National Alliance for Physician Competence History Instigation The Physician Accountability for Physician Competence Initiative was instigated by the Federation of State Medical Boards to engage the medical community in a dialog about the future of healthcare in the United States - with the ultimate goal of answering the question: How does the profession of medicine identify, measure and evaluate the ongoing competence of its members to assure the public of its commitment to accountability? The following is provided as a history of the Alliance activities to date. For more information and to view the documentation from all Alliance activities please see http://www.innovationlabs.com/summit/ The following organizations have contributed financially to making these activities a success: The Association of American Medical Colleges AARPAccreditation Council for Continuing Medical EducationAccreditation Council for Graduate Medical Education American Board of Internal Medicine FoundationAmerican Board of Medical SpecialtiesAmerican Medical Association American Osteopathic Association American Osteopathic Board of Emergency Medicine Association of American Medical CollegesAssociation for Hospital Medical Education Blue Cross/Blue Shield AssociationChristiana Care Council of Medical Specialty Societies Crozer- Keystone Health System Educational Commission for Foreign Medical Graduates The Federation of State Medical Boards Iowa Board of Medical Examiners Michigan Board of Medicine National Board of Medical ExaminersNational Board of Osteopathic Medical Examiners Oregon Board of Medical Examiners The Robert Wood Johnson Foundation Texas A&M Health Science Center Texas A&M University A l l i a n c e H i s t o r y D o c u m e n t Page 1
Summit I: March 24-25, 2005 Focus: Scenario Development On March 24 25, 2005, a group of leaders drawn from a broad cross section of healthcare came together for two days in Fort Worth, Texas, for the first Physician Accountability for Physician Competence Summit. The focus of this summit was to begin a dialogue about the future of physician self-regulation by exploring the context within which physicians will be expected to demonstrate accountability in the year 2020. Stimulated by the book, Solving Tough Problems, by Adam Kahane this first meeting focused on identifying and prioritizing the trends and developments that are influencing the healthcare delivery system in the United States and then using this information to develop scenarios about what that system might look like in 2020. The scenarios were intended to be used during subsequent meetings as the context within which to explore solutions to the question how does the healthcare community evaluate and measure physician competence over the career of the physician? To encourage as broad a dialogue as possible about this issue, summit participants were asked to solicit feedback from their respective organizations on the scenarios plausibility and possible implications on their organizations constituencies. A summary document containing these scenarios was developed and distributed to support this ongoing dialog and feedback. The final scenarios are provided below in Addendum B. Summit II: December 8-9, 2005 Focus: Scenario Implications A second summit took place in Chicago on December 8 9, 2005. The goal of the second meeting was to continue exploring how physician competence should be measured and evaluated in the future, using the scenarios and the feedback received from various stakeholder groups as the context for that discussion. Participants explored many possible options for how physician competence might be measured and evaluated in each of the five future states. At the conclusion of the meeting, the group had developed the following: a draft definition of competence; a draft table of contents for a document describing the behaviors and values one would expect of a competent physician; drafts of several models of regulatory systems to stimulate further conversation about measuring and evaluating physician competence in 2020; and a timeline and task list for activities that needed to occur over the next 12 to 16 months. The group also endorsed the notion of creating a national alliance of organizations focused and aligned around the goal of ensuring physician competence. A l l i a n c e H i s t o r y D o c u m e n t Page 2
Summit III: June 28-29, 2006 Focus: Good Medical Practice Document and National Alliance for Physician Competence During a third summit on June 28 29, 2006 in Philadelphia, participants began writing content for the good medical practice document and developed more fully the concept of a National Alliance. Discussions about the relationship between maintenance of licensure and maintenance of certification and about how to engage the practicing community and the public in this effort were also initiated. It was evident by the end of the meeting that a shift in ownership for the initiative occurred as participants proactively began to identify and tackle issues and challenges that will need to be resolved if the vision of having a uniform, meaningful system for assuring the continuing competence of physicians is to be realized. An even more illustrative indicator of the shift were the generous pledges by participants to a request for financial and human resources to keep the national dialogue moving forward over the next 12 months. Summit IV: January 14-16, 2007 Focus: GMP-USA, National Alliance, Trusted Agent/Portfolio System Between Summit III and Summit IV several work groups further developed some draft documents to be used as catalysts for conversations in the fourth Summit. A proposal for the formation of a National Alliance on Physician Competence, an outline for a Trusted Agent/Portfolio System could look like and a further iteration of the draft of the Good Medical Practice document, were completed prior to the Summit. 