1. science
2. medicine

Working with Partners to Engage
Physicians in Quality Improvement
Webinar
December 10, 2014
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Webinar Instructions
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 ABIM staff will respond to questions after the
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Agenda
 Who is ABIM and what is MOC?
 Why is MOC relevant to the Transforming
Clinical Practice Initiative?
 How ABIM can work with you to support practice
transformation?
“ABIM’s mission is …
to enhance the quality of health care by
certifying internists and subspecialists who
demonstrate the knowledge, skills, and
attitudes essential for excellent patient
care.”*
“We are…
Of the profession, for the public.”*
*ABIM strategic plan adopted by the Board of Directors on June 5, 2007
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What are the Specialty Boards?
State
Licensing
Boards
Specialty
Societies
Specialty
Certification
Boards
Mandatory
Voluntary
Voluntary
Government-run or
sanctioned
Membership-run
Independent nonprofits
Not specialty
specific
Specialty specific
Specialty specific
Grant licenses to
practice medicine
Serve members
with education and
advocacy
Define disciplines
and set standards
for those disciplines
24 Member Boards
Certify more than 750,000 physicians
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Allergy & Immunology
Anesthesiology
Colon/Rectal Surgery
Dermatology
Emergency Medicine
Family Medicine
Internal Medicine
Medical Genetics
Neurological Surgery
Nuclear Medicine
Obstetrics & Gynecology
Ophthalmology
Orthopedic Surgery
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Otolaryngology
Pathology
Pediatrics
Physical Medicine
& Rehabilitation
Plastic Surgery
Preventive Medicine
Psychiatry & Neurology
Radiology
Surgery
Thoracic Surgery
Urology
The Breadth of Internal Medicine
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Adolescent Medicine
Adult Congenital Heart Disease
Advanced Heart Failure &
Transplant Cardiology
Cardiovascular Disease
Clinical Cardiac
Electrophysiology
Critical Care Medicine
Endocrinology, Diabetes &
Metabolism
Gastroenterology
Geriatric Medicine
Hematology
Hospice and Palliative Medicine
Infectious Disease
Internal Medicine
Interventional Cardiology
Medical Oncology
Nephrology
Pulmonary Disease
Rheumatology
Sleep Medicine
Sports Medicine
Transplant Hepatology
 Certify 1 of every 4
practicing physicians in US
 More than 200,000 ABIM
Board Certified Physicians
 More than 150,000 diplomates
enrolled in MOC
 More internists than any other
specialty
 Most frequent patient
encounter is with internist
All ABIM materials are protected by the federal Copyright Act, 17 U.S.C. § 101, et seq.
Initial Certification Requirements (ABIM)
 Complete pre-doctoral medical education
 Meet the training requirements
• Program Director’s evaluation of ACGME
core competencies and moral and ethical
behavior
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Patient Care
Medical Knowledge
Practice-based Learning and Improvement
Interpersonal and Communication Skills
Professionalism
Systems-based Practice
 Meet licensure requirements
 Pass a Board Certification examination
Maintenance of Certification
 A structured framework for certified physicians that
helps them to:
• Stay up to date
• Possess and maintain sound clinical skills,
judgment and diagnostic acumen
• Engage in quality improvement activities
• Incorporate patient perspectives into their practice
 A standard for assuring competence.
• Certification and MOC is the nationally recognized
process for assuring these competencies.
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MOC Program Components
 Maintain a valid and unrestricted medical license
 Two-year milestone
 Complete any MOC activity (will count toward fiveyear milestone)
 Five-year milestone
 Self-Assessment of Medical Knowledge
 Engagement in Quality Improvement
 Patient Safety Activities
 Patient Voice Activities
 Ten-year milestone
 Pass a secure exam in specialty area
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*Courtesy of the Center for Medicare and Medicaid Innovation
TCPI Projects and MOC Requirements
Specifications for
TCPI projects and
“stages of change”
MOC requirement
for engagement in
quality
improvement
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Standard for Engagement in Practice Assessment
Interpreting data about clinical practice.
