In my last blog entry, I addressed the intense debate about certification -- particularly the requirements for Maintenance of Certification (MOC). I outlined commitments from our Board of Directors to simplify the process and to make it more relevant to all pediatricians, while remaining true to the board’s mission. The changes are a work in progress, but I do have updates for you, particularly concerning the MOC quality improvement (Part 4) activities. First, let me say I appreciate the comments so many of you have made by email and through this blog. You were quite clear that something has to be done differently to make the process more intuitive, more applicable to your daily practice, and more effective at measuring and improving pediatric care. Every one of your comments has been read and analyzed to help guide our efforts to improve the certification process. One suggestion that we can implement now is finding more ways to earn MOC credit for quality improvement activities that you’re already doing.
A great example is the QI work that goes into achieving recognition as a Patient Centered Medical Home. A number of QI activities are required to become recognized as a PCMH. Dr. Christopher Cunha, chair-elect of the ABP Board of Directors and a general pediatrician in private practice in Kentucky, has recently gone through the process of PCMH recognition through the National Committee for Quality Assurance (NCQA). He and his partners were engaged in quality measurement and improvement activities for about 18 months. It was a lot of work, he says, but ultimately very rewarding. Read more about their PCMH experience here. “It gives you a chance to look at your practice, and see what you do well, and where the gaps are,” he tells us. “It takes some time in the beginning, but you learn a lot about efficiencies, too, and that makes things easier in the long run. It’s a win-win for the patient and the provider. And it can be transformational for the whole practice.” As chair of the MOC subcommittee, Dr. Cunha has been a strong advocate for awarding MOC credit to physicians who participate in the PCMH process.
“We’re really trying to improve access and care delivery, and that should be rewarded,” he says.
For guidance on how to access the applications, apply for credit and more, please view the brief video provided: There is a direct application for NCQA recognition, but physicians who have achieved PCMH recognition from other organizations also can apply for credit through the “Create Your Own QI Activity” process. Our staff is ready and willing to help you.
These “Create Your Own” applications will allow pediatricians to earn credit for many of the QI projects they’ve already done. These projects have to meet specific standards and measurements to ensure quality, but we are hopeful that many pediatricians will find that they have already met these requirements. For those who are just starting a project, we’ll work with you to make sure your plans include all the elements needed to earn Part 4 credit. For instructions on how to access the application on the MOCAM website, refer to the instructional video above.
We recognize that not all of our diplomates are seeing patients. We’re starting with a pathway for those who develop and lead substantial health care quality initiatives – including department chairs, chief quality officers, directors of public health departments and others. The application requires documentation demonstrating that you have supported at least two quality and safety efforts within the organization and have expertise in quality/safety science. Stay tuned for additional pathways that will make earning Part 4 credit more efficient and more relevant to specific practices. We have a vested interest in the relevance and simplicity of the process. We care about all of the nearly 80,000 pediatricians -- including the 200+ pediatricians who voluntarily serve on ABP boards, committees and subboards -- who are enrolled in MOC activities. The four physicians on our staff – including myself – are meeting the requirements of MOC as well.
Our next major initiative in improving MOC is the examination (Part 3). Last weekend (May 15-16), the ABP hosted a Future of Testing Conference. We assembled experts in testing and medical education as well as practicing pediatricians and pediatric subspecialists. The lectures, panel discussions and breakout sessions focused on the broad questions, including the overall value of giving periodic tests of knowledge. We also drilled down into specifics – if you are going to take a test, should it be in a highly-secure, proctored environment, or is remote proctoring adequate? What about no proctoring? Should test-takers have access to on-line resources? Should only certain online resources be allowed? Should time be limited for looking up answers, just as time is limited during a patient visit? Recommendations from this conference will be discussed by the ABP Board of Directors in June, and I will let you know as soon as I can what decisions are made. Keep watching this space (or better yet, “follow” the blog), social media and your email inbox. And keep letting us know what you think of this MOC evolution.
David G. Nichols, MD, MBA
President and CEO