CMS collaborates on maintenance of licensure pilot projects

Tuesday, May 01, 2012 01:30 PM

JoAnne Wojak, Director, Continuing Medical Education

In March 2011 the Colorado Medical Society Board of Directors recommended that CMS work collaboratively with the Colorado Medical Board (CMB) and the Department of Regulatory Agencies (DORA) on maintenance of licensure requirements for Colorado physicians. This collaboration includes an opportunity for CMS to participate in a Federation of State Medical Boards (FSMB) national pilot project for physician maintenance of licensure (MOL) along with 10 other states that have also volunteered. The FSMB, with input from dozens of stakeholder organizations over many years, developed and adopted the “Framework for MOL,” which is the foundation for the
MOL pilot projects and the future re-licensure requirements for Colorado physicians.

CMS took the initiative on demonstrating professional accountability back in 2010 when its committee on patient safety and professional accountability, whose lofty goal is to make Colorado the safest state in the country for patients, determined “patient safety begins with physician licensure” and “part of making Colorado the safest state for patients is demonstrating physicians’ own commitment to continuous improvement and high professional standards.” A special committee was then formed to research and make recommendations for a continued competency program for physicians in Colorado.

MOL framework
Discovering that a national MOL effort by the FSMB was underway, the subcommittee, chaired by Christine Lamoureux, MD at the time, studied the FSMB framework and determined that while there were challenges, the framework represented a continuous learning and improvement cycle that incorporates self-assessments, CME and practice improvement activities — a model that experts say is effective for lifelong learning in medicine. And, given the established guiding principles associated with the MOL framework, it will enable physicians to successfully participate without being overly burdened.

For example, physicians who are board certified and participate in their Maintenance of Certification or Osteopathic Continuous Certification (OCC) most likely will not have to do anything else for MOL due to the very rigorous board certification requirements. That includes the majority of physicians in Colorado. Additionally, a Colorado MOL program would not require a high-stakes examination to assess a physician’s knowledge and skills. Other types of activities could be used for this, such as hospital procedural privileging or computer-based case simulations, which might produce information about knowledge and skills gaps and guide a physician toward appropriate learning activities.

The national health care movement toward quality improvement is already requiring physicians to engage in various performance improvement activities that involve looking at their own data. These types of activities can also be used toward MOL requirements. Other options the MOL subcommittee proposed included taking a wait-and-see approach and responding to future requirements that may be proposed by the Colorado Medical Board/FSMB, or introduce our own state-specific MOL proposal and timeframe including a legislative bill in 2012 or 2013. The CMS board made the right decision to work in collaboration with the CMS and DORA. It will strengthen the chances of a bill being passed and ensure CMS involvement in the process. Marschall Smith, program director with DORA and who works closely with the medical board, has acknowledged that “Colorado Medical Society is a full partner in this collaboration, and they will have an equal vote.”

MOL pilot studies
The purpose of the FSMB pilot studies is to help prepare state medical boards and physicians for successful participation in MOL. The pilot studies will help us to understand the magnitude of MOL by looking at state board readiness, resources, current renewal systems and physician practices. A careful and methodical approach using focus groups, surveys and other activities will help us to identify and address any major issues or obstacles that would prevent MOL implementation. Some pilots will test new tools that physicians could choose to use for MOL. One of the important goals is to ensure that there are many choices of affordable tools and activities available in order for all physicians to meet requirements.

According to the FSMB, the first phase of the pilots will begin this summer and will continue through 2013. CMS will be involved in some of the pilot studies and may ask select physician members to participate. An exact date for a MOL legislative bill has not yet been determined, but once MOL is launched we expect to phase in the requirements over five to eight years.

If you are a CMS physician member and are interested in joining the subcommittee on MOL please contact (720) 858-6309.

“Maintenance of licensure begins with honoring and helping to sustain an individual physician’s life-long commitment to patient safety and wellbeing” – Colorado Medical Society Subcommittee on Maintenance of Licensure.