ABIM

1
ABIMs MOC ChangesHow to Deliver the Message to
ACCs Members and Constituents

• Developed for members of ACC Boards, Committees,
  Councils and Other Messengers
• January 2014

2
Commercial Disclosures

• Eric R. Bates, MD, FACC
• Professor of Internal Medicine
• University of Michigan
• Commercial Interest Nothing to Disclose
• Frederick Masoudi, MD, FACC
• Professor of Medicine, Division of Cardiology
• University of Colorado School of Medicine
• Commercial Interest Nothing to Disclose
• John S. Rumsfeld, MD, PhD, FACC
• Professor of Medicine, Division of Cardiology
• University of Colorado School of Medicine
• National Director of Cardiology, U.S. Veterans
  Health Administration
• Chief Science Officer, ACC National
  Cardiovascular Data Registry (NCDR)
• Commercial Interest Nothing to Disclose

3
Webinar Goals

• Our goal is to provide information about ABIMs
  new MOC program so that you, ACCs member
  leaders, can
• Communicate the changes to ABIMs MOC program to
  your constituents and colleagues
• Explain how the changes will impact different
  categories of ABIM diplomates
• Know when to refer a cardiologist to ABIM for an
  explanation of how the new certification
  requirements apply to them
• Understand the challenges of delivering this
  message and have answers to the questions that
  might be asked
• Know where to locate tools and resources to help
  with your presentations

4
Challenges

• Many changes to the MOC program
• Complexity of new approach
• ACC does not have all the answers because
• some elements of the new MOC program are still in
  development by ABIM
• some information from ABIM seems to conflict
  and/or is not clear.

5
Presentation Content

1. Evolution of Certification Process
2. 2014 Changes to MOC
3. What the Changes Mean for Cardiologists
4. What Our Members Think
5. What ACC is Doing to Support its Members
6. Role of the Messengers
7. Tips for Messengers

6
Introduction

• Section 1

7
ABMS ABIM

• All 24 of the medical boards that comprise the
  American Board of Medical Specialties (ABMS) are
  in the process of implementing a more continuous
  approach to Maintenance of Certification
• To meet new requirements outlined by ABMS, the
  American Board of Internal Medicine (ABIM) is
  changing its MOC program.
• ABMS and ABIM believe that a more continuous MOC
  program helps you keep pace with the changes in
  the science of medicine and assessment.

8
ACCs Role

• Interpret ABIMs materials that describe their
  new MOC program and communicate the key themes to
  our members.
• Provide educational products and other support
  that help our members
• Study for ABIMs Cardiovascular Disease MOC exam
  (the Boards)
• Secure Self-Evaluation of Medical Knowledge
  credits (MOC Part II)
• Undertake Self-Evaluation of Practice Assessment
  modules (MOC Part IV)

9
When it comes to ABIMs MOC program

• ACC does not
• Review
• Edit
• Comment
• Vote
• on certification or recertification requirements.

10
Evolution of Certification Processes

• Section 2

11
Certification Process Up to 2006

• Secure exam after completing fellowship
• Lifetime certification with NO end date
• Secure exam after completing fellowship
• Time-limited certification WITH an end date
• Recertification exam every 10 years

12
Certification Process 2006 - 2013

• Secure exam after completing fellowship
• Time-limited certification with an end date
• Maintenance of Certification exam every 10 years
• Completion of
• Self-Evaluation of Medical Knowledge Modules
• Self-Evaluation of Practice Performance Modules

13
Components of Maintenance of Certification 2006 -
2013
14
Maintenance of Certification Points 2006 - 2013
100 Points Every 10 years
Part II Self-Evaluation of Medical Knowledge
modules Part IV Self-Evaluation of Practice
Assessment modules
15
2014 Changes to MOCWhat We Know and Dont Know

• Section 3

16
Certification Process 2014 and Beyond

• Two Separate Designations
• Board Certified
• Meeting MOC Requirements
• Certification represents passing initial exam
• Meeting MOC Requirements is a new and separate
  obligation

