Maintenance of Certification

1
Maintenance of Certification
2
MOC will be mandatory by 2010 - 100 points
over 5 years in Parts 2 4Part 2 knowledge
assessment AAP PREP endo and ABP 30
best articlesPart 4 QI project AAP
EQIPP module or collaborative QI registry
3
LWPES AAP voted for Congenital Hypothyroidism
and Type 1 Diabetes as QI initiatives

• Congenital Hypothyroidism
• Age of screen T4
• Confirmatory FT4, TSH
• Age of confirmation
• Age of rx initiation
• Rx dose
• Thyroglobulin?, ultrasound?, scan?
• Age at normalization of TFTs
• Education provided (need tool kit/brochure)
• Follow-up care

• Type 1 Diabetes
• Monitoring frequency of testing A1c,
  microalbumin, lipids, TFTs, celiac panel, BP, eye
  exams, BMI
• Treatment Long-acting insulin given to pump pts
  for pump failure, treatment of HTN and lipids and
  levels at which rx begun, insulin regimens used
• Management plan and goals in chart with
  documentation that handouts given to patient
• Patient education noted in chart (eg, sick day
  rx, hypoglycemia rx)
• Access Documentation that pt received contact
  info for diabetes team 24 hours a day, 7 days a
  week

4
Issues with Implementation

• Funding
• NACHRI, ABP, and AAP are attempting to obtain
  funding nationally
• Because data shows medicaid saves with QI
  initiatives, states may fund them
• Some initiatives are funded by hospitals of
  participants
• Registry
• Centralized database among all subspecialties
• Generalize database used by other collaboratives
  (CF?)
• Adapt California database
• Data input
• Electronic transfer from EPIC or other EMRs
• Manual

5
Next Steps

• ABP will sponsor a 1 day meeting for task force
  members
• Congenital hypothyroidism Roz Brown (chair),
  Steve La Franchi, Susan Rose, Alan Rogol
• Diabetes Robert Schwartz (co-chair), Janet
  Silverstein (co-chair), Ken Copeland, Lynne
  Levitsky, Fran Kaufman
• Make tools available on LWPES and AAP website for
  members to use as pilot
• Those who pilot it will fill out assessment/
  evaluation with suggestions for improvement and
  will receive credit toward Part 4 MOCE
• Based on results of pilot, measures will be data
  collection refined, measures will be tested/
  validated, tools will be improved