By Jacob Coverstone and Erin Schwarz
A continuing conversation with Dion Richetti, vice president of accreditation and recognition, and Teri McCauley, manager of accreditation and recognition systems with the AACCME.
Earlier, you mentioned that as the simplification process went into effect, as the structured abstract went into effect, compliance rates started going up.
Did anybody question or look at that change as potential for false positives?
Could it have been that we were no longer assessing enough, or thorough enough information to tell that a provider was operating in a noncompliant manner? Or, are you absolutely confident that as much information as is needed to make accurate findings is still being presented by providers throughout the process? That the trend of improved compliance findings after the collection process was simplified are all accurate.
Providers, as you know, attest to only giving the ACCME accurate information, and we are a voluntary, self-regulated system. Our objective is to provide opportunities for providers to tell us what they’re doing well, and sometimes we see that they’re not always meeting the expectations.
There’s no indication that the data we’ve been receiving for the past 10 years under the current set of criteria fails to give us the information we receive to make accreditation decisions that are fair, accurate and objective.
Remember, the change that we have put in place for the most part are not changes to the information we collect. And, throughout the entire review process, and all the way through the ARC and up to the board meeting, we ask providers for additional materials. We have that opportunity to ask for more information if something is unclear.
Are there character-limited fields in the new platform? Could there be an issue where there “won’t be enough space” or something similar in the webform? In the PDF, at times, there wasn’t enough space to sufficiently articulate gaps or other information. Are you prescribing a character limit?
In terms of our word limits, nothing has changed from the abstract. The ACCME has taken the abstract and moved it into an online platform, and also we have simplified some of the tabular information into a format, which is the same, so that surveyors get a complete set of documents related to financial relationships and individuals in control of content. We spend the most time going back to providers for a complete and thorough list of all individuals in control of content and the relevant financial relationships and the nature of those relationships.
We do our very best to give providers every opportunity to provide all of the information. If you follow the structured abstract, you should be able to, as a provider, give the ACCME and its volunteers the information we need in a way that will be the most efficient and have the best results.
You said something interesting. You said that providers have used a variety of different “tactics,” and that’s what providers are hungry to learn. We often refer providers to the ACCME’s online compendium of compliance and noncompliance. Does the ACCME plan to update the compendium? Do you feel like everything up there remains applicable, or can we look forward to getting new examples?
The answer is “yes” and “yes.”
The ACCME no longer publishes a static compendium document. On our website, what we have instead is a dynamic interface where anyone can search for examples across all 38 criteria. [Editors’ note: You can view the ACCME compendium here: http://www.accme.org/examples-compliance-and-noncompliance]
We have recently redesigned our website and as part of the redesign process we updated and streamlined the examples.
As a response to the standardization of how information will be received by ACCME, are you expecting that new compendium examples will be broader reaching — such that examples may be more applicable to a broader number of organizations — because the information will now be input in a similar manner? There won’t be as much variance in the submission process, or do you think it’ll kind of stay the same since compendium examples are based off of surveyor reported information?
I want to clarify. I think the term “standardization” isn’t the ACCME’s objective. In other words, providers don’t have a standard way that they do CME. What the ACCME wants to do is simplify the accreditation process. We want providers to use — and we think our system allows for — a liberation of format. We’re not asking for everybody to do things in a cookie-cutter way in their education, and we think that the Commendation Criteria, with the menu of choices, helps providers to be unique and specific in what they do. So our examples are only driven by the creativity of the providers who submit their examples.
We don’t anticipate any change in the ACCME’s approach about putting that information out. We want the resource to be as applicable to as many providers as possible, but we realize that there are different provider types, and we’ve always encouraged providers to read the examples and try to see themselves within it but not necessarily to copy those examples — but to take from those examples what’s applicable to them as a unique provider of CME.
I hope that’s helpful, I’m not sure we’ve answered your question.
Thank you, I think that addresses what we were trying to ask. Kind of a side question — and one that we think everyone wants to know the answer to — is why is PARS so slow now?
The initial download when providers first interface with the enhancements, which has been available since the fall of last year, does take a little bit of time to open the application. I’m not sure if we’ve had other complaints about PARS being slow, other than that initial opening when a provider logged in and created a new password to the dashboard.
Any time I go to PARS now, I’m faced with a screen that says “preparing application,” and it takes several minutes to actually get to the next page.
We are working on this issue as it arises, and we encourage providers to contact us if they experience this issue. We’re always looking to hear from our providers and, with the online system, we are sending our normal evaluation that the ACCME conducts after each interview. We’re happy to hear providers’ suggestions for changes and improvements to the system.
If a provider is working on their self-study in PARS, and they’re not saving their work regularly, and the system times out, will any work entered since the provider last hit “save” be lost, or would their progress be automatically saved at the point of timing out?
The information is saved at that timeout. It autosaves it.
We’re now beginning to work with the fourth cohort and the feedback has been primarily positive. We understand that there have been technical issues, and it’s important that we continue to hear about those issues, and nobody should every be shy about contacting the ACCME, particularly about technical difficulties and using our system.
Well, thank you. This has been a wonderful opportunity to speak with you about an issue of great curiosity and importance to our readers.
Summary of Changes to ACCME Accreditation Process
- All documentation will be submitted online, through the PARS system, including a) self-study narrative and b) performance-in-practice files.
- The self-study outline has been modified to eliminate the “two example” requirement for Criteria 2-6 and focuses questions on provider’s process or processes for each Criteria (click here to see the outline for the July in November 2019 cohorts).
- The performance-in-practice files require similar information as was previously requested in the structured abstract (click here to see the version for the July and November 2019 cohorts).
- The ACCME requests that providers complete a template Excel file, rather than submitting individual completed disclosure forms or other documentation
ACCME’s “Performance-in-Practice Individuals in Control of Content” Excel Template
ACCME’s Instructions for Providers