Outgoing president George Mejicano kicked things off at the Alliance for Continuing Education in the Health Professions annual meeting with a quick walk-through of the work that ACEHP has done in the past year. In addition to changing its name (Mejicano revealed a new logo with the wave of a Harry Potter-inspired magic wand) and enacting a new bylaw that allows two new members to join the board, the new national disclosures system is on schedule for rollout this year, and the Alliance is also gearing up to launch a research institute. Another change for 2012, though not quite as happy a change as far as I’m concerned, is that Paul Weber, who has done an outstanding job as the Alliance’s executive director, is retiring in May. I hope to catch up with Paul this afternoon and get some of his thoughts on his time with the organization, so more on that later.

Gabrielle Kane, president of the Society for Academic CME, then took to the stage to talk about the “family reunion” feeling of working with ACEHP, with the support of a healthy grant from Pfizer specifically aimed at improving research in CME. She outlined the SACME research agenda, which is based on two main projects at this point: A literature review to identify gaps and guide new research; and a taxonomy project. She invited Alliance members to participate in both.

My first full day at the Alliance for Continuing Education in the Health Professions annual conference, going on now in Orlando, was packed. Some notes on the meeting as a meeting.

I’ll get the whining out of the way first:

-Yes, I already have stuffed-brain syndrome from having way too much thrown at me in too little time with no connection between session topics and no time for reflection built in.

-We hit the “I know you can’t read this slide, but…” wall before the first general session was over.

-We hit the “I know this classroom setup makes it almost impossible to break into small groups, but we’ll have to do our best…” shortly thereafter.

-Healthy food is good, but replacing the chips with bean salad and the cookie with an apple in the bag lunch seems a bit over the top. Must we resort to Starbucks for all our dietary sins?

-Speaking of over the top, is it just me, or are there way too many sessions to choose from? I know, tough problem to have, but I’m finding myself torn between six or seven I want to go to in every single time slot. It’s making me crazy to be missing so much good content (and hearing people tweet about some of those sessions to the #acehp12 hashtag just makes it worse).

Awesome aspects, meeting-wise:

-Free WiFi! Thanks to Bernie Halbur, PhD, FACME, ACEHP’s Professional Development & Meeting Management Director, for making it happen, along with everything else we’re enjoying logistically. I gave her a standing ovation when she was recognized yesterday at the general session, and I wasn’t the only one.

-Love having the brief outdoor breezeway walk to the exhibition area, and the tables set up for eating/hanging out/computing along the way. At least we’re assured of the opportunity to catch five minutes or so of the gorgeous Florida weather as we go back and forth, instead of never even knowing if the sun is shining or not, as so often happens at marathon meetings.

-Beautiful hotel (the JW Marriott), beautiful rooms, nice jogging path, great fitness center. I don’t know much about golf, but the course looks good to me.

-Being able to hold the new CCMEP celebration out on the patio last night was a wonderful touch. Again, being able to get outside in January means a lot, especially to those of us who hail from the frozen North!

(Cross-posted on face2face.)

I spend a lot of time with continuing medical education providers, but not so much with the meeting planners who make those meetings at which the CME is conducted happen, so it was fascinating to have the chance to sit in on a frank discussion of what their biggest challenges are, and what they are doing to resolve them, as my last session of PCMA 2012.

One thing that seemed to be of huge concern was the idea that exhibitors were going to start asking them to provide physician attendees’ National Provider Identification numbers. Since this is public information, I’m having a hard time understanding why that is the meeting planner’s problem—why can’t the exhibitors just look them up? If someone can explain why this is potentially a big issue for exhibitors, please let me know. I tried to find out from a few folks after the session ended, but everyone was in a rush to leave so I didn’t really get much other than if an exhibitor demands it, it’s their problem. Which I get, but I don’t get why exhibitors would demand this from them. Light-shedding on this would be welcome!

Other big issues were the costs of complying with government regulations and Accreditation Council for CME rules, pressures to find new sources of revenue, building traffic to the exhibition floor, international initiatives (including visa-related challenges), CME credit interchange with other countries, and all the various codes and rules and regulations they are supposed to follow nowadays.

