AOA Osteopathic Continuous AOA Osteopathic Continuous Certification UpdateCertification Update

CME Sponsors ConferenceCheryl Gross, MA, CAE

January 13, 2012

Learning Objectives

• Learn the process by which the Specialty Certifying Boards are developing their plans for OCC

• Review the current criteria for OCC• Learn the changes to the certification process that

OCC will cause• Review specialty CME and its relationship to OCC• Learn ways in which CME providers can plan for

OCC

Types of AOA Board Certifications

Primary (General) CertificationCertification of Special Qualifications (CSQ)– CSQ becomes primary or DO can maintain

both primary and CSQ certificationsCertification of Added Qualifications (CAQ)– Must maintain primary and CAQ

AOA Certifications

C S Q

PRIMARY CERTIFICATION

CAQ

CAQ

CAQ

CAQ

Standards Review Process

Through the process, the BOS provides:

“the public with a dependable mechanism for identifying practitioners who have met particular standards”*

*Standards for Educational and Psychological Testing, American Psychological Association, 1985

Influencing Factors on the Development of OCC

OCC

Allopathic

MOC

IOM Reports on Quality CareAOA CAP

Program

Perf. Improvement

InitiativesPatient

PerceptionFSMB and

MOL

CMSS Conjoint Committee

AOA Clinical Assessment Program (CAP)

• Improves patient outcomes by providing valid assessments of current clinical practices in osteopathic residency programs and physician practices

• CAP is a Web-based performance measurement program which analyzes data taken directly from patient medical records

AOA Clinical Assessment Program (CAP) cont’d

• CAP for Residency Programs - Used as an accreditation requirement by ACOFP and ACOI for all osteopathic residency training programs

• CAP for Physicians – Receive 20 AOA Category 1b CME credits per each measurement set completed

• CAP for Physician Quality Reporting System (PQRS) – CAP was chosen as a qualifying registry by CMS in 2008-2011 for participation in the PQRS registry for payment program

Continuous Certification Goals

Ensure high standards for patient care

Provide physicians with the means to continually assess and improve their abilities

Assure stakeholders that physicians are being assessed by reliable and valid measures

Transparent to public and communicate information about physicians’ competence

Source: Lipner, R., and Magallanes, T. (2010).

OCC and MOL

• A number of state boards are pilot-testing Maintenance of Licensure (MOL) programs now – more in the next few years

• FSMB has recommended that state legislation include that participation in OCC be deemed as having met the state’s MOL requirements

Osteopathic Continuous Certification (OCC)

Similar to ABMS Maintenance of Certification (MOC) program

Required for all diplomates with time-limited certifications

Five components - core competencies are to be implemented within the components

Unrestricted Licensure

– Valid unrestricted license to practice medicine in one of the 50 states or Canada

– Adhere to the AOA’s Code of Ethics

Lifelong Learning

– Minimum of 120 credits of CME during each three-year cycle (three boards require 150 credits)

– Minimum of 50 specialty credits must be in the specialty area of certification

AOA CME Requirements

120 CME Credits

For approval:

– Certificant presenter

– Relevant topic

Exceptions reviewed on individual basis

DescriptionMaximum Number of

Credits per Cycle

1 Annual OMED Conference and Exposition

Determined Annually by Each Specialty Board

2 AIDS Seminars (Osteopathic and Allopathic)

5

3 Risk Management / Patient Safety 54 Ethics 0

5 AOA Specialty College Conferences & Seminars

ALL

6 AOA State Society Seminars 257 Medical Journals / Home Study Courses 208 Scientific Exhibits 59 AMA/PRA Courses Specified by Board

DescriptionMaximum Number of

Credits per Cycle10 Formal Teaching in the Specialty Specified by Board11 Standardized Life Support Specified by Board

12 Specialty Certifying Board Test Construction

15

13 Publications 1514 Healthcare Facility Meetings 015 Hospital Inspections 016 Acute Care Hospital Programs 25

17 College of Osteopathic Medicine (COM) Seminars

25

18 Osteopathic Foundation Seminars 25

NEW SPECIALTY CME REQUIREMENT

A minimum of 25% of the 50 specialty credits per 3-year cycle must be obtained in the CAQ specialty area

Practice assessment components will also be developed at the CAQ level

OCC Component 3

Cognitive Assessment

– At least one psychometrically valid and proctored examination through the period of certification

– Must assess a physician’s specialty medical knowledge as well as core competencies in the provision of health care

OCC Component 4

Practice Performance Assessment and Improvement

– Diplomates must engage in continuous improvement through comparison of personal practice performance measured against national standards for his or her medical specialty

General Process for Component 4

Example of Component 4:AOBFP

Completion of the educational unit of four OCCAP modules during cert period– An OCCAP measure set will be completed (data from

20 charts is entered for the measure set) for one module.

