THE AMERICAN BOARD

of PEDIATRICS

VIRGINIA A. MOYER, MD, MPHVICE PRESIDENT, MOC AND QUALITY

MOC *This presentation is intended solely for the educational purposes of the ABP. Please refrain from extracting its content to use in presentations. If you should desire such resources, requests can be made by emailing us at moc@abpeds.org.

THE AMERICAN BOARD

of PEDIATRICS

•For the first year (1933), an oral exam, then•A written exam followed by an oral exam•= Permanent certification•Irrevocable (almost)

In the Beginning…

THE AMERICAN BOARD

of PEDIATRICS

The Evolution of Board Certification

ABP certifications were issued without

any end dates= permanent certificates

Beginning in 1988, diplomates were obligated to pass a test of knowledge

every 7 years and oral exams were eliminated

Certificates issued 2003-2009 had end-dates and

required diplomates to pass a test of knowledge every 10 years and to complete one Part 2 and one Part 4

activity

Certificates issued 2010 and forward have no end-date, and

require diplomates to pass a test of knowledge every 10 years and to earn 100 points in Part 2 and Part 4 activities every 5 years

1988 2003 2010

THE AMERICAN BOARD

of PEDIATRICS

Part 1 – Professional Standing Patient care, Interpersonal & communication skills, Professionalism

Part 2 – Knowledge Assessment Patient care, Medical knowledge, Practice-based learning & improvement, Systems-based practice

Part 3 – Cognitive Expertise Medical knowledge (the exams)

Part 4 – Performance In Practice Patient care, Practice-based learning & improvement, Interpersonal & communication skills, Professionalism, Systems-based practice

MOC is based on the 6 Core Competencies

THE AMERICAN BOARD

of PEDIATRICS

Every 5 years: 1. Document licensure status 2. Earn a total of 100 points of MOC activities: • Part 2 (Knowledge Self Assessment) – at

least 40 points• Part 4 (Quality Improvement) – at least

40 points• + 20 points from either Part 2 or 4

3. Enroll in the next MOC cycle

Keep your email address up to date!

Every 10 years: A secure examination in each area of certification

Note: General Pediatric certification is not needed to maintain a specialty certification (such as Neonatology)

General Peds exam is given 11½ months per year

Specialty exams are given for 4 weeks in the spring and 6 weeks in the fall.

Basic MOC Requirements

THE AMERICAN BOARD

of PEDIATRICS

• A single, all-inclusive fee every 5 years to maintain one certificate: Includes one “ticket” for an MOC exam every 10 yearsNo additional fee for ABP-developed MOC activities

•A second certificate requires an additional exam (with a fee) but does NOT require any more MOC activities or feesThe MOC cycle belongs to the person, not the certificate

• Whatever the process is when you enroll for a given cycle, it will not change for you during that cycleAny changes will apply to the next cycle

Commitments to Diplomates

THE AMERICAN BOARD

of PEDIATRICS

•Must hold an unrestricted license to practice medicine in a US state or a Canadian province. No license can have a disciplinary action against it. •Certificates are revoked for disciplinary actions against a license, or for unprofessional behavior (such as felony convictions)•How to promote and assess professionalism is a topic of much discussion in the Boards community•Focus of ABP Education and Training Committee

Professionalism/Professional Standing (Part 1)

THE AMERICAN BOARD

of PEDIATRICS

• Internally developed activities (n > 50): General Pediatrics Knowledge Self-assessment Specialty knowledge self-assessments Question of the Weeko Note: no additional charge for ABP activities, or for CME associated with these activities

• Externally developed activities (n > 100) PREP (general and subspecialties) IHI Open School courses Many other organizations, including many CME courses o External organizations can charge for their activities

• Currently investigating ways to expand: CITI, other CME activities that include self assessment

Lifelong Learning and Self-assessment(Part 2)

THE AMERICAN BOARD

of PEDIATRICS

• QI projects originating in the workplace• Led by individual diplomates• Sponsored by institutions or organizations

• Credit for Quality Improvement (QI) projects published in peer-reviewed articles or as posters/platforms

• Web-based QI projects ABP Performance Improvement Modules (PIMs) AAP EQIPP – FREE to FAAPs Other organizations (NASPGHAN)

Improvement in Practice (Part 4)

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•Over 1000 institutional QI projects have been approved from more than 150 organizations•Portfolio sponsors can approve projects on behalf of ABP

41 Pediatric portfolio sponsors (CHOP, Cinti, ICN) 61 Multispecialty portfolio sponsors (Seattle, Nationwide,

Mayo) Many more in the pipeline

Improvement in PracticeSponsored by institutions/organizations

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of PEDIATRICS

•Small Group Quality Improvement Projects (completed) 25 points This allows up to 10 diplomates to receive credit for a project they have already

completed. The review and processing fee is $75 per project (not per diplomate) •Proposed QI project

This allows a diplomate or team to submit a proposal and receive feedback and coaching if desired to develop a new project. There is no fee for this service.

•NCQA PCMH 40 points This allows diplomates whose practices achieve NCQA PCMH designation to

receive credit for the QI work that is entailed. There is no fee. •QI Program Development 40 points

This allows diplomates with expertise in quality and safety who lead large (usually institutional) QI initiatives to receive credit for their leadership. Review and processing fee is $150 per individual.

Pathways launched May 2015

THE AMERICAN BOARD

of PEDIATRICS

•New MOC Landing page and search functionality •MOC for Residents/Fellows •Highly specialized, single-purpose portfolios (eg, BMJ Quality, REACH Institute, APPD Learn)•Repeat credit for approved projects A diplomate who continues to participate in long term, substantial QI

projects is eligible for Part 4 credit each time he or she meets participation requirements

•Revised criteria for “meaningful participation” •Lower processing fees

Other new initiatives and recent changes:

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of PEDIATRICS

Residents can now earn Part 4 MOC credit during residency for meaningful participation in QI activities (just like a diplomate) PIMs and other online modules Approved QI projects in institutions and organizations Authorship of qualifying QI articles or posters/platform presentations

Resident MOC credit will be “in the bank” for when they become certified. Accumulated credit will then be applied to their first 5-year MOC cycle. Residents can access other ABP Part 2 activities (e.g. self assessments and QOW), but will not receive bankable credit for any Part 2 activities.

MOC for Residents

THE AMERICAN BOARD

of PEDIATRICS

In order to receive credit, each diplomate attests to meaningful involvement in the work, by meeting 4 criteria: Be intellectually engaged in planning and executing the project.Participate in implementing the project's interventions (the changes designed to improve care).Review data in keeping with the project's measurement plan.Collaborate actively by attending team meetings.

Meaningful involvement in improvement efforts

THE AMERICAN BOARD

of PEDIATRICS

•Redesign of the PIM platform to be more course-like and user-friendly (Fall 2015 forward)•New QI application pathway tailored to improvements in medical education (Spring 2016) Is expected to include a pathway utilizing the ACGME NAS annual

program evaluation•Examplar applications that focus on Improvement in Professional Practice (eg, improvement in education, in research processes, etc)

What else is in the works: