The other, titled Transparent or Translucent?, gave me a different way to look at the whole concept of transparency. Increased transparency has been a big push in CME: Sometimes it’s a good thing—like the ACCME’s attempts to make its processes and procedures clearer—and sometimes what sounds like a good thing can have some unintended bad consequences (witness the new proposed rule in the Sunshine Act that could cause a real nightmare in reporting requirements for CME providers). Does being able to see clear through something, such as financial relationships between healthcare providers and pharma, really engender trust? Given what happened with ProPublica’s Dollars for Docs series, I tend to doubt it. Not sure what translucence would look like in this case, but it’s an interesting concept to ponder, isn’t it?

If you aren’t already familiar with the issues involved in this aspect of the proposed Sunshine Act, I would urge you do get up to speed (resources: here and here). And do it today, because the deadline to respond to the HHS is tomorrow, February 17. This could really affect your business, so please check into it and let HHS know what you think. (Submit comments here.)

Update: I forgot to mention that the Alliance for Continuing Education in the Health Professions also has weighed in on this issue (download a PDF of its response here). Not surprisingly, the Alliance has many of the same objections to this proposal as the CME Coalition. To quote from the Alliance letter to CMS:

“These potential consequences include: (1) reluctance on the part of physicians to serve as faculty or even to participate in industry-supported CME because the reporting requirements could result in the incorrect perception that these individuals are receiving some direct benefit from industry support; (2) burdensome reporting requirements for CME providers who already operate with limited resources and tight margins and would be required to determine the value of benefits that accrue to covered recipients attending CME programs; and (3) a reluctance on the part of commercial supporters to fund CME activities due to the difficulty in calculating, tracking and reporting the indirect benefit of their support on faculty and participants.”

She talked a lot about various competency frameworks, and the similarities (many) and differences (few) between those developed by U.S. and Canadian organizations. She also provided a fairly daunting list of challenges for interprofessional education, from stereotyping to time, geography (we both have big countries), to resources, power/hierarchy issues, political will, unions, professional regulators, and policies that don’t support team-based approaches.

She says she wants to “put the ‘I’ back in teamwork,” meaning that people need to take personal responsibility for examining what stops us from collaborating effectively as practitioners. What barriers do you face? She gave us several areas to think about:

* Social capital: Basically, this is about trust and respect. How do you build these among colleagues and team members? How do you lose them? Are there “teachable moments” in everyday interactions you can take advantage of to build trust and respect?

* Rhetoric: The words we choose can make all the difference in an interaction. She suggested practicing word choice in e-mail, since it has a built-in time delay you don’t get in conversation. What words do you use? Does a disregard for grammar and spelling indicate a disregard for the recipient? Think about it.

* Perspective taking: Remember, her colleague told her, it’s not all about you (what??). How do you figure out where another person is coming from? How can you teach others to discover others’ perspectives? This one is particularly sticky, I think.

* Negotiate priorities: How do you work with others to determine what’s important and what isn’t?

* Resolving conflicts: How do you create a safe place to have conversations around areas of conflict?

* Building relationships: How do we build relationships, and how do we teach people to build constructive relationships with colleagues?

He set the stage by citing just how bad it is in the U.S. (32 percent of patients say they’ve experienced medical and/or lab errors, more than a slew of other countries he listed, and our readmission rates are pretty dismal). And costs are seriously out of control: U.S. salaries have increased 38 percent over the past 10 years, while healthcare costs have soared 131 percent. If milk had that inflation rate, it would cost $48 per gallon. Yikes, anyone! While the cost of care in the U.S. is double that of other Western nations, they’re also experiencing ridiculous (my word, not his) healthcare inflationary rates.

But while things like healthcare reform, CMS’ PQRS, Maintenance and Certification and likely soon, Maintenance of Licensure, and ARRA and HITECH, and other acronyms I think I missed as we whizzed through the slides, are aligning, there are still misalignments, he said.

Quoting Don Berwick, he said, “You can’t fatten a pig by weighing it repeatedly,” meaning that while it’s great we’ve put work into measurement and reporting, it’s now time to focus on improvement.

Among his recommendations:

* Get to know the national performance improvement initiatives (NQF, NPP, etc.) Join them.

* Adopt NQF and NPP recommendations as a framework for what you do.

* Facilitate national and local discussions between measurement improvement groups, CPD groups, and HIT groups. As he said, the other two groups already are starting to come together, and “You need to get into the dance.”

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.

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.)

According to a press release, CME Peer Review, produced the video to “help advance awareness of COI with a goal of enhancing the quality of continuing education. ‘Standardized, effective management of COI allows planners and faculty to focus on what is important – enhancing patient care,’ says Jane Ruppenkamp, President, CME Peer Review.”

Once we learned the conference’s Twitter hashtag (#acehp12) and how to pronounce ACEHP ( “a-sep,” according to one poster. “Think antiseptic”), and got an update on the weather forecast—“fluorescent and 70 degrees”—we dove into lessons learned/favorite experiences from past Alliance meetings. These included:

• Don’t feel you have to stay in a session that you’re not getting anything out of.

• Don’t worry about missing sessions in favor of hallway conversations. These conversations, and the relationships that can come out of them, are some people’s best conference experiences.

• It can be empowering to look around and realize how many others in the room are in the same boat as you.

• Keep an open mind. “Some of my best ideas came from conversations with people who disagree with me,” said one person. I can’t agree more.

• It’s great to be able to meet people we previously had only known virtually.

• Know that those who preach adult learning principles don’t always practice what they preach.

• Make dinner reservations ahead of time.

• Don’t let the faculty off the hook if they start glazing over the details. Be empowered as a learner.

When it comes to preparing, most are following @theCMEguy’s blog post suggestions, particularly going through the abstracts and making a list of first-, second-, and third-tier choices for each time slot; and setting up meetings. Being a bit of a techno-geeky group, we’re also loading up on apps, such as Tweetchat and Streamboard for meeting tweets, setting a time for an in-person tweetup (Monday at 6 pm), debating whether to tweet to the main #acehp12 hashtag or use the session-specific identifiers (use both as separate hashtags I believe was the consensus), and placing wagers on the total number of tweets to come out of the conference this year.

But just going through the abstracts doesn’t necessarily mean you’re going to get what you need. How do you find out which sessions may have sounded better on paper than in reality and vice versa? Some rely on the Twitter stream for thumb-ups and –downs. Others hover in the doorway before committing to a session. Others rely on tried-and-true presenters who they know will do a good session, though I personally am always torn between going to a session whose faculty I know is great and looking for the fresh voices and fresh ideas that this community needs to hear.

The sessions people are looking forward to most seemed to depend mostly on whatever their biggest challenges are, from performance-improvement CME to updates from the Accreditation Council for CME to anything to do with grants. The on-site technology help station also is getting some interest from folks, as are technology sessions. What we all hope to get out of the conference varied too, with one recently unemployed poster looking to network and the rest of us hoping to rustle him up a job. Others are looking to make new contacts, and learn more about MOC/MOL, future trends, grants, and technology.

Among our collective goals for this year’s conference?

* Spend at least one meal as a mentor and at least one meal as a mentee.

* Find new ideas, fresh voices, and better ways of doing things. Make connections, learn, speak, share.

* Spend at least one session sitting next to someone you’ve never met.

* Spend more time at meals downstairs than up in your room checking e-mail.

• Participate! Engage, share, be an active learner.

I hope to see you in Orlando!