Archive for June, 2011

Quotes

June 30, 2011

If you want to lift yourself up, lift up someone else.  -Booker T Washington

CME AMA PRA Category 2 Credit™

June 27, 2011

AMA PRA Category 2 Credit

The AMA recognizes that there are other educational experiences that may not be developed by an accredited CME provider or may not qualify for direct credits, but that do provide valuable learning for the physician. Examples of such activities include:

• Teaching residents, medical students or other health professionals

• Unstructured online searching and learning (i.e., not Internet PoC)

• Reading authoritative medical literature

• Consultation with peers and medical experts

• Group discussions

• Self-assessment activities

• Medical writing

• Preceptorships

• Research

• Participating in live activities not designated for AMA PRA Category  CreditParticipation in an activity listed above may be claimed by the physician for AMA PRA Category 2 Credit™ if all three of the following are true:

1) The activity complies with the AMA definition of CME.

2) The activity complies with the AMA ethical opinions on gifts to physicians from industry and ethical issues in CME (i.e., is not promotional)

3) The activity is determined by the physician to be a worthwhile learning experience related to his or her practice.Accredited CME providers may not designate activities for AMA PRA Category 2 Credit. These must be claimed and documented by the physician learner. Recording AMA PRA Category 2 Credit activities is important, as these credits may count toward meeting the requirements for the AMA PRA, as well as for licensing and other credentialing requirements. When claiming AMA PRA Category 2 Credits, physicians should calculate the number of credits based on the number of hours of participation rounded to the nearest quarter hour (e.g., 85 minutes of participation amounts to .5 AMA PRA Category 2 Credits).

Summary

To receive AMA PRA Category  and AMA PRA Category 2 Credits, it is important for physicians to recognize that:

•  AMA PRA Category  Credit is the most common metric for verifying participation in CME.

•  AMA PRA Category  Credit can be awarded only by ACCME- or SMS accredited CME providers or by the AMA itself.

•  Legitimate AMA PRA Category activities can be identified by use of the trademarked term “AMA PRA Category  Credit™.”

• Accredited CME providers may designate (in advance) AMA PRA Category  Credit for a variety of formally planned learning activities, but no activities may be designated for credit retrospectively.

• Physicians may claim AMA PRA Category  Credit directly from the AMA for specific learning experiences that can be documented and that are not formally sponsored by an accredited CME provider.

• It is physicians’ ethical responsibility to claim credit only commensurate with their participation in the activity.• Physicians must maintain their own records of CME credits earned.

• AMA PRA Category 2 Credits may be used to meet the requirements for both AMA PRA and for other credentialing purposes.

There are three easy ways to get additional information about AMA PRA credit and the AMA Physician’s Recognition Award:
Visit http://www.ama-assn.org/go/pra
E-mail pra@ama-assn.org
Call 312.464.4672
Copyright 2007 American Medical Association. All rights reserved. Permission
is granted to any individual or entity to copy and distribute this material as
long as the copyright statement is included, the contents are not changed, and
the copies are not sold or licensed or included in any publication that is sold
or licensed. Any use of this material to imply AMA approval or endorsement of any 
program is specifically prohibited.

Quotes

June 23, 2011

“Nothing in life is more important than the ability to communicate effectively.”  – Gerald R Ford, 38th President of the United States

CME AMA PRA Category 1 Credit™

June 20, 2011

AMA PRA Category 1 Credit™ is commonly recognized as one of the metrics for verifying a physician’s participation in continuing medical education (CME) activities. These and other types of credit—such as the American Academy of Family Physicians Prescribed and Elective credits, the American Osteopathic Association CME credits, or the American College of Obstetricians and Gynecologists Cognate credits—are accepted by many credentialing bodies for meeting various CME requirements. These bodies include licensing boards in 46 states, as well as specialty boards, the Joint Commission and other credentialing entities.

Organizations recognized to award AMA PRA Category 1 Credit

AMA PRA Category  Credit may only be awarded by the AMA or by CME organizations/providers accredited by the Accreditation Council for Continuing Medical Education (ACCME) or a recognized state medical society (SMS). Visit www.accme.org for a list of the approximately 2,500 recognized providers.