One participant was particularly concerned about the Council of Medical Specialty Societies’ newish ethical code that is designed to limit drug and device company influence over patient care. While similar in many ways to the ACCME’s Standards for Commercial Support, it also prohibits society presidents, CEOs, and editors-in-chief of society journals from having direct financial relationships with relevant for-profit companies in the healthcare sector. One participant said her organization actually had to ask one of its journal editors to resign after her society agreed to abide by the CMSS code.

Sponsorships and exhibit dollars on the decline had most of the crowd at least someone frazzled. As one person said, “With the PhRMA Code, they don’t want to sponsor anything anymore.” Several said their organizations were going the same route as PCMA, offering year-round sponsorships that extend far beyond the meeting rather than providing one-offs on tote bags and banners. (Note: This article offers some good tips on how to get more sponsorship dollars. And here’s another one.) One thing sponsors particularly seem to like, said some participants, is being able to meet with board members and other influential people in the industry at board and other high-level meetings. Some said they give preferential treatment on the show floor to exhibitors that are also in more extensive sponsorship relationships, others said they kept it completely separate.

From what people were saying, I’m not sure they’d buy into this snip of research finding that physicians aren’t eschewing the trade show floor now that the tchotches are out due to PhRMA Code restrictions. It sounds like, for medical meetings as for other types of association conferences, it’s becoming more and more of a push to get people on the show floor and interacting with exhibitors. While product theaters can help, they don’t appear to be a major solution to the exhibition drain problem. As one person said, “The surveys say they value exhibitions, but they don’t go. We give them food, product theaters, we’re even putting the reception on the show floor. Nothing seems to help.”

One said she was going to take the “continue the conversation” idea from PCMA, where a follow-on informal session is held after a keynote so those who want to can dive deeper into the material, only hold it on the show floor. Which is fine, as long as it isn’t for credit, warned another person. Another pointed to a different angle on the problem: Maybe it’s the booths that aren’t so attractive. So that organization offers a consultant who can evaluate exhibitor booths and suggest ways to improve them.

Some said they had added a virtual trade show component as a complement to repurposing educational content from the conference for online distribution, but it didn’t appear that the value was all that high (one said that only 42 percent of virtual attendees visited the virtual exhibit, which I thought actually sounded pretty good. Another said it was more like 25 percent for his group). Streaming the educational session, with or without CME credit attached, live and archived, seemed to be pretty popular among attendees of most of the planners who said they had done it. However, interest dropped off a cliff when members were asked if they would pay for it, one person said (shocking, I know!). Another said she had a good response to charging one fee to get access to all the content, and an additional fee on top of it if they wanted to get CME credit for it.

They didn’t talk a lot about CME educational grants, but one person did point out that, now that pharma budgets for CME grants are shrinking, their ad budgets actually are growing. Accordingly, medical organizations are beginning to put more of their focus on attracting those ad dollars to support the overhead for their meetings.

There was more—a lot more—but I’ll leave this one with two of the wildest promotional ploys I’ve heard of:

One was a company that brought colored chalk and proceeded to draw its logo on the sidewalk in front of the medical conference’s headquarters hotel. Another person told of a company that put its logo on the mainsail of a big sailboat and had it sail up and down the harbor in view of the meeting (I’m not sure if this was in San Diego, but I could see it happening there.)

Note: This is cross-posted at the face2face blog.

I kept forgetting to bring my camera, but I did finally remember to get a few shots on the last day of the National Task Force on CME Provider/Industry Collaboration conference (click to enlarge the thumbnail photos).

Douglas Henley, MD, FAAFP, with the American Academy of Family Physicians, gave the Shickman Lecture: Collaborating for Advances in Professional Education and Patient-Centered Care. He talked about the cacophony of information, guidelines, and data healthcare providers have to contend with, and how med ed professionals can get their attention. For example, he said CME providers should rally behind—and deliver their activities via—plug-and-play, cost-effective healthcare information technology. He also talked about the need for team-based, patient-centered care, and publicly available reporting of conflicts of interest, physician knowledge, treatment options, etc.

I particularly liked this quote: “CME providers can help clinicians understand it’s always going to be a journey, and targets will always be moving. But there are measures that matter. We need to pay attention to the disease states that are most important to healthcare today.”