Making a change to improve practice.
Assessing the effectiveness of changes
made.
The Six Domains of Quality
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Safe
Effective
Patient-centered
Timely
Efficient
Equitable
Partnership Options Embedded in MOC
Portfolio Program
• Approved institutions apply Board standards to a portfolio
of their own QI efforts for MOC credit.
• Institutions are responsible to verify physician
participation.
Approved Quality
Improvement
(AQI) Pathway
• Institutions apply to have individual QI efforts
approved for MOC credit.
• Physician initiates credit process and institution
verifies participation.
Completed Project
PIM
or
Self-Directed PIM
• Physicians can use Completed Project Practice
Improvement Module (PIM) to report participation in
completed projects and Self-Directed PIM to
support QI activity using data from registries or
other sources.
• Physician self-attests to participation
Comparison of Options
Portfolio
Program
Approved
Quality
Improvement
Program
Self-Directed
and Completed
Project PIM
Sponsor
organization
application?
Yes
Yes
No
Application Fee
Yes
No in 2015
N/A
Specialties
Included
19 ABMS Boards
ABIM
ABIM
Scope of Program Multiple QI
projects
Single QI project
Single QI project
Verification and
Credit Process
Physician claims
credit at ABIM,
and ABIM
contacts sponsor
to verify
Physician claims
credit at ABIM. No
sponsor
verification
Organizational
sponsor sends
physician
information to
Boards
Standards for Portfolio Sponsors
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7.
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Commitment to supporting physician involvement in MOC
Demonstrate past success in improving quality of care
Be committed to using QI to address gaps in quality of care
Make QI training and educational opportunities available
Have the infrastructure to support the Portfolio Program
Be HIPAA compliant
Contribute to the QI body of knowledge
Organizational Application Process & Finances
» Application
www.mocportfolioprogram.org
• Organizational readiness checklist
• Organizational Profile (overview of organization and QI
infrastructure)
• 3 Quality Improvement Efforts
• Participation Agreement
» Finances (subject to change)
• $1,000 to apply
• $5,000 to participate (if approved) for 2 years
• $5,000 to renew participation for 2 years
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AQI Program Requirements
 Focus on clinical topics related to a national priority,
regional initiative or local gap in patient care and relevant
to ABIM board certified physicians
 Identify specific organizational and activity-level goals
and objectives
 Incorporate robust QI resources and/or tools directly
related to the program objectives
 Engage physicians in making a change to a system or
process of care
 Require sufficient and active participation by physicians
in all stages of the activity
Telling Physicians about your AQI Program
We list it on our
website
We provide a
link to you
We provide you
with a badge
Self-Directed PIMs
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This PIM supports individual physicians or a group
of physicians to complete a quality improvement
activity using quality data they already receive or
gather
Incorporates a library of commonly used quality
measures for ease of reporting, and physicians
can also submit their own measures
Process:
1. Review your data (not provided by ABIM)
2. Make a plan for improvement.
3. Test the impact of your plan.
4. Reflect on what you have done.
Completed Project PIM
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This PIM allows physicians to report on a quality
improvement activity they have already completed
Uses the same library of measures as the SelfDirected PIM
Process:
1. Complete your project in your practice
2. Order and complete the CP-PIM within 2 years
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Designed to take about 20 minutes, and must be
completed by an individual physician
Newly Introduced: Patient Safety & Patient Voice
 ABIM Board Certified physicians need to
complete these requirements every five years
 Activities currently approved for credit can be
found on ABIM’s website
 More activities will be approved to satisfy this
requirement in the future
 Physicians will be able to self-attest to meeting
these requirements
Obtaining a Letter of Support
 For organizations looking to design their program
with MOC in mind, ABIM can provide a letter of
support
 For participants interested in receiving a letter,
please e-mail us at [email protected]
advising of your interest and if there is a particular
ABIM program you might look to target
Questions
For any questions following the webinar, please
visit abim.org/supportQI or e-mail us at
[email protected]