National Alliance for Physician Competence Discovery Workshop

Context

Tactics

Report Outs

Bryan

We have a renegade report that will go first.

Bill Rouse

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This is a network of relationships rather than an organizational chart. It is a network of shared values and a network that facilitates the key work of the stakeholders. It should be a network that stakeholders feel they can't live without once they have it.

This is an image of a social network - it's a network of organizations.

How would you make life easier? You provide access to people and organizations. You can have GMP and online tools to deal with different versions. You can have one site for all relevant forms. It can be a superstructure.

You can take advantage of existing infrastructure like SecondLife and LinkedIn.

You join the Alliance by joining SecondLife. Your avatar reflects you. You fly to Alliance Island. You can connect to members once you are there. Alliance Island might sound odd now but IBM has a presence in SecondLife.

We have a place in SecondLife for the Alliance Network. I can log in and go through this world. This is all infrastructure out there that is free.

This is a real meeting actually going on in SecondLife. This is a real infrastructure that exists out there.

LinkedIn is a way to connect with colleagues. Some of you may already take advantage of it.

How would we build a network? We would buy land in SecondLife and build Alliance Island. There would be Forums and events that are hosted. You could have a shared calendar. It would be a resource rich environment.

How would we build a network? We would buy land in SecondLife and build Alliance Island. There would be Forums and events that are hosted. You could have a shared calendar. It would be a resource rich environment.

IBM has had product launches in SecondLife. The Department of Homeland Security has invited me to do a keynote address in SecondLife.

It could serve as a front door and be complimentary to physical space. It can serve as a place to educate the public. You can conduct conferences and training sessions in SecondLife. You can do this for low cost and you are up and running almost immediately.

How outlandish is this?

If we decided to do this today how long would it be before we could go there? About two weeks. The basic cost is zero if you don't buy land.

I've participated in a micro-lender meeting in SecondLife every week. I've gone there and you can have dialogs that are like instant messaging. Even when you are not logged in you can receive emails and other groups. It's becoming common to have a place in SecondLife.

IBM has a couple hundred locations in SecondLife.

Our Board is looking at a Board Management software package. How is this different? This deals with physical, virtual space and that kind of interactions. That software is more specialized.

You have to have an avatar in order to participate in SecondLife. You design your Avatar and then walk around.

Do you have to be online at the same time? Yes.

There are places that you need passwords to get in.

If Stanford wants to give a class they would build a space in SecondLife. In order to have real estate you have to buy it.

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Revisiting Principles

We were interested in outlining some concepts from the Complexity Science perspective and then we mapped those to the things you have been discussing.

The idea is to make the Good Medical Practice document more of a web type thing and link to it and also link through to many other documents.

The idea is to make the Good Medical Practice document more of a web type thing and link to it and also link through to many other documents. So the idea to apply the ranking methods is, as more of the physician digital footprint becomes available, there could be more of an assessment process working. In an assessment you have many dimensions and you can be good in some things and not so good in others. Then you can allow the wiki to help you learn how you can bring up your weak areas.

It's important to have a web presence and have people accessing your information. There are sites out there that are allowing people to rank and give people feedback. You want to leverage that information and have links to it. You want to be providing an environment for aggregation rather then doing the work yourselves.

The wiki is a very good way to grow your information space. That seems like the most practical step from where you are now.

Those are some of the practicals. The wiki is a very good way to grow your information space. That seems like the most practical step from where you are now.

Physician assessment across a range of competencies is very important. If it is an assessment of competencies and a continuous improvement process that can be much more sellable.

Breaking it up into parts so that small groups could both access that as well as add value to that makes sense.

There could be a site for clinical guidelines that could be used as part of the assessment tool that is used. Letting the community create the guidelines is an interesting idea.

Envision a hyperlink to something that is very specific to your specialty and you can see some of assessments that are connected to that. You can take advantage of the network effects as well.

We've noticed that in these feedback systems it is good to write that you like something but then to say that they aren't right in these other areas.

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Good Medical Practice

We talked about getting the GMP document out. The first phase would be a comment period. That is ready to happen now. We would get the document stamped as a draft - it would not a wiki - and be able to comment on the same document up front. They would have about 3 or 4 months to get it out and ask for feedback. That feedback can be gathered on a web site so it is orderly and manageable.

We thought that the GMP could be distributed to constituents and that they could be encouraged to give feedback but they would know that this is not an endorsement. The transmittal letter needs to talk about the history of where the document came from and to clearly state that this is not an endorsement.

A workgroup of the committee and the whole Alliance would look at that and then it would be considered version 1.0 and be ready to go out. It would be stated that this is the opinion of the Alliance participants.

Version 1.0 should be published in journals and organizations should be encouraged to publish it in their newsletters.

Once version 1.0 is out for a period of time a wiki could be put up and the living, breathing process could begin.

Once version 1.0 is out for a period of time a wiki could be put up and the living, breathing process could begin.

When is the document final? How do you balance the idea that it is something that people will build things from and at the same time having it be a living document.