Identifying legitimate AMA PRA Category 1 Credit activities

Physicians should be aware that some non-accredited organizations advertise “Category  Credits” but these are not the same as “AMA PRA Category 1 Credit™.” When selecting CME activities, physicians should be certain the credit is being awarded by an accredited CME provider. Accredited CME providers are required to have two statements on their promotional materials. One must state the source of their accreditation (ACCME or SMS) while the other designates the maximum number of AMA PRA Category Credits for the activity. To help physicians identify legitimate AMA PRA Category activities, the AMA requires its CME providers to trademark the credit phrase (“AMA PRA Category 1 Credit™”). If credit is not indicated in this manner, physicians should question whether the activity is in fact eligible for AMA PRA Category  Credit.

Recognition of new methods of learning

Since the inception of the AMA PRA credit system, the AMA has sought to recognize a variety of CME activities in which valid learning occurs and for which physician participation can be documented. Originally recognition was limited to live activities, enduring materials and journal CME. In recent years, the AMA has expanded the types of activities that may be awarded AMA PRA Category  Credit. While credit for most of these activities is awarded by accredited CME providers, there are some activities that require the physician to apply directly to the AMA for credit. It is important for the physician to recognize all of the types of learning activities for which CME credit may be awarded, to claim credits from the accredited CME providers or from the AMA, and to maintain a complete record of his or her accrued CME credit.

Learning activities that are planned by accredited CME providers

CME providers who have achieved ACCME or SMS accreditation are granted the privilege to designate/award AMA PRA Category  Credits for the activities outlined below if such activities meet all requirements prescribed by the AMA. These formally structured activities must be reviewed and designated for credit in advance of physician participation. CME providers must not designate or award credits retrospectively; this practice may warrant the withdrawal of the accredited CME provider’s privilege to award credits. The CME provider will indicate to physicians how to claim credit for each type of activity.

Activities for which accredited CME providers can designate/award credit include:

Live activities: These are CME activities that physicians must attend (in person or virtually), such as national conferences, live Internet teleconferences, local workshops, seminars, grand rounds or departmental scientific meetings. Credit is awarded based on each hour of participation claimed by the physician rounded to the nearest quarter-hour or 0.25 credit. Accredited providers may also award credit to faculty for live activities in the ratio of two credits for each hour of presentation.

• Enduring materials: These include CME activities such as printed, recorded, audio, video and/or online/electronic activities planned as educational activities. Providers designate credit based on a good faith estimate of the amount of time it will take a physician to complete the activity. Credit is awarded based on each hour of participation claimed by the physician rounded to the nearest quarter-hour or 0.25 credit.

• Journal-based CME learning: These represent CME activities within a peer-reviewed, professional journal designated for credit by an accredited CME provider (e.g., the Journal of the American Medical Association). A maximum of one credit is awarded for completion of each designated article.

• Test item writing: Another CME activity includes researching, drafting and defending potential questions for examinations given by the National Board of Medical Examiners or a member board of the American Board of Medical Specialties (ABMS®), or for peer-reviewed, published self-assessment educational activities from a national medical specialty society. A physician may be awarded a maximum of 0 credits for completion of each test item writing activity.

• Manuscript review (for journals): This includes CME activities in which journal manuscripts indexed by MEDLINE® are critically reviewed under the direction of an editor working with an accredited CME provider. A physician may be awarded a maximum of three credits for completion of each manuscript review.

• Performance improvement (PI) learning: These are CME activities involving a structured, three-stage process by which a physician or group of physicians can: () learn about specific performance measures and retrospectively assess their practice; (2) implement interventions to improve their outcomes; and (3) re-evaluate their performance. With PI CME, a physician may be awarded five credits for completion of each of the three stages of PI CME that he or she is actively engaged in, with an additional five credits being awarded if a physician completes all three stages in sequence. The PI CME learning model integrates performance improvement interventions as part of an educational activity. The PI model of CME recasts the important role that CME can play in changing/measuring physician performance. It is anticipated that participation in PI CME activities as planned by accredited CME providers will be recognized by specialty boards as meeting the requirements for Part IV of Maintenance of Certification Performance in Practice. PI CME may also be accepted as meeting other requirements for performance data, such as Centers for Medicare & Medicaid Services pay for performance and eventually maintenance of licensure. Physicians can advance the development of PI CME by working with accredited CME providers to encourage the development of these activities.

