Webinar
December 10, 2014
1

Webinar Instructions
 Please enter your audio code when logging onto the presentation
 All attendees will be muted during the actual presentation
 Please ask questions using the questions section of GoToMeeting
 ABIM staff will respond to questions after the presentation

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 strategic plan adopted by the Board of Directors on June 5, 2007
4

What are the Specialty Boards?
State
Licensing
Boards
Mandatory
Specialty
Societies
Voluntary
Government-run or sanctioned
Not specialty specific
Membership-run
Specialty
Certification
Boards
Voluntary
Independent nonprofits
Specialty specific Specialty specific
Grant licenses to practice medicine
Serve members with education and advocacy
Define disciplines and set standards for those disciplines

 Allergy & Immunology
 Anesthesiology
 Colon/Rectal Surgery
 Dermatology
 Emergency Medicine
 Family Medicine
 Internal Medicine
 Medical Genetics
 Neurological Surgery
 Nuclear Medicine
 Obstetrics & Gynecology
 Ophthalmology
 Orthopedic Surgery
24 Member Boards
Certify more than 750,000 physicians
 Otolaryngology
 Pathology
 Pediatrics
 Physical Medicine
& Rehabilitation
 Plastic Surgery
 Preventive Medicine
 Psychiatry & Neurology
 Radiology
 Surgery
 Thoracic Surgery
 Urology

The Breadth of Internal Medicine
•
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


 practicing physicians in US
Board Certified Physicians
More than 150,000 diplomates
More internists than any other

 Certify 1 of every 4
More than 200,000 ABIM enrolled in MOC 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
• 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.
9

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
10

11
*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
12

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
 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
Yes
Self-Directed and Completed
Project PIM
Sponsor organization application?
Application Fee
Specialties
Included
Yes
Yes
19 ABMS Boards
Scope of Program Multiple QI projects
Verification and
Credit Process
Organizational sponsor sends physician information to
Boards
No in 2015
ABIM
Single QI project
Physician claims credit at ABIM, and ABIM contacts sponsor to verify
No
N/A
ABIM
Single QI project
Physician claims credit at ABIM. No sponsor verification

1.
Commitment to supporting physician involvement in MOC
2.
Demonstrate past success in improving quality of care
3.
Be committed to using QI to address gaps in quality of care
4.
Make QI training and educational opportunities available
5.
Have the infrastructure to support the Portfolio Program
6.
Be HIPAA compliant
7.
Contribute to the QI body of knowledge
17

18
» Application
• Organizational readiness checklist www.mocportfolioprogram.org
• 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

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

 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.

 This PIM allows physicians to report on a quality improvement activity they have already completed
 Uses the same library of measures as the Self-
Directed PIM
 Process:
1.
Complete your project in your practice
2.
Order and complete the CP-PIM within 2 years
 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 qualityimprovement@abim.org
advising of your interest and if there is a particular
ABIM program you might look to target

For any questions following the webinar, please visit abim.org/supportQI or e-mail us at qualityimprovement@abim.org