17
Summary of What Will be New in 2014

• MOC now applies to all diplomates (including
  grandparents)
• 100 MOC points now have to be secured on a
  5 year cycle with some activity required every
  2 years
• Patient Safety Patient Survey requirements
• 20 MOC points awarded for every first exam
  attempt within each specialty

18
Maintenance of Certification 2014 Points and
Cycle Changes
Complete an MOC activity every 2 years
Part II Self-Evaluation of Medical Knowledge
modules Part III MOC secure exam Part IV
Self-Evaluation of Practice Assessment modules
19
New Patient Safety Patient Survey Requirements

• Patient Safety
• Some ABIM MOC modules currently meet this
  requirement
• ABIM will be adding more options in the future
• ABIM is developing a process so that diplomates
  can use patient safety activities at their
  institution to meet this requirement
• Patient Survey
• Some of ABIMs existing Performance Improvement
  Modules (PIMs) Part IV activities include
  patient surveys
• ABIM will offer options to meet requirement
  without doing a full PIM
• ABIM is developing a process so that diplomates
  can use patient survey activities at their
  institution to meet this requirement

20
What the Changes Mean for Cardiologists

• Section 4

21
Those Who Certified Prior to 1990 (Grandparents)

• Starting January 2014 new MOC requirements apply
  to you.
• To be reported as Meeting MOC Requirements
• Enroll in the MOC program by March 31, 2014
• Complete an MOC activity to earn MOC points every
  2 years
• Earn 100 MOC points every 5 years
• Complete patient survey patient safety modules
  every 5 years
• Pass ABIMs Cardiovascular Disease MOC
  Examination (the Boards) by December 31, 2023
  (10 years)
• Your initial certification in Cardiovascular
  Disease does not expire. You will remain
  certified whether or not you are Meeting MOC
  requirements. However, if you choose not to
  undertake all required MOC activity, you will be
  reported as Certified. Not Meeting MOC
  Requirements.

22
Those in 10-year MOC cycles

• Starting January 2014 new MOC requirements apply
  to you.
• Finish out your individual 10-year MOC cycles for
  Parts II IV, and the MOC exam. Any points
  earned after January 2014 will apply both to
  those you need to earn to maintain your existing
  certification and to be Meeting MOC
  Requirements.
• To be reported as Meeting MOC Requirements
• Enroll in the MOC program (if not currently
  enrolled in MOC) by March 31, 2014
• Complete an MOC activity to earn MOC points every
  2 years
• Earn 100 MOC points every 5 years
• Complete patient survey patient safety
  requirements every 5 years

23
Those Newly Certified after January 2014

• Starting January 1, 2014 the new MOC requirements
  apply to you.
• To be reported as Meeting MOC Requirements
• Activate your MOC program by March 31, 2014
• Complete an MOC activity to earn MOC points every
  2 years
• Earn 100 MOC points every 5 years
• Complete patient survey patient safety
  requirements every 5 years
• Pass the ABIM Cardiovascular Disease MOC
  Examination (The Boards) every 10 years

24
Sub-Specialty Certification

• As in previous years, diplomates must still hold
  a current, valid ABIM certification in
  Cardiovascular Disease to be eligible for renewal
  of certification in
• Advanced Heart Failure and Transplant Cardiology
• Clinical Cardiac Electrophysiology
• Interventional Cardiology
• If you have more than one ABIM certification, all
  MOC points earned will apply to all
  certifications you are actively maintaining.
• If you are maintaining certification in
  Interventional Cardiology, you will need to
  continue to attest to meeting additional
  program-specific requirements.
• You will receive 20 MOC points for completion of
  one MOC exam per certification area being
  maintained.

25
ABIM/ABMS Reciprocal Credit for Dual-Boarded
Diplomates

• ABIM-certified physicians who are maintaining
  certification through another of the the ABMSs
  24 member boards (e.g. the American Board of
  Pediatrics) may be eligible to receive points for
  Self-Evaluation of Medical Knowledge and
  Self-Evaluation of Practice Assessment.
• To receive credit, ABIM diplomates will need to
  attest that they are current and participating in
  the other Boards MOC program.
• For more information, please call ABIM at
  1-800-441-ABIM.