• Internet point of care learning (PoC): This form of CME activity represents structured, self-directed online learning by physicians on topics relevant to their clinical practice. Learning for this activity is driven by a reflective process in which a physician must document his or her clinical question, the sources consulted and the application to practice. A physician may be awarded 0.5 credits for completion of the three-step learning cycle.

•Other activities: Additional structured activities, such as committee learning or learning plans/contracts, that are developed in accordance with all appropriate AMA PRA rules may be designated for CME credit.

Learning activities recognized directly by the AMA

Certain activities have been recognized by the AMA as valuable learning experiences that are not formally sponsored by an accredited CME provider. The AMA will directly award credit for these activities when all required documentation is submitted. ACCME-/SMS-accredited CME providers may not award credits for these activities; credit may only be awarded by applying directly to the AMA (www.ama-assn.org/go/cme).

Other educational activities recognized by the AMA for CME credit include:

• Faculty may claim two AMA PRA Category  Credits for each hour they present at a live activity designated for such credit. Credit may be claimed in 5 minute or 0.25 credit increments.

• Publishing articles (publishing, as a lead author, an article in a journal included in the MEDLINE bibliographic database; 0 AMA PRA Category  Credits per article)

• Poster presentations (preparing a poster presentation, which is also included in the published abstract, for a conference designated for AMA PRA Category  Credit; five AMA PRA Category  Credits per poster presentation)

• Medically related advanced degrees (25 AMA PRA Category  Credits)

• ABMS® member-board certification, recertification and/or maintenance of certification (recognizes the educational effort associated with successfully completing an ABMS board certification process; 25 AMA PRA Category  Credits)

• Accreditation Council for Graduate Medical Education (ACGME)–accredited education (recognizes the educational effort associated with successful participation in an ACGME-accredited residency or fellowship program; 20 AMA PRA Category  Credits per year)

• Independent learning (credit varies depending on the details of the approved project)

Claiming AMA PRA Category 1 Credit and maintaining CME records

It is important for physicians to recognize their ethical responsibility to only claim CME credits commensurate with their actual participation in any CME activity. Accredited CME providers are expected to award AMA PRA Category  Credits based on the amount of credit claimed by the individual physician rather than awarding the maximum amount of credit designated for the activity. This is why CME providers ask physicians how many credits are being claimed before issuing certificates or transcripts. Physicians should claim credit immediately upon completion of the activity.There is currently no central repository for collecting and maintaining a record of a physician’s CME credits. Some hospitals and medical societies do provide tracking services for physician members, but because physicians obtain CME from many sources, these systems depend on physician self reporting to be complete. Ultimately each physician must be responsible for maintaining his or her own records of participation in CME.

There are three easy ways to get additional information about AMA PRA credit and the AMA Physician’s Recognition Award:
Visit http://www.ama-assn.org/go/pra
E-mail pra@ama-assn.org
Call 312.464.4672
Copyright 2007 American Medical Association. All rights reserved. 
Permission is granted to any individual or entity to copy and distribute 
this material as long as the copyright statement is included, the contents
are not changed, and the copies are not sold or licensed or included in any
publication that is sold or licensed. Any use of this material to imply AMA 
approval or endorsement of any program is specifically prohibited.

Quotes

June 16, 2011

“To succeed…you need to find something to hold onto, something to motivate you, something to inspire you.”  – Tony Dorsett

How To Keep Track of CME Hours

June 13, 2011

You need to keep track of the CME Hours you do for reporting purposes.  We suggest creating a form that will be useful for you and/or your physicians to record their CME hours.  This is NOT an official form of the Texas Medical Board and is NOT required for compliance with the CME requirements.  Please understand, that if used, the guidelines for the form below should be retained as a personal record keeping process only.