As of July 1, 2008 there might be a version 2.0 but the wiki is going on at the same time. We would have a group that would watch what the changes are that are taking place and the topics are that are being brought up and what is being looked at most frequently.

The Alliance should actively promote the GMP document.

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December Summit Group

The next event will be in Dallas on December 5-7, 2007.

We're looking at having three sessions at the same time with about 30 people in each session.

We're looking at having three sessions at the same time with about 30 people in each session. There will be some kind of a welcome and dinner on the first night and then have three concurrent sessions and possibly reconvening all three groups to share across the sessions. We can invite experts in the different content areas and they can either stay with one group or move around between sessions.

We normally put together a sponsor team to help the facilitation team figure out the objectives and the assignments. We want to develop three sponsor groups - one for each focus area.

One session will focus on the Alliance organization and sustainability. Another session will focus on measuring competency. The third session will focus on the infrastructure for information exchange (including a portfolio and the trusted agent).

The first draft of the objectives for the Alliance session are:

We would revise the proposal that was created last January and send that out prior to the Summit. Dinner won't be served on the second night unless some funding is obtained.

We also talked about doing some work on a plan to engage physicians in this process. This could address the value versus burden issue.

The second event will be to develop an action plan and develop pilot projects and develop plans for those pilots. We'd have the updates and feedback and some organization around the Good Medical Practice document. We'd have to figure out about dealing with the feedback from the launch. We'd like to have this organized before December so the group can look at it.

We'd probably have people there that know about assessments and how they are being used. There is a paper being produced discussing the connections between MOC and MOL. There needs to be transparency and a communication plan for each of these sections.

In the third session we will talk about the trusted agent, the design principles and the rules we're going to use to bring this into being. Right now it's a joint project but we need to discuss the right structure for moving forward. We would need to identify some pilot projects and the funding for those as well. We could possibly be engaging some software vendors to get some understanding about how all this can work. We could possibly do a demo online or onsite.

A 'save the date' letter has been sent out to a lot of people. We want to invite 150 people to the event to get about 100 people to attend. We'd get the preferences for what event they want to attend and we'd invite experts to each event to round out the group.

What about getting more participants from ABMS - the positive deviants for MOC?

What about getting more participants from ABMS - the positive deviants for MOC? We can figure out which boards are out there and not doing it in a burdensome way. There is a conference on portfolios in October and we could pull from that as well.

What is the mechanism for invitations? We have a list of 123 people that have been invited previously. Of the individuals that have been attending they will get first choice to attend. Then we will fill in with content experts.

You mentioned we wanted to expand the list of invitees. If we have suggestions for others can we send them to you? Yes.

These three areas seemed to be the ones where there was the most interest during the last Summit. In topic two and three we need more expertise invited.

Does that sound reasonable?

How many people have been at one or more Summits? About 80 have been to one or more of the Summits. If you have new names you can send them to Frances or Carol. For the measuring competencies event and for setting standards we will need to rely on people from specialty boards. For the information exchange session we probably need more IT expertise.

It also should address the legal issues around data sharing as well.

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National Alliance

Jordan came up with something that we talked about before but we think this should be the National Alliance for Assessing Physician Competence.

We talked about housing an organization at the Federation of State Medical Boards for now. The individuals that have given their heart and soul to this would continue to do that.

We talked about starting slowly. We talked about housing an organization at the Federation of State Medical Boards for now. The individuals that have given their heart and soul to this would continue to do that. Most of their time would be devoted to the Alliance. That would require a memorandum of understanding between all these organizations. That could be the agent to hire those people and house them there. They would then identify the jobs and time to allow this process to go on and move forward.

We need a steering committee. There was a lot of input about this and the conversation was about being a management committee versus a governance committee. They would figure out the job and evaluate the people doing the job. There was a suggestion that people would come up with names for this steering committee. They would be people that have contributed to the formation but the suggestion is to find people that have the right skills.

We talked about members giving seed costs - these organizations are providing the funding that would allow the infrastruture to occur. Other members might not be contributing the seed costs but the meeting would be 'pay to play' (each participant would be assessed the cost of the meeting). At the outset it would be difficult to expect the infrastructure to go looking for funding at this point. It is essential to provide support through seed costs to get this going.

We need to develop a summary document for someone to begin to understand what we did here.

We've identified three areas of focus. Communication within the profession first and then going out to the other areas.

Capture institutional memory. If you looked at what we did today - three groups said we should go to a 501c3 and one group said to do this kind of thing that we are talking about doing. We need to develop a summary document for someone to begin to understand what we did here. We also need an ability to capture how and why the process got started and to communicate the choices around the process as well as the decisions that have been made.

We suggest to put out a press release about the Alliance and to communicate what we are doing by December.

Questions: should everyone be expected to pay seed costs? Should every constituent of an umbrella organization become a member? We don't think so. They can come to the meetings but they might not be a paying member.

The members of the steering committee might not be representational of organizations but those that have had experience with the Summit process.

Should this group come up with a slate for the steering committee for the December meeting? I think I saw a thing planned for December around staffing and the Alliance.

Maybe those people can define what competencies are needed in the steering committee but we wanted a good sense of diversity in that group.

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