THE AMERICAN BOARD of PEDIATRICS VIRGINIA A. MOYER, MD, MPH VICE 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 ing us at

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 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

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 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 years  No 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 fees  The 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 cycle  Any 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 Week o 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)

THE AMERICAN BOARD of PEDIATRICS 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 Practice Sponsored by institutions/organizations

THE AMERICAN BOARD 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:

THE AMERICAN BOARD 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: