ACTIVITY DISCLAIMER. Maintenance of Certification (MOC): Saving Time, Getting More

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1 Maintenance of Certification (MOC): Saving Time, Getting More Joseph Tollison, MD, FAAFP ACTIVITY DISCLAIMER The material presented here is being made available by the American Academy of Family Physicians for educational purposes only. This material is not intended to represent the only, nor necessarily best, methods or procedures appropriate for the medical situations discussed. Rather, it is intended to present an approach, view, statement, or opinion of the faculty, which may be helpful to others who face similar situations. The AAFP disclaims any and all liability for injury or other damages resulting to any individual using this material and for all claims that might arise out of the use of the techniques demonstrated therein by such individuals, whether these claims shall be asserted by a physician or any other person. Every effort has been made to ensure the accuracy of the data presented here. Physicians may care to check specific details such as drug doses and contraindications, etc., in standard sources prior to clinical application. This material might contain recommendations/guidelines developed by other organizations. Please note that although these guidelines might be included, this does not necessarily imply the endorsement by the AAFP. DISCLOSURE It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflict of interest (COI), and if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. All individuals in a position to control content for this activity have indicated they have no relevant financial relationships to disclose. The content of my material/presentation in this CME activity will not include discussion of unapproved or investigational uses of products or devices. Joseph Tollison, MD, FAAFP Senior Advisor to the President of the American Board of Family Medicine. Dr. Tollison practiced family medicine for 30 years, and taught medical students and residents for 25 years. He has held many academic and administrative appointments, including committees of the American Board of Medical Specialties. Since 2008, he has been the senior advisor to the president of the American Board of Family Medicine. Dr. Tollison believes that challenges facing family medicine today include resident training modification, reimbursement challenges, and helping family physicians maximize their MC-FP programs. Learning Objectives 1. Identify resources that will help to overcome potential barriers related to the successful completion of MOC (MC-FP). Audience Engagement System Step 1 Step 2 Step 3 2. Develop an individualized strategy to successfully complete the MOC (MCFP) process. 3. Recognize the best pathway to successfully meeting the Part IV requirement (PPM, PPM Alternative, and MIMMs). 1

2 Opportunities Involving Your Board Certification CME provides a minimum of 1/4 of your AAFP/ABFM required CME Flexibility/Control increasing number of choices of on-line programs so that you may select and individualize your overall program among these are many choices of Part IV alternatives, which may save duplication of effort and time CME Awarded by the American Academy of Family Physicians Exam Locations greatly increased availability of locations and dates for proximity and travel cost savings PQRS a CMS-sponsored significant financial benefit available through ABFM may be paired with a PPM quality improvement activity for a two for National reporting system for quality of care A one time snapshot of current practice Avoid 2017 payment adjustment from CMS SAM = 12 CME Credits PPM = 20 CME Credits MIMM = 20 CME Credits Cultural Competency MIMM = 9 CME Credits ABFM s OVERARCHING APPROACH ALIGNMENT EVIDENCE? REDUNDANCY PART IV (PERFORMANCE IN PRACTICE) GENERATION 1 5 PART III (COGNITIVE EXAM) ABFM s MC FP (MOC) Requirements Part I: Evidence of professional standing Part II: Evidence of a commitment to lifelong learning and involvement in a periodic self-assessment process Part III: Evidence of cognitive expertise Part IV: Evidence of evaluation of performance in practice Unchanged Since Our Inception in

3 HOW CAN WE HELP YOU DO WHAT YOU NEED TO DO NOW? SUPPORT CENTER LIVE CHAT ( LIVE HELP ) THE PHOENIX WEBSITE S (PERIODIC) APP (EXAM PREP) RESOURCES INCLUDE: SAM STUDY GROUP SUPPORT PQRS SUPPORT BOOTH (818 AAFP FMX PUBLICATIONS (eg: AAFP FMX) YOUTUBE CHANNEL PRESENTATIONS Latest MC FP Info On site Discussion Invitations Welcome State Chapter & Review Courses Contact the ABFM Support Center Phone: help@theabfm.org Live Chat Website ABFM Phone: Fax: Support Center Assistance Extended Hours Available! 8:00 am - 9:00 pm (eastern) Monday - Friday & 9:00 am - 5:00 pm (eastern) Saturday Live chat available from ABFM Home page Summer & Winter Edition Each Year Mailed and ed to All Diplomates PDF Available on ABFM Website 2 Minute Rule Have a Question after 2 minutes? Contact our Support Center!! 3

4 ABFM Mobile Site ABFM Exam Prep App Exam Preparation Tools Available on ABFM Website: Exam Preparation Assistance Videos Outlining Study Plans Study Tips 2-Week Checklist Exam Tutorial Access these tools on the ABFM website If you have direct, continuing patient care, click Yes. If you have NO direct, continuing patient care responsibilities, click NO. 4

5 NO Access to Continuing Patient ABFM Care? MC-FP Part IV Methods in Medicine Modules (MIMMs) ABFM Products no additional charge beyond the cost of MC-FP Current Topics: Cultural Competency MIMM Hand Hygiene PPM (with simulated patient data) ABFM Self-Directed Activity Clinical Information Management MIMM (complete only if already begun prior to August 1, 2015) Approved Part IV Alternatives (Examples of Approved Part IV Alternatives) American Academy of Family Physicians (METRIC) Multi Specialty Portfolio Approval Program (MSPP) Sponsor organization activities Reach Out and Read, Inc. module Improving Early Literacy Intervention New Jersey Academy of Family Physicians (NJAFP) module Performance in Practice Colorectal Cancer Screening National Committee for Quality Assurance (NCQA) Physician Recognition Programs Approved programs: Diabetes, Heart/Stroke, Back Pain, Patient Centered Medical Home Individual level certificates of recognition in Heart/Stroke, Diabetes, Back Pain, or PCMH (only 2011, Level 3) can be submitted for Part IV credit Organization level certificates of recognition require additional physician attestation to be considered for Part IV credit Visit the ABFM website for the complete current list of Approved Outside Vendor Activities (listed under the Maintenance of Certification Section click the Part IV Performance in Practice) Polling Question Successful completion of an approved ABFM PPM Alternative provides what percentage of credit for the Part IV MC FP requirement? A. 100% B. 25% C. 50% 5

6 NO ABFM Approved Part IV Activities Do you have Continuing Patient Care? Yes ABFM MC FP Part IV Important Benefits of the PPM 1) Applied to your practice and your patients 2) Provides performance-based overview of your practice 3) Directed and controlled by you 4) Data available only to you (non-discovery) PPM ABFM Approved Part IV with Patient Data PPM Alternatives Part IV Modules with Patient Data Self Directed Activity with Patient Data Physician Quality Reporting System (Diabetes) avoid CMS payment adjustment 3 Step Process There are 2 ways to submit patient data in a PPM Step 1 Collect Data for 10 Patients (Initial Patient Data Collection) Step 2 Implement Your QI Plan Step 3 Collect Data for 10 NEW patients (Final Patient Data Collection) Enter your data prospectively based on individual patients Aggregate Entry Mode Enter data retrospectively for multiple patients Most commonly used for physicians who have Electronic Health Records (EHR) What is the Difference Between Individual and Aggregate Data Entry Mode? Patient Data Collection is Completed on Paper Polling Question Individual Data Entry Mode Collect Patient Data Prospectively Via Office Visits Enter Patient Data into PPM Manually How many patients are required for successful completion of each of the pre and post audits of an ABFM PPM? PPM Aggregate Data Entry Mode Patient Data Collection is Completed Using EHR Collect Patient Data Retrospectively Using EHR A. 10 B. 75 C. 30 Enter Data into PPM Using EHR 6