CME Activities Completed

Name:  ____________________________________

License Number:  _______________________________

From:______________________, 201____  (date of current license)

To: ________________________, 201____   (date of next registration)

Activity Title: ____________________________________________________________

Date: _____________________________

# of Credits:  _________________________

Type of Credit (AMA, AAFP, AOA):  ___________________________________________

Texas Physicians may complete up to 12 hours (of the required total 24 hours every 12 months).

At least 12 hours every 12 months, including 1 hour of ethics and/or professional responsibility education, must be completed through participation in formal CME activities, but all 24 hours may be completed in this category.  Formal CME activities are defined as conferences, seminars, symposia, case conferences, grand rounds, educational presentations, self-study courses or materials, etc. which are:

  • Designated for Category 1 credit of the Physician’s Recognition Award of the American Medical Association
  • Approved for prescribed credit by the American Academy of Family Physicians
  • Designated for Category 1A and 2B credit of the American Osteopathic Association

Informal activities are not always provider verifiable. If available, retain brochures, computer transcripts or certificates of attendance. If not available, maintain a personal log of activities completed. The following may be reported as informal hours:

  • Conferences, seminars, grand rounds, case conferences, journal clubs, etc. not designated for formal credit. Record activity title; date; and clock hours expended.
  • Self instructional materials or courses not designated for formal credit and self-assessment examinations and reviews. Record activity/course title; date of use; and clock hours expended.
  • Reading clinically relevant medical journals or articles and use of literature search databases in connection with the provision of patient care. Record name of publication or data base utilized; date read/used; clock hours expended.
  • Participation in patient care review activities (peer review or hospital quality of care review committees); research/preparation time for medical presentations delivered to health professionals; Up to 10 hours may be claimed for: publication of a medical or medically related article; for each chapter of a medical or medically related book or other medical education materials; preparation of an exhibit displayed at a scientific medical meeting or other CME activity.
    Articles must be published in a recognized medical journal that is primarily read by physicians or other health professionals. Credit may be claimed only once for publications or exhibits even if it is reissued in a changed format. Record the type of activity; date completed; and clock hours expended.
  • Up to 6 hours may be claimed for volunteer services at a site serving medically underserved populations, as defined in the Medical Practice Act. The volunteer hours should be a site other than the physician’s primary practice location.

Quotes

June 9, 2011

“One isn’t necessarily born with courage, but one is born with potential. Without courage, we cannot practice any other virtue with consistency. We can’t be kind, true, merciful, generous, or honest.”   – Maya Angelou

Rules for Formal & Informal CME Credits for Texas Physicians

June 6, 2011

Formal Activities

At least 24 credits every 24 months, including 2 credits of ethics and/or professional responsibility education, must be completed through participation in formal CME activities, but all 48 hours may be completed in this category. This includes conferences, seminars, lecture presentations, grand rounds, case conferences, self-study courses, etc. which are formally designated for credit as:

1.  Category 1 of the Physician’s Recognition Award of the American Medical Association
2.  Prescribed credit of the American Academy of Family Physicians
3.
Category 1A and 2B credit of the American Osteopathic Association

Brochures or promotional materials for CME activities and self instructional courses or materials will carry a specific statement advising physicians if the activity has been approved for any of the above types of credit.

Whether a particular hour of CME involves the study of medical ethics and/or professional responsibility will be determined in the course planning by a CME provider accredited by the Accreditation Council for Continuing Medical Education or a state medical society; the American Academy of Family Physicians; or an accredited CME provider approved by the American Osteopathic Association.

Documentation of Formal Activities

Documentation of attendance at formal CME activities can be obtained from the provider of the activity in the form of a CME reporting form, attendance certificate, CME transcript or letter of verification of attendance.

Documentation to verify attendance should not be submitted to the Texas Medical Board with the application for registration. Documentation, however, should be retained by the physician for reference in reporting CME hours completed and in the event that verification is requested by the board in a random audit of compliance.

