuing medical education accreditation system
Chicago, IL
February 25, 2014

The Accreditation Council for Continuing Medical Education (ACCME®) is pleased to announce that the Board of Directors has adopted changes to simplify the accreditation requirements and process. The purpose of the changes is to streamline the accreditation system while maintaining high standards and continuing to support continuing medical education (CME) as a strategic asset to healthcare improvement initiatives.

The changes include:

  • Simplifying and removing some of the Accreditation Criteria and policy requirements
  • Changing terminology from “joint sponsorship” to “joint providership”
  • Offering providers an abstract as an ACCME-approved tool to use when verifying performance-in-practice
  • Simplifying the process for organizations applying for initial accreditation

These changes are designed to remove redundancies while maintaining the continuous improvement model and the high standards that are essential for designing and implementing independent, effective, and relevant CME. The number of criteria required for accreditation is reduced from 15 to 12, one policy is eliminated, and five policies are modified. The changes will simplify the process for accredited providers and offer greater flexibility, while retaining the Plan-Do-Study-Act cycle which is integral to the ACCME’s expectations.

These changes apply to all CME providers within the ACCME accreditation system, including providers directly accredited by the ACCME and those accredited by ACCME Recognized Accreditors (state or territory medical societies that are recognized by the ACCME as accreditors of intrastate CME providers).

A list of the specific changes is attached to this news release. The ACCME has updated the Accreditation Requirements and Descriptions PDF to reflect these changes; please use this PDF as your reference for the current requirements. We are in the process of updating the ACCME Web site and other accreditation materials to incorporate these changes.

Implementation of Changes

The changes are effective immediately.

  • Elimination of requirements: Accredited providers will no longer be evaluated for compliance with the requirements that have been eliminated.
  • Change in terminology: We do not expect accredited providers to change or reprint any materials that currently exist. We expect accredited providers to use the term “joint providership” for new materials published after January 1, 2015. Please note that this change in terminology applies to accreditation statements for jointly provided activities as well as other materials.
  • Accreditation process: Providers will have the option of using an abstract to verify performance-in-practice or to continue using labels. We are in the process of producing the abstract.
  • Initial applicants: Organizations applying for Provisional Accreditation will no longer be required to have an on-site survey. Surveys are still required; conference calls are the standard interview format the ACCME currently uses. Initial applicants and accreditors continue to have the option of using other survey formats including televideo and face-to-face, if circumstances warrant it.

Accredited Providers: What This Means for You

Regardless of where you are in the accreditation process, you will no longer be evaluated for compliance with any requirements that have been eliminated.

  • If you are in the March 2014 decision cohort, you were not reviewed for compliance with the requirements that have been eliminated and your decisions will not reflect those requirements. For progress reports that had a noncompliance finding in one of the eliminated requirements, we are providing feedback about your effectiveness in meeting those requirements, in support of your continuous improvement and in recognition of the work you did in the progress report process.
  • If you have already submitted materials for reaccreditation, you do not need to resubmit or change those materials. The ACCME will ensure that you will not be reviewed for any requirements that have been eliminated.
  • If you are preparing for reaccreditation, do not change any of the materials you have already prepared or are in the process of preparing. The ACCME will ensure that you will not be reviewed for any requirements that have been eliminated.
  • If you are in a future accreditation cohort, you will not need to submit materials related to compliance for the requirements that have been eliminated.

For more information, please see this Ask ACCME Q&A.

Intrastate providers: Please note that these changes apply to all providers within the ACCME accreditation system. Recognized Accreditors are responsible for implementing these changes for intrastate providers. Please check with your accreditor about the implementation process.

Join Our Webinar to Learn More

The ACCME will hold a free webinar on March 11, from 1-2:30 PM CT, to discuss the changes and answer questions. This webinar is open to all stakeholders; however enrollment is limited. For more information about the webinar, including connection instructions, please visit the Event Page on our Web site. The webinar will be recorded and published on the ACCME Web site.