26
Doctors of Osteopathy (D.O.s)

• D.O.s must certify with the American Osteopathic
  Board of Internal Medicine (AOBIM) which
  introduced new Osteopathic Continuous
  Certification (OCC) January 1, 2013.

27
What We Dont Know

• When a diplomate could be reported as Not
  Certified
• ABIM staff has suggested that certain categories
  of diplomates might lose their certification if
  they do not secure the required MOC points within
  the required timeline.
• The ways in which an ABIM diplomate can be
  reported as Not Meeting MOC Requirements by
  ABIM
• This seems to depend on each diplomates specific
  certification situation (year certified, multiple
  specialty certification, dual-boarded)
• What the Patient Survey and Patient Safety
  modules requirements will be when they are
  finalized
• Precisely how dual-boarded MOC attestation must
  be done by diplomates.

28
What Our Members Think

• Section 5

29
ACC Member Surveys Main Themes

• Over half are not aware of the 2014 changes to
  MOC.
• Although most are enrolled, cardiologists do not
  find value in MOC.
• Cardiologists are divided on the impact of the
  MOC changes with many believing it will affect
  their practice negatively.
• Although half say that the MOC changes will not
  affect future plans to continue practicing,
  two-fifths are either unsure or say that their
  plans have been affected.

30
Awareness of ABIM MOC Changes
31
MOC is 5th Highest Challenge to Practicing
Medicine

1. Reimbursement /payment cuts/Medicare issues (69)
2. Work-life balance/extensive workload/work hours
   (35)
3. Costs/rising costs (31)
4. Government regulations (28)
5. MOC/certification/training (23)     

32
What ACC is Doing to Support its Members

• Section 6

33
Communications Plan

• In order to address member concerns, an
  initiative has been launched by ACC to
  communicate a consistent message about the MOC
  changes to members. This initiative is designed
  to
• Inform membership about ABIMs MOC changes and
  explain that they were not initiated by ACC.
• Highlight the variety of educational and quality
  improvement opportunities that ACC makes
  available to its members to assist with securing
  MOC points (Parts II, III and IV).
• Establish a forum to gather member feedback on
  the ABIMs MOC changes and advocate to ABIM on
  members behalf.

34
Three Complementary Communication Strategies
35
One Voice

• ACC will build awareness among its domestic
  members about the new requirements, with a
  special focus on Grandparents. This will
  include
• Informing members clearly and concisely about the
  new ABIM requirements and the fact that these are
  not ACC requirements
• Providing presentations, webinars, web pages,
  articles, mail, emails, editorials, exhibits,
  events, and social media resources which address
  ABIMs MOC changes.
• ACC will become a comprehensive and credible
  source of information on the changes

36
Easy Button

• ACC will highlight its educational and
  performance improvement opportunities that are
  available to assist members with the new MOC
  requirements.
• Dedicated ACC web pages addressing the ABIMs
  changes to MOC and the impact on diplomates MOC
  point requirements (www.cardiosource.org/MOC)
• An ACC MOC Changes Resource Kit including a
  Glossary, FAQs and Talking Points (in production)
• List of ACCs MOC Part II (Self-Evaluation of
  Medical Knowledge) educational modules
  (www.cardiosource.org/MOCEducation)
• List of ACCs MOC Part IV (Self-Evaluation of
  Practice Assessment) performance improvement
  modules (www.cardiosource.org/MOCEducation)
• Step-by-step instructions for ABIMs MOC Part IV
  Self-Directed PIM and use of NCDR data
  (www.cardiosource.org/SelfDirectedPIM)

37
We Hear You

• ACC will work to establish an online forum for
  gathering member feedback on issues critical to
  the MOC change initiative that will serve as a
  foundation for ACCs advocating to ABIM on its
  members behalf.
• ACC will provide mechanisms to systematically
  gather information from members Listening
  tour
• ACC will advocate to ABIM on members behalf
  making recommendations for process improvements

38
Role of the Messengers

• Section 7

39
One Voice - Getting the Message Out
40
Messengers Inform the Members
41
Objectives For Messengers

• Communicate details of ABIMs MOC changes to
  domestic physician members in your
  constituencies.
• Inform members clearly and concisely about the
  details of the new requirements and share
  Important Dates and Calls to Action
  (following two slides)
• Reinforce the fact that these are not ACC
  requirements
• Describe ACC resources that help members obtain
  MOC credit
• Provide answers to general questions where
  possible, or direct those with specific questions
  to ABIM (www.abim.org)