He also spent some time talking about how social factors, education, law enforcement, agriculture, and environmental policy all equal health policy, since they are all important factors in healthcare. (I’m not sure I bought all of his arguments on this one, especially when he talked about education levels’ correlation with poverty, violence, obesity, smoking, etc.—they’re correlated, but does less education cause these things? I don’t think he made his case.)

Anyway, it was a thought-provoking talk. Which was followed with a panel discussion led by John Kamp, PhD, JD, with the Coalition for Healthcare Communication.

Kamp led Henley and David Hoyt, MD, American College of Surgeons, and Dave Davis, MD, FCFP, Association of American Medical Colleges, in a discussion of where we are and where we’re going. Among the current challenges:

Moving from didactic to using any and all formats that will help docs learn

Moving from physician-centered to team-based activities

Moving from therapeutic-centered topics to prevention, screening, and non-clinical patient treatment

Moving education from the ballroom to workplace learning

Moving from butts-in-seats outcomes to performance and patient health outcomes

Moving from traditional commercial support financial model to more pluralistic models that have all healthcare organizations contributing to CME financing

Moving from CME being a standalone to CME being integrated into the entire organization

Hoyt talked about a surgeon-specific system of educational peer review that allows the surgeons to track their own standings and assess their practices. All in all, it was a good panel discussion, and Kamp kept it on track and provocative.

Here are a few shots from the exhibit area:

On the left is Alexis Weinstein, Healthmatters CME, Colleen Filak, MS, CCMEP, Concordia Healthcare Education (whose tweets I have been enjoying for a while but I hadn’t met her until this conference), and Audrie Turnow, CCMEP, Paradigm Medical Communications, who wrote a great column for Medical Meetings last year on how to beat the post-con blues (i.e., how do you actually do something with what you learned once you’re back in your real life).

Paul Paul Piché, BSc, MBA, and Martin Robert, PhD, HIT Global Inc. (Piché is also president of the board of the Global Alliance for CME, which he said is holding its 2012 meeting in Toronto the day before the 2012 CME Congress.)

Last but by no means least, here are Wendy Turrell, DrPh, CCMEP, Aspire Health Consulting, Debrah Fisher, Alliance for CME, and Mila Kostic, University of Pennsylvania School of Medicine

I loved the interactive case studies (just like I love Medical Meetings’ Ethical Hypothetical case studies). My only complaint is that it took such a long time to get through all the introductory stuff that we ran out of time to do even five cases.

The session on excellence in education—I still have whiplash! Dr. James Holly raced through the Southeast Texas Medical Associates model, which I think I’ll fall in love with once I have a chance to actually look through all his slides and the Setma.com Web site, where he says they post pretty much everything. Basically, its model of care is all about performance-improvement CME, where they continually measure performance over a set of metrics. He urged other providers to just take those first baby steps toward PI CME, whatever the right toddles might be for your specific organization.

I went to the specialty society community of practice breakout session, and it was interesting to see what their hot topics were: quality (in terms of both value proposition and PI CME); innovations in collaborating with all sorts of other organizations; Risk Evaluation and Mitigation Strategy and CME; and strategic planning/visioning. I promised not to write about the specifics of what we talked about, but it was one of the better sessions of the day, I thought.

Speaking of REMS, I got a little lost during the hot topics session on just that subject later in the afternoon. I don’t know if it was due to the post-lunch slump or what, but I’m still not entirely sure I have a good grip on all the issues related to it. I have a feeling REMS will feel a bit nebulous until the FDA publishes its blueprint (or maybe it’s just me). Kudos to the panel for agreeing to come back for a half-hour of informal Q&A between the next session and the reception—I wasn’t the only one who still had lots of questions when we ran out of time during the session.

Thanks to the AAFP’s Mindi McKenna, PhD, MBA, for bringing the discussion back to earth with a great session on the implications of Maintenance of Certification and Maintenance of Licensure for CME collaboration. She also included some audience participation in the form of asking us to respond to questions using an audience response system (did you know that 62 of the 69 licensing jurisdictions require docs to earn CME, or that 15 states currently mandate topic-specific CME? I do now.).

The reception afterward was really nice, too. It seemed to be pretty well-attended, and the crab cakes and conversations both were delicious!