Future Discussion

The set of changes that has been adopted does not include the following proposals that have been under discussion:

  • Commercial interest logos: The ACCME Board of Directors decided to defer adoption, pending further discussion, of changes to the Standards for Commercial Support to prohibit the use of commercial interest logos in the acknowledgment of commercial support.
  • Accreditation with Commendation: The ACCME is in the process of developing a menu of potential new commendation criteria and will share those ideas with the stakeholder community at a later time. The ACCME decided to separate the simplification proposal from the Accreditation with Commendation proposal in order to expedite the simplification process, in response to stakeholders’ requests.

Listening to Stakeholders

The changes are based on the ACCME Board of Directors’ strategic planning, the ACCME’s experience evaluating providers under the 2006 Accreditation Criteria and analysis of accreditation data, and feedback from stakeholders.

The changes reflect the ACCME’s ongoing process of engagement with the CME and stakeholder community. In making its decision, the ACCME reviewed the feedback of more than 700 respondents: there were 245 respondents to the call for public comment issued in December 2013; and there were 458 respondents to the informal online survey that the ACCME conducted prior to the call for comment, in the spring of 2013, to gather feedback about the simplification proposal.

In addition, during the last few years, the ACCME convened more than 20 focused discussions with more than 1,000 participants to discuss how to simplify and evolve the accreditation requirements and process.

Building on Success

The simplification changes build on the success of accredited CME providers in achieving the ACCME’s expectations under the current accreditation requirements. These requirements have been in place since 2006 with no substantive changes. From November 2008 through December 2013, the ACCME has made 894 decisions for providers seeking accreditation or reaccreditation. The proportion of providers achieving Accreditation with Commendation has increased and the proportion of providers receiving Accreditation with a progress report has dropped.

When the ACCME released the 2006 Accreditation Criteria, its goal was to position CME as a strategic asset to US health care quality improvement efforts. Accreditation data shows that providers are facilitating practice-based education that supports healthcare professionals’ commitment to lifelong learning. Accredited CME providers are partnering with quality initiatives within their institutions, health systems, and communities. Accredited providers have successfully demonstrated that CME is a Bridge to Quality™.

Leadership Comments

“The ACCME and its stakeholders believe that it is important to simplify the accreditation requirements and process while maintaining high standards. These changes demonstrate the commitment of the ACCME to listening to stakeholders and to responding to the evolving healthcare environment. The changes build upon the success of accredited providers in meeting ACCME expectations and are part of the ACCME’s ongoing process of continuous improvement,” said Carlyle H. Chan, MD, Chair, Board of Directors, ACCME.

“Accredited CME exists within a wider system, with multiple, overlapping levels of regulations and requirements. Our purpose in adopting these changes is to clarify the ACCME’s part of the system and facilitate the evolution of accredited CME. We look forward to our continued engagement with stakeholders about shaping the future of our CME system,” said Murray Kopelow, MD, President and CEO, ACCME.

“The state medical society CME system has been engaged throughout the process of simplifying and evolving the accreditation requirements and process. These changes will make an immediate difference to accredited providers, offering them greater flexibility and simplifying the process. At the same time, our national accreditation system maintains a comprehensive, rigorous process for producing accredited CME that supports healthcare improvement for patients and their communities,” said Sandy Deeba, CME Manager, Oklahoma State Medical Association (OSMA). OSMA is an ACCME Recognized Accreditor. (Recognized Accreditors are state or territory medical societies that accredit intrastate organizations offering CME. All CME providers within the ACCME accreditation system follow the same requirements).

Resources

Simplification Webinar

ACCME Simplification and Evolution Web page

Accreditation Requirements and Descriptions

Ask ACCME Q&A

Call for Comment Summary and Responses—Simplifying the Accreditation Requirements and Process: This PDF includes the summary and analysis of the responses, the ACCME Board of Directors decision, the full text of the responses, and the call for comment survey.

Media inquiries
Tamar Hosansky
312-245-4066
thosansky@accme.org

Other inquiries
info@accme.org

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The Accreditation Council for Continuing Medical Education (ACCME®) is a nonprofit organization based in Chicago that is responsible for accrediting US institutions that offer continuing medical education through a voluntary, self-regulatory system. The ACCME also has a system for recognizing state medical societies as accreditors for local organizations offering CME.