7 Steps to complete your first PPM Review the Pre-Quality Improvement Comparison Reports 1 Choose 1 Clinical Indicator (Problem Area) 2 Choose Chronic Care Models (Change Environment) 1 Choose Intervention in EACH Chronic Care Model (Action Resources Available) Select at least 1 clinical indicator as an area for improvement. Choose 2 of 6 Chronic Care Model (CCM) Categories 1. Community Resources and Policies Performance in Practice Module Change concepts and interventions that utilize community resources to meet the needs of patients (NCQA Physician Practice Connections category Patient Education and Support) Select at Least 2 Chronic Care Models (CCM) to guide you in selecting interventions for improvement 2. Health System 3. Self Management Support Change concepts and interventions that create a culture, organization, and mechanisms that promote safe, high quality healthcare Change concepts and interventions that empower and prepare patients to manage their health and healthcare (NCQA Physician Practice Connections category Patient Education and Support) Choose 2 of 6 Chronic Care Model (CCM) Categories 4. Delivery System Design Performance in Practice Module Change concepts and interventions that assure the delivery of effective, efficient clinical care and selfmanagement support (NCQA Physician Practice Connections category Care Management) Choose ONE intervention category within each Chronic Care Category previously chosen. 5. Decision Support Change concepts and interventions that promote clinical care consistent with scientific evidence and patient preferences (NCQA Physician Practice Connections category Clinical Information Systems/Evidence Based Medicine) 6. Clinical Information Systems Change concepts and interventions that organize patient and population data to facilitate efficient and effective care (NCQA Physician Practice Connections category Clinical Information Systems/Evidence Based Medicine) Choose 1 Intervention. Choose 1 Intervention Item. 7

8 Design your Quality Improvement (QI) Plan Note: Add Custom Step is an optional step. Implement your QI Program for at least 1 week Repeat Physician and Patient Questionnaires Once the questionnaires are complete and the data is entered in the PPM, You will be able to review your Post Quality Improvement Comparison charts. Aggregate Entry Mode Select the type of EHR you use in your practice Print Forms Hand Out Forms ( Only) Let Your Staff Help IMPORTANT!!! Self Directed PPM All activities must: Be developed using evidence-based criteria and national standards Ensure the physician is meaningfully involved Incorporate pre- and post-intervention evaluation of the physician s performance using evidence-based quality indicators Include the development and implementation of an individualized plan for improvement Input Data 8

9 Nichole Lainhart, Program Manager MC-FP Alternatives Activities Phone: , ext 1230 Support Center Phone: Live Chat From: Joseph Tollison Leaving Tsunami Hazard Zone. [Photograph]. Retrieved from Dr. Tollison s Personal Photo library ABFM Superstars Oldest Diplomate: 96 years young Diplomates 70 years young and beyond: 1,312 RESOURCES INCLUDE: SUPPORT CENTER LIVE CHAT ( LIVE HELP ) THE PHOENIX WEBSITE S (PERIODIC) APP (EXAM PREP) SAM STUDY GROUP SUPPORT PQRS SUPPORT BOOTH (818 AAFP FMX PUBLICATIONS (eg: AAFP FMX) YOUTUBE CHANNEL PRESENTATIONS Latest MC FP Info On Site Discussion Invitations Welcome State Chapter & Review Courses Continuous MC FP Set a Goal of 1 Module Per Year! Year 1: Complete 1 Module Year 2: Complete 1 Module Year 3: Complete 1 Module Connect with the ABFM Joseph W. Tollison, MD Senior Advisor to the ABFM President jtollison@theabfm.org , ext

10 From: Dr. Joseph Tollison Sky Diving. [Photograph]. Retrieved from Dr. Tollison s Personal Photo library From: Marsha Norris Leave No Diplomate Behind. [Altered Image]. Retrieved from URL Helpful Tips As a practice time saver, be quick to call the ABFM Support Center ( , Monday Saturday) for assistance with MC FP (MOC) programs. Avail yourself of ABFM website resources (eg: the Exam Prep Videos and Exam Prep App) to enhance your MC FP efforts. 10