ACCME vows crackdown, calls for "new paradigm" in CME

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Days before a critical AMA House of Delegates vote on commercial support of CME, the Accreditation Council for Continuing Medical Education (ACCME) vowed to crack down on errant providers and proposed a “new paradigm” for commercial support.

Urging that “due consideration be given to the elimination of commercial support,” ACCME cautioned that “the debate should not go on without discussion of alternatives as nothing would be worse than the deconstruction of a system without the identification of alternatives.” 

ACCME proposed a “new paradigm” wherein: 
  • Needs assessments are performed by organizations that do not receive commercial support or have relationships with industry, such as government agencies;
  • Practice gaps are corroborated by bona fide performance measurements of the learners' own practice, such as the National Quality Form;
  • Content comes from curricula specified by medical societies and agencies such as the AMA, AHRQ, ABMS, FSMB, and;
  • CME is verified as being free of bias. 

Alternately, the group said, “these conditions could provide a basis for a mechanism to distribute commercial support derived from industry-donated, pooled funds.”

In the meantime, ACCME vowed to put more accredited providers on probation, particularly those found in violation of its Standards for Commercial Support, and said the rate of probation has increased to about 10% of providers seeking reaccreditation from 1% in the past. Providers found to be non-compliant with ACCME requirements will be asked to implement changes within weeks rather than months and to establish an improvement plan followed by verification of improvements within a year. The council's inquiry process “is now focusing on the early stages of interaction between commercial supporters and accredited providers,” who “cannot receive guidance, either nuanced or direct, on the content of the activity or on who should deliver that content.” Prohibited “guidance” includes “communications from commercial interests announcing or prescribing any specific content that would be a preferred, or sought after topic for commercially supported CME …. As such communication would be considered ‘direct guidance on the content of the activity.'” Also off-limits: “Communications…regarding a commercial interest's internal criteria for providing commercial support.”

ACCME is soliciting comments on the guidance and its “new paradigm” proposal. 

On Sunday, an AMA committee is scheduled to vote on a proposal by the group's Council on Ethics and Judicial Affairs calling for an end to commercial sponsorship of CME. 
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