42
Important Dates

• March 31, 2014 If ACC members are not already
  enrolled in MOC, they should enroll on the ABIM
  website by March 31, 2014 to become an ABIM
  diplomate and be Meeting MOC Requirements
• December 31, 2015 By December 31, 2015, ABIM
  diplomates should complete an MOC activity to
  earn ABIM MOC points to continue to be reported
  as Meeting MOC Requirements
• December 31, 2018
• By December 31, 2018, ABIM diplomates should earn
  a total of 100 MOC points in a mix of Self-
  Evaluation of Medical Knowledge Self-Evaluation
  of Practice Assessment
• By December 31, 2018, complete the new patient
  safety and patient survey requirements

43
Calls to Action

• Find educational activities that provide MOC
  points, as well as CME credits, at
• ACC
• http//cardiosource.org/MOCEducation
• Table and web links to ACCs Part II and Part IV
  activities
• ABIM
• http//www.abim.org/maintenance-of-certification/m
  edical-knowledge.aspx
• Links to ABIMs Part II activities
• http//www.abim.org/moc/earning-points.aspx
• Links to ABIMs Part IV activities

44
Tips for Messengers

• Section 8

45
Messenger Action

• Familiarize yourself with these resources
• JACC article and companion piece
• http//moc2014.abim.org/
• http//www.cardiosource.org/MOC
• http//www.cardiosource.org/MOCEducation
• ACCs MOC FAQs, Talking Points Glossary (in
  production for publication in January 2014)

46
Delivering the Message

• Direct participants to supplementary materials
  and other resources
• MOC Resource Kit content (consider bringing hand
  outs for the audience)
• ACC and ABIM websites, emails and phone numbers
• Tailor content to the audience
• Not every audience will require the same level of
  detail.
• Adapt your pace and content as appropriate

47
Responding to Audience Questions

• Redirect questions about Why?
• All questions about Why should be made by the
  audience member directly to ABIM.
• Focus on what we know so far
• What is staying the same
• What is changing
• How and When cardiologists need to act

48
Responding to Audience Questions (cont.)

• Dont try to explain how the rules apply in
  specific cases (e.g. sub-specialty certification,
  dual boarded, multiple expiration dates)
• It is ACCs role to communicate the upcoming
  changes but not to interpret them for individual
  cardiologists
• Refer all questions about specific application of
  the new rules to ABIM at
• 510 Walnut Street, Suite 1700Philadelphia, PA
  19106
• Phone [phone]-ABIM Mon - Fri 830 a.m. - 8
  p.m. ETSat 9 a.m. - 12 p.m. ET
• E-mail MOC2014_at_abim.org

49
Responding to Audience Questions (cont.)

• Know the portfolio of education products that ACC
  and ABIM provide for diplomates to pass the
  Boards, and secure Medical Knowledge and Practice
  Assessment (Part II, III and Part IV) MOC points.
• ABIM website (See Resources slide)
• ACC website (See Resources slide)
• ACC PIM Support Line (1-800-253-4636 x.5404)

50
Questions?

• Contact
• The Master Trainers
• Ellen Cohen, Director of Certification and
  Accreditation, ACC
• ecohen_at_acc.org [phone]
• Melanie Stephens-Lyman, Associate Director of MOC
  Part IV Products, ACC
• mstephenslyman_at_acc.org [phone]

51
Resources

• Changes to Maintenance of Certification
• ABIM http//moc2014.abim.org/
• ACC http//www.cardiosource.org/MOC
• MOC Part II Modules
• ABIM http//www.abim.org/maintenance-of-certific
  ation/medical-knowledge.aspx
• ACC http//www.cardiosource.org/MOCEducation
• MOC Part IV Modules
• ABIM http//www.abim.org/moc/earning-points.aspx
  
• ACC http//www.cardiosource.org/MOCEducation

52
Good Luck!

• Thank you for your interest and attention