Informal Activities

Physicians may complete up to 24 credits (of the required total 48 hours every 24 months) by participating in informal CME activities. The following may be reported as informal credits:

  • Conferences, seminars, grand rounds, case conferences, journal clubs, etc. not designated for formal credit. Record activity title; date; and clock hours expended.
  • Self-instructional materials or courses not designated for formal credit and self-assessment examinations and reviews. Record activity/course title; date of use; and clock hours expended.
  • Reading clinically relevant medical journals or articles and use of literature search databases in connection with the provision of patient care. Record name of publication or data base utilized; date read/used; clock hours expended.
  • Participation in patient care review activities (peer review or hospital quality of care review committees).
  • Research/preparation time for medical presentations delivered to health professionals.
  • Up to 10 hours may be claimed for: publication of a medical or medically related article; for each chapter of a medical or medically related book or other medical education materials; preparation of an exhibit displayed at a scientific medical meeting or other CME activity.  Articles must be published in a recognized medical journal that is primarily read by physicians or other health professionals. Credit may be claimed only once for publications or exhibits even if it is reissued in a changed format. Record the type of activity; date completed; and clock hours expended.
  • Up to 6 hours may be claimed for volunteer services at a site serving medically underserved populations, as defined in the Medical Practice Act.  The volunteer hours should be at a site other than the physician’s primary practice location.

Informal activities are not always provider verifiable. If available, physicians should retain transcripts or certificates of attendance. If not available, the attached log sheet may assist in maintaining a personal record which could easily be submitted to the Texas Medical Board if requested.

Excess Hours Carried Forward

Excess formal or informal credits earned in one 24-month period may be applied toward the registration period’s requirements. A maximum of 48 excess credits may be carried forward and these credits must be applied within two years following the date of the registration period during which they were earned. A licensee under a two-year license period may apply up to 24 CME hours retroactively to the preceding year’s annual requirement.  These hours may be counted only toward one registration period.

Presumed Compliance

A physician will be presumed to have complied with the CME requirement if in the preceding 36 months he/she becomes board certified or recertified in a medical specialty. The TMB has determined that the activities undertaken to become boarded or recertified exempt the physician from all CME requirements. This exemption is valid for one registration period only.  Physicians in residency/fellowship training or who have completed such training within six months prior to the license expiration date will satisfy the formal and informal CME requirements by their residency or fellowship program.

Retired Physicians

Retired physicians “on official retired status” with the Texas Medical Board will not be required to report CME activities. Physicians who are retired from practice but wish to retain an active license must meet the CME requirement.

Exemption Request

Exemptions are subject to the approval of the executive director of the Texas Medical Board and must be requested in writing at least 30 days prior to the expiration date of the license.

An exemption may be requested for the following reasons:

  1. catastrophic illness
  2. military service of longer than one year’s duration outside Texas
  3. medical practice and residence of longer than one year’s duration outside the U.S.
  4. good cause on written application of the licensee that gives satisfactory evidence to the board why the physician is not able to comply

Noncompliance

Failure to obtain and report 48 credits of CME every 24 months at the time of license renewal will result in nonrenewal of the license until the physician obtains and reports the required CME hours. However, the executive director of the board may issue a temporary license for a period of up to 30 days to the physician who has not complied with the CME requirement. Note that this 30 day extension through the temporary license is at the discretion of the executive director and is not an automatic grace period. The temporary license not only allows the board time to verify the accuracy of information related to the physician’s CME hours, but also allows the physician an opportunity to correct any deficiency so as not to terminate ongoing patient care. CME credits which are obtained during the 30 day grace period after the expiration of the licensee’s permit to comply with the CME requirements for the preceding two years, shall first be credited to meet the CME requirements for the previous registration period and then any additional credits obtained shall be credited to meet the CME requirements for the current registration period.

Failure to comply with the CME requirement for renewal of a license invokes the monetary penalty for late registration and may invoke Administrative Penalties as determined by the Disciplinary Process Review Committee of the board.  A false report or statement to the board regarding CME hours is basis for disciplinary action by the board.

Log Sheet

A log sheet needs to be made to record CME Credits.  Create your own or you may obtain additional copies  that are also available from the Texas Medical Association’s continuing medical education office.

Quotes

June 2, 2011

“The bad news is time flies. The good news is you’re the pilot.”   – Michael Altshuler