The ACCME's mission is to identify, develop, and promote standards for quality continuing medical education that improves healthcare for patients and their communities. There are approximately 2,000 accredited CME providers in the United States, whose activities educate more than 24 million healthcare practitioner participants annually.

The ACCME's member organizations, which represent the profession of medicine and include physician licensing and credentialing bodies, are the American Board of Medical Specialties, the American Hospital Association, the American Medical Association, the Association of American Medical Colleges, the Association for Hospital Medical Education, the Council of Medical Specialty Societies and the Federation of State Medical Boards of the US, Inc.

For more information, visit www.accme.org.

 

CHANGES to ACCME REQUIREMENTS AND PROCESS

The ACCME has updated the Accreditation Requirements and Descriptions PDF to reflect these changes; please use this PDF as your reference for the current requirements.

Accreditation Criteria

The purpose of the changes to the Accreditation Criteria is to remove redundancies and streamline the Criteria while maintaining the continuous improvement model and the high standards that are essential for designing and implementing independent, effective, and relevant CME. These changes reduce the number of criteria required for accreditation from 15 to 12. They will simplify the process for accredited providers, while retaining the Plan-Do-Study-Act cycle, which is integral to the ACCME’s expectations.

1.       Edit Criterion 1: Mission Statement

FROM

The provider has a CME mission statement that includes all of the basic components (CME purpose, content areas, target audience, type of activities, expected results) with expected results articulated in terms of changes in competence, performance, or patient outcomes that will be the result of the program.

TO

The provider has a CME mission statement that includes ‘expected results’ articulated in terms of changes in competence, performance, or patient outcomes that will be the result of the program.

2.       Eliminate Criterion 4: The provider generates activities/educational interventions around content that matches the learners’ current or potential scope of professional activities.

3.       Eliminate Criterion 14:  The provider demonstrates that identified program changes or improvements, that are required to improve on the provider's ability to meet the CME mission, are underway or completed.

4.      Eliminate Criterion 15 The provider demonstrates that the impacts of program improvements, that are required to improve on the provider's ability to meet the CME mission, are measured.

Policies
These changes remove requirements that predate the current accreditation criteria and are no longer necessary due to the evolution of CME and technology.

5.       Eliminate Organizational Mission and Framework: The accredited provider must have an organizational framework for the CME unit that provides the necessary resources to support its mission including support by the parent organization, if a parent organization exists.

6.       Eliminate some special requirements for enduring materials

Because there is no direct interaction between the provider and/or faculty and the learner, the provider must communicate the following information to participants so that they are aware of this in-formation prior to starting the educational activity

1. Principal faculty and their credentials;

2. Medium or combination of media used;

3. Method of physician participation in the learning process;

4. Estimated time to complete the educational activity (same as number of designated credit hours);

5. Dates of original release and most recent review or update; and

6. Termination date (date after which enduring material is no longer certified for credit).

Providers that produce enduring materials must review each enduring material at least once every three years or more frequently if indicated by new scientific developments. So, while providers can review and re-release an enduring material every three years (or more frequently), the enduring material cannot be offered as an accredited activity for more than three years without some review on the part of the provider to ensure that the content is still up-to-date and accurate. That review date must be included on the enduring material, along with the original release date and a termination date.

Sometimes providers will create an enduring material from a live CME activity. When this occurs, ACCME considers the provider to have created two separate activities – one live activity and one enduring material activity. Both activities must comply with all ACCME requirements, and the enduring material activity must comply additionally with all ACCME policies that relate specifically to enduring materials.

7.       Eliminate some special requirements for Internet CME (retaining 3 that support the Standards for Commercial Support)

There are special requirements for Internet CME because of the nature of the activities:

  Activity Location: ACCME-accredited providers may not place their CME activities on a Web site owned or controlled by a commercial interest.

Links to Product Web sites: With clear notification that the learner is leaving the educational Web site, links from the Web site of an ACCME accredited provider to pharmaceutical and device manufacturers’ product Web sites are permitted before or after the educational content of a CME activity, but shall not be embedded in the educational content of a CME activity.

Transmission of information: For CME activities in which the learner participates electronically (e.g., via Internet, CD-ROM, satellite broadcasts), all required ACCME information must be communicated to the learner prior to the learner beginning the CME activity.