– Completion of one attended or web-based AOBFP approved educational unit referable to this module

– Completion of an AOBFP web-based exam for each module based on the educational unit

– Candidate enters final chart data from an additional 20 charts for measure set

Example of Component 4:AOBEM (Draft)

Future Practice Performance Component– Identify a self-assessed target area for improvement

– Review care from patient charts represented in that target area

– Compare data to national benchmarks

– Identify areas for improvement

– Implement practice improvement program

Example of Component 4:AOBPM (Draft)

Self-appraisal of practiceDiplomates will complete modules and submit chart reviews– College develops modules – These reports will be submitted to the AOBPM once

in every three year OCC cycle– Close alliance with specialty college

Example of Component 4:AOBS (Draft)

• Chart Evaluation and Self Evaluation– Submit Charts for review – 360 Evaluation (performance and behavior)

• Hospital Based/Surgery Center Based (QA/QI)– Will accept verified participation as

component 4• Surgical Clinical Assessment Program

OCC Component 5

Continuous AOA Membership

– Membership in the professional osteopathic community provides physicians with online technology, practice management assistance, national advocacy for DOs and the profession, professional publications and CME activity reports and programs

Core CompetenciesIncorporated into each Board’s OCC Process

– Osteopathic Philosophy/Osteopathic Manipulative Medicine

– Medical Knowledge – Patient Care– Interpersonal and Communication Skills – Professionalism– Practice-Based Learning and Improvement – Systems-Based Practice

Osteopathic Philosophy and OMM

Physicians are expected to: – Demonstrate and apply knowledge of accepted

standards in osteopathic manipulative treatment appropriate to their specialty

– Remain dedicated to life-long learning and to practice habits in osteopathic philosophy and OMM

Medical Knowledge

Physicians are expected to:

– Demonstrate and apply knowledge of accepted standards of clinical medicine in their respective area

– Remain current with new developments in medicine

– Participate in life-long activities

Patient CarePhysicians must:

– Demonstrate the ability to effectively treat patients

– Provide medical care that incorporates the osteopathic philosophy, patient empathy, awareness of behavioral issues, the incorporation of preventive medicine and health promotion

Interpersonal & Communication Skills

Physicians are expected to:

– Demonstrate interpersonal and communication skills that enable them to establish and maintain professional relationships with patients, families, and other members of health care teams

Professionalism

Physicians are expected to:

– Uphold the Osteopathic Oath in the conduct of their professional activities that promotes advocacy of patient welfare, adherence to ethical principles, collaboration with health professionals, life�long learning, and sensitivity to a diverse patient population

– Be cognizant of their own physical and mental health in order to effectively care for patients

Practice-Based Learning & Improvement

Physicians must:– Demonstrate the ability to critically evaluate

their methods of clinical practice, integrate evidence�based medicine into patient care

– Show an understanding of research methods

– Improve patient care practices

Systems-Based Practice

Physicians are expected to:

– Demonstrate an understanding of health care delivery systems

– Provide effective and qualitative patient care within the system

– Practice cost�effective medicine

Non-Expiring Certifications

Voluntary participation

– Maintenance of Licensure

– CMS PQRS reimbursement

– Public demonstration of commitment to ongoing quality and assessment

CAQs and OCCComponent 2 - Minimum of 25% of 50 specialty credits/3-year cycle must be obtained in the CAQ specialty area

Component 3 – Exams at the CAQ level

Component 4 - Practice assessment components at the CAQ level

MUST complete primary OCC and CAQ OCC

Dual Certifications – AOA/ABMSBoards will make a pathway available to utilize work forward ABMS MOC to meet the criteria for OCC

Additional osteopathic components may be required

Still under discussion

Dual Boards / AOA BoardsMust participate in full OCC process for both Boards

Example: Internal Medicine and Emergency Medicine

Non-Clinical PhysiciansBoards will offer a way to declare non-clinical status

Will need to participate in all OCC components

Practice performance assessment in Core Competencies will be developed

Re-entry process will be developed

Loss of CertificationBoards will develop reentry pathways for those with time-limited certificationsFor non time-limited certifications:– Re-entry pathway– Granted re-instatement, with a time-limited

certification

AOA OCC PlatformAll Certificants

Dashboard Program– At-a-Glance– All 5 Components– Physicians Can Upload Info– Boards Easily Create Compliance Reports

• Approved - Under Development

OCC – CME Sponsors

• Need significantly more quality osteopathic CME available at the subspecialty level

• Need practice performance assessment modules for core competencies– Ex. Professionalism, Osteopathic Philosophy

• Possible remedial CME for demonstrated areas of concern

Questions / Concerns?

AOA Division of Certification(800) 621-1773, ext. 8266

certification@osteopathic.org