In many ways, the ACCME manifests its role as a deliberative body that sets standards and implements systems to ensure those standards are being met, and that this deliberative process, in every aspect, uses input from the CME community in order to guide the decision-making of the ACCME.
Two examples of this are our Rule Making Process and our Complaints and Inquiries Process. And here in 2010 and 2011, these two processes come together to produce new refinements to our Complaints and Inquiries Process that for the first time addresses the providers’ responsibilities to learners after a provider is found not in compliance with some elements of the ACCME’s requirements.
In August 2010, we issued a call for comment about our Complaints and Inquiries Process. We had revised this process for handling complaints and inquiries regarding ACCME accredited providers to balance transparency with confidentiality.
Under our current process, if the ACCME finds a provider in Noncompliance, the provider is responsible for demonstrating that it has rectified the issue through a Notice of Corrective Action or through a Progress Report at a later time. This communication is between the ACCME and the provider and is kept confidential by the ACCME. As part of our ongoing commitment to accredited CME’s accountability and in response to feedback from stakeholders, the ACCME deliberated about whether providers should also have obligations to learners if an activity is found not in compliance. In considering the options, the ACCME seeks to balance transparency and accountability with providers’ confidentiality and to serve the best interests of the accredited CME system, physician learners and the public.
In September 2010, a call for comment closed on this issue. In this call, we asked the CME system what they thought about adding the following policy to our requirements. The policy was:
When the ACCME Complaints Process determines that an activity is found to be not in compliance with the Standards for Commercial Support or the Content Validation Value Statements, that the accredited provider will be required to provide corrective information to the learners, faculty and planners. The provider will submit to the ACCME a report describing the action that was taken and the information that was transmitted. Providers will determine how to communicate the corrective information and are under no obligation to communicate that the activity was found in Noncompliance with the ACCME’s requirements.
The call for comment issued responses from a few accredited providers in the CME system and there were no suggestions for drastic modifications to our proposal. At the November 2010 ACCME Board meetings, the ACCME took action to implement the proposed policy. This is a change in the process to handle complaints and inquiries, but it's also one of the first manifestations of our Rule Making Process going full circle. From an issue coming to the ACCME from the CME community, the ACCME deliberating on it, proposing a solution — but first, going back to the CME enterprise with the proposed solution in the form of a call for comment — receiving the information, deliberating again on the information that was received, then taking action to implement an appropriate policy.
So, we’re announcing now, that this policy has been integrated into the ACCME’s procedures for handling complaints regarding the ACCME accredited providers. This will be posted on our Web site and will be implemented with the next complaints and inquiries that we get.
It’s very important to point out that in this policy we are not specifying what exactly it is that the accredited provider has to do in order to inform the learners about this noncompliance or about change. That will be left up to the accredited provider, and that the ACCME will simply ensure that action has been taken and that it is meaningful. This is an interactive, informative process with the accredited providers. And it isn’t critical that we all be able to specify exactly what is an acceptable and not acceptable practice. These are going to depend on the facts and circumstances of each of the accredited providers and, as always, the ACCME is going to work with the accredited providers in implementing this.
This is an action in keeping with our policy and approach of transparency. That we want providers and the system to know what it is that we are finding in compliance and not in compliance. And ensuring that accredited CME is in the best interests of the public and of the learners.
So, here we have a manifestation of ACCME as a deliberative body that uses a Rule Making Process, that engages with the community, and has modified its Complaints and Inquiries Process in order to ensure that some of the responsibilities that providers have for the learners are manifest in the remedial actions that they take after the conclusion of the ACCME’s process. Thank you.