Advertising: Advertising of any type is prohibited within the educational content of CME activities on the Internet including, but not limited to, banner ads, subliminal ads, and pop-up window ads. For computer based CME activities, advertisements and promotional materials may not be visible on the screen at the same time as the CME content and not interleafed between computer windows or screens of the CME content.

Hardware/Software Requirements: The accredited provider must indicate, at the start of each Inter-net CME activity, the hardware and software required for the learner to participate.

Provider Contact Information: The accredited provider must have a mechanism in place for the learner to be able to contact the provider if there are questions about the Internet CME activity.

Policy on Privacy and Confidentiality: The accredited provider must have, adhere to, and inform the learner about its policy on privacy and confidentiality that relates to the CME activities it provides on the Internet.

Copyright: The accredited provider must be able to document that it owns the copyright for, or has received permissions for use of, or is otherwise permitted to use copyrighted materials within a CME activity on the Internet.

8.       Eliminate some special requirements for journal-based CME

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.

The ACCME considers information required to be communicated before an activity (e.g., disclosure information, disclosure of commercial support, objectives), CME content (e.g., articles, lectures, handouts, and slide copies), content-specific post-tests, and education evaluation all to be elements of a journal-based CME activity.

The educational content of journal CME must be within the ACCME's Definition of CME. ACCME Accreditation Requirements

Journal CME activities must comply with all ACCME accreditation requirements. Because of the nature of the activity, there are two additional requirements that journal CME must meet:

The ACCME does not consider a journal-based CME activity to have been completed until the learner documents participation in that activity to the provider.

None of the elements of journal-based CME can contain any advertising or product group messages of commercial interests. Disclosure information cannot contain trade names. The learner must not encounter advertising within the pages of the article or within the pages of the related questions or evaluation materials.

9.       Eliminate some special requirements for Regularly Scheduled Series (RSS)

The ACCME defines a regularly scheduled series (RSS) as a course that is planned as a series with multiple, ongoing sessions, e.g., offered weekly, monthly, or quarterly; and is primarily planned by and presented to the accredited organization’s professional staff. Examples include grand rounds, tumor boards, and morbidity and mortality conferences. ACCME-accredited providers that offer regularly scheduled series must describe and verify that they have a system in place monitor these activities’ compliance with ACCME accreditation requirements. The monitoring system must:

1. Be based on real performance data and information derived from the RSS’s that describes compliance (in support of Accreditation Criteria 2-11), and

2. Result in improvements when called for by this compliance data (in support of ACCME Criteria 12-15), and

3. Ensure that appropriate ACCME Letters of Agreement are in place whenever funds are contributed in support of CME (in support of the ACCME Standards for Commercial Support: Standards to Ensure Independence in CME Activities).

Also, the provider is required to make available and accessible to the learners a system through which data and information on a learner’s participation can be recorded and retrieved. The critical data and information elements include: learner identifier, name/topic of activity, date of activity, hours of credit designated or actually claimed. The ACCME limits the provider’s responsibility in this regard to “access, availability and retrieval.” Learners are free to choose not to use this available and accessible system.

10.   Edit “joint sponsorship” to “joint providership” throughout the requirements, including in the accreditation statement, as shown in the examples below. The purpose of the change is to support consistency within our own terminology and with the terminology used by other accreditors.

Accreditation Statement for Jointly Provided Activities

“This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of (name of accredited provider) and (name of nonaccredited provider). The (name of accredited provider) is accredited by the ACCME to provide continuing medical education for physicians.”

Joint Providership Policy

“The ACCME defines joint providership as the providership of a CME activity by one accredited and one nonaccredited organization Please note: the ACCME does not intend to imply that a joint providership relationship is an actual legal partnership. Therefore, the ACCME does not include the words partnership or partners in its definition of joint providership. One accredited provider must take responsibility for a CME activity when it is presented in cooperation with other accredited providers or with a nonaccredited organization and must use the appropriate accreditation statement. “

Accreditation Process
These changes are designed to simplify the process and increase flexibility.

11.   Add a Performance-In-Practice Structured Abstract as a tool for documentation review.

12.   Eliminate the requirement for on-site interviews for initial applicants.