65 participants representing 42 different organizations convened in Tampa, Florida on January 14 16, 2007 for Summit IV. In the Summit the group examined how a "continuum of competence" encompassing the system that includes Medical Schools, Residency Programs, Licensure, Specialty Certification, Credentialing and Privileging, the Accreditation of Institutions, and the long-term Maintenance of the physician's Competency throughout one's career might be impacted if something like a Good Medical Practice document and a Trusted Agent/Portfolio System were in use. At the end of this Summit participants decided to take the Good Medical Practice document through one more iteration of writing and editing before distributing this to get feedback from a broader constituent group. The group also decided to continue to explore the formation of a National Alliance for Physician Competence but wanted to delay formalizing the organization while they take time to learn about the various options for an organizational structure. Several organizations are taking part in small pilot demonstrations to model the secure sharing of data and how something like a Trusted Agent/Portfolio system could work. A l l i a n c e H i s t o r y D o c u m e n t Page 3
Continuum Interfaces Conference: August, 2007 Focus: Aligning Interfaces between Certifying Boards and Licensing Boards In August 2007 a group met to continue exploring ways to align the interfaces between Certifying Boards and Licensing Boards. Discovery Workshop: August 27-29, 2007 Focus: Organization Structures and Complex Adaptive Systems On August 27-29, 2007, InnovationLabs convened a Discovery Workshop at Catalyst Ranch in Chicago. The purpose of this event was to introduce new concepts and models around complex adaptive systems to the group of people developing what might now become the National Alliance for Good Medical Practice (a vehicle to assure the public of physician competencies). Six catalysts were invited to present research and experiences from fields as diverse as complexity science, network theory, and non-profit scaling models. The participants used these new concepts to craft visions for the Alliance, its structure, its functions and its development path. These visions will serve as input for the next Summit to be held in Dallas on December 5-7, 2007. Portfolio Conference: October 2007 Focus: National Framework for Data Sharing In October 2007, the Association of American Medical Colleges (AAMC), Accreditation Council for Graduate Medical Education (ACGME), National Board of Medical Examiners (NBME) and Federation of State Medical Boards (FSMB) convened a broad sampling of educators, regulators, potential users, and technical experts at a two day Invitational Conference in Baltimore. The overall goal the group agreed upon was to conceptualize and initiate the development of a new national framework providing physicians with learner-centered data compilations and tools that support their education, professional development, and practice improvement, and which can be authorized for reporting to external entities. A white paper was produced which summarizes the results of this meeting. Summit V: December 6-7, 2007 Focus: GMP-USA, Measuring Competence, National Alliance, Infrastructure for Data Sharing Between Summit IV and Summit V the Good Medical Practice document was edited and distributed to a broader constituent group for input and feedback. A web site was set up (http://gmpusa.org) and version 0.1 was made available for review. A l l i a n c e H i s t o r y D o c u m e n t Page 4
Summit V took place on December 6-7, 2007 in Dallas, Texas. Based on overwhelming feedback from participants at the January summit in St. Petersburg about needing to expedite progress on several fronts, the December meeting was organized as three mini summits which took place simultaneously. Each mini-summit focused on a specific track of work emerging from previous meetings. The three tracks of work were: Track 1: Sustaining the Effort Track 2: Measuring Competencies Track 3: Infrastructure for Information Exchange Summit VI: July 7-9, 2008 Focus: GMP-USA, efolio Framework and Infrastructure for Data Sharing as well as National Alliance Evolution Between Summit V and Summit VI the Good Medical Practice document was edited based on comments from the previous Summit. Version 0.2 was reviewed and updated. A survey was conducted on the use of the GMP and a survey tool was developed to get feedback on the utility of each bullet in the GMP document. A l l i a n c e H i s t o r y D o c u m e n t Page 5