This article features takeaways from the ACCME’s Oct. 28, 2021, webinar about the new Standards for Integrity and Independence. It is based on this Twitter thread, linked here.
On Oct. 28, 2021, the ACCME hosted a webinar that had an incredibly strong draw with reportedly 1,800 registrants. The webinar opened with an introduction by ACCME CEO Dr. Graham McMahon, followed by a panel of six accredited CE providers, some case examples answered by ACCME’s staff, a question and answer session and a very robust discussion of the content in the chat function among attendees.
During the introduction, Dr. McMahon reviewed the original resources that the ACCME released on this topic in December 2020, along with an introduction to the new standards which included a transition timeline, standards at a glance, the full text of the standards and a toolkit which included a sample disclosure form, sample content review form and a sample form for educational planning when identification, mitigation and disclosure are not required. Dr. McMahon reminded the attendees that accredited organizations can stop complying with elements from the old ACCME Standards for Commercial Support that are not in the new standards. As a reminder, accredited organizations are no longer required to:
- Collect disclosure information from individuals in control of content about the relevant financial relationships of their spouses or partners.
- Identify, mitigate or disclose relevant financial relationships for nonclinical activities, activities where the learner group is in control of content, or self-directed activities.
- Disclose to learners the absence of relevant financial relationships for nonclinical activities, activities where the learner group is in control of content or self-directed activities.
Next, Marcia Martin from the ACCME interviewed a panel of six accredited providers about how they implemented the new standards at their organizations. Most of them indicated they started by using resources provided by the ACCME, such as the Transition Checklist. Michelle Bruns, MLA, from the American Heart Association, explained that her organization created an online course about the new standards that is now required for their content creators. Andrea Thrasher from Cincinnati Children’s described how she changed her process to get the clinician planners more deeply involved in the identification of relevant relationships and mitigation decisions. Many of the panelists and participants in the chat indicated they used the new standards as an opportunity to begin collecting disclosures via an electronic/online method.
Steve Singer from the ACCME announced additional resources provided by the ACCME on its website. In addition to the original resources from December 2020, the ACCME has added:
- Case scenarios for when it is acceptable to use owners and employees of ineligible companies in accredited education (PDF, PPT and interactive quiz),
- Visual aids to explain the new standards to people who may be asked to be planners, faculty, reviewers, etc., for continuing education activities (PDF and PPT).
- Archived ACCME webinars and PDF of the slides.
- JAMA article by Dr. McMahon, which discusses the guiding principles behind the new Standards.
Dion Richetti and Dr. McMahon discussed several of the case scenarios provided, including the rationale for each response. As each case was discussed, Richetti and Dr. McMahon highlighted ways in which providers can determine if a company meets the definition of “ineligible,” as well as how to decide if the individual qualified as an owner/employee. There are many nuances to this topic, and additional clarification is available on the updated ACCME FAQ page.
Next, ACCME staff responded to questions that were posed by attendees in advance of the webinar. There was a great deal of action in the chat section regarding the new requirement to separate ancillary activities from continuing education by 30 minutes. Richetti clarified that the goal of this requirement is to ensure that learners are not unwillingly subjected to marketing by ineligible companies.
Richetti and Dr. McMahon also clarified that providers may use the new term “relevant financial relationships” to replace “conflicts of interests,” but it’s not mandatory; the ACCME removed the term “conflict of interest” because of the negative connotation that some planners/faculty have with the concept. Richetti indicated that providers do not need to tell the learners how relevant financial relationships were mitigated, just that they were mitigated.
Finally, it was recommended that providers become familiar with the ACCME’s performance-in-practice Excel spreadsheet for individuals that were involved in the content of the accredited activity. Richetti indicated it might be convenient for providers to track their review, identification and mitigation of individuals directly on this spreadsheet, but at the minimum, providers should know what data is required on that spreadsheet.
In closing, a key message delivered by the ACCME is that we continue to think about our learners as we as we apply these rules. If something might bother them or cause them pause, we should take action to address it so that we can protect the integrity and independence of accredited medical education.