Next up after the keynote was the AMA’s Bette-Jane Crigger, PhD, who walked us through 10 myths about the recently passed CEJA Report 1-A-11.

Call me crazy, but a lot of it seemed to be that famous word-parsing thing that CME professionals tend to do, where meaning gets read into something that perhaps doesn’t deserve it, and where it gets glossed over in areas where perhaps it deserves more attention. Or is just too vague to really draw meaningful conclusions, a not uncommon thing in this field, it seems.

Example: Myth 1 was that the CEJA report prohibits industry support of CME. No, she explained, it doesn’t prohibit it; “The goal is to gain independence from industry support.” Not prohibited, but try to avoid it if at all possible.

Or take Myth 6, that it just duplicates the ACCME’s Standards for Commercial Support. Yes, there are some similarities, she said, but it also offers complementary guidance, since it’s aimed toward physicians, where ACCME’s SCS are for CME providers.

It was interesting, but she really didn’t do any myth-busting. Instead it was more of a comparison of complaints received against the goals the report tried to achieve.

One of the most interesting questions went unanswered: How will this new report affect the criteria for PRA Category 1 credit? That’s still to be determined, she said. Likewise, while it only addresses accredited CME, “the principles should be thought to be equally germane” to other activities (such as those for maintenance of licensure and maintenance of certification) as well.

The National Task Force on CME Provider/Industry Collaboration conference got under way today. My brain is uncomfortably stuffed; if it had a belt, it would have to let it out so all that gray matter could expand to accommodate all the info crammed into it today.

One of my big takeaways was similar to that of the thoughtful CME educator blogger: That perception still trumps reality. He says it better than I could, so I’ll let that one lie.

This morning’s keynoter, Dr. William Carey from the Cleveland Clinic, centered his talk around the thesis that a well-regulated industry/CME relationship benefits patients, healthcare professionals, and the public good. And yet, because so much of the discussion around CME and industry occurs under the circus tent of a media and political theater that doesn’t (and for the most part doesn’t care to) understand all the nuances and firewalls, CME providers still have to deal with misperceptions about what it is they do, and why.

It’s not all black and white, he pointed out. Docs are painted to be so good and pure and patient-centric, and yet who was it who carried out the infamous Tuskegee syphilis experiment? And Big Pharma is thought to be so nasty and self-serving that everything it does is suspect, and yet somehow it manages to produce live-saving drugs, make contributions to charities, and support education that has nothing to do with its product categories.

All this misperception can make moving forward feel like this (my new favorite video!):

Then he went into the latest AMA Council of Ethical and Judicial Affairs 1-A-11 report, which in its fifth iteration the House of Delegates finally passed this summer.

Dr. Carey wound up by polling the audience about the possible impact the CEJA report could have on CME, the results of which Dr. Joseph Kim kindly compiled here.

Other than the video, my favorite part of this session actually came afterward, when we were directed to write down (on a form provided) our key takeaways, and what we planned to do with them, then discuss them with others at our table. There was only one other person at my table (that’s what I get for sitting up front), but we had a great discussion, and who knows, I may actually do some of what I said.

You know you’ve implemented some great ideas into your CME activities—why not get some recognition for your work? You have until September 9 to submit your application (which has been shortened from previous versions) for the Alliance for CME’s Member Sections Great Idea Awards.

You have a bit longer—until October 14—to get in your application for the Alliance’s Distinguished Member/Fellow Awards, which, says the Alliance, “are offered to members through numeric points accumulated for a variety of services within the association. The application can be downloaded and saved to your computer and is formatted to automatically calculate your points.”

I can hear the moans now: The American Medical Association’s House of Delegates has finally approved the latest of its Council on Ethical and Judicial Affairs many versions of proposed recommendations around commercial support and CME. Sigh. I’m with our MM columnist Stephen Lewis on this one: CEJA just officially turned itself into an oxymoron. Never mind what the Alliance for CME thinks, or what I would guess would be the opinion of vast majority of CME providers who actually do this stuff day in and day out.

No, this must mean that at least some of the greater minds at the AMA HOD think it’s a good idea to ignore current safeguards and react to the potential for the perception of some possible problem, rather than base actions on evidence and data.