Peter S. Greene, M.D., Executive Director June 5, 2017 Building the Infrastructure for Continuous Improvement: A MedBiquitous Update Peter S. Greene, M.D., Executive Director June 5, 2017

MedBiquitous Mission To develop and promote technology standards for the health professions that advance lifelong learning, continuous improvement, and better patient outcomes.  Not-for-profit, member-driven, standards development organization

What do I mean by standard? Technical specification Lingua franca Enables data exchange and interoperability Very open license

Selected Achievements Supporting credentialing of 800,000 certified MDs & DOs Data on 839 Opioid CE activities & 400,000 + learners reported to FDA 141 medical schools in the US & Canada sending curriculum data to central system 340 virtual patients available under open access 388,000 Learner-MOC activities reported to certifying boards $650,000 saved by the AOA in the first 2 years of CME data collection Note updated figures from AAMC – 91% of US Medical Schools accredited by LCME (134/147) participated this year. 5 Canadian and 2 osteopathic schools submitted data as well. 388,540 activity reports going through PARS to certifying boards.

Building the Foundation: The MedBiquitous Architecture These standards form the data model that MedBiquitous builds on. * Official ANSI Standards ** In ballot/public review through 6/12

Educational Achievement Documentation of competence, assessment, entrustment Funded by the AAMC and NBME Note that the Educational Achievement specification is in review within the MedBiquitous Standards Committee. In Ballot/ Public Review

Standards and Competency-based Education Many of our standards are related to supporting Competency-based education. In September, our Competencies Working Group published a guide illustrating how the different standards could be used together to support CBE. The guide shows how MedBiquitous standards support the representation of and connections among Competencies, Competency Frameworks, performance Frameworks, and Entrustable Professional Activities, the infrastructure for measuring CBE.

Medical Education Metrics Supporting expansion in FDA reports of Opioid CE metrics Specialty Years in practice State Regulatory action expanding to include Immediate Release opioids Our Medical Education Metrics Working Group continues to support the FDA’s efforts related to the Opioid crises. The ER/LA Opioid Risk Evaluation and Mitigation strategy, or REMS, requires manufacturers to support clinician education, which is happening through accredited CE. CE providers send data to their accrediting bodies, which in turn send data to the manufacturers for reporting. Now that data will include clinician specialty, years in practice, and state in which they practice, allowing the FDA to get a better sense fo which clinicians are receiving the education. In addition, the FDA has indicated that the program will likely expand to include Immediate Release Opioids, and MedBiquitous will modify its definitions and guidance to enable collection of that broader data set.

Financial Interest The draft Financial Interest specification created in the Financial Interest Working Group is being used in the Convey system for streamlining the process of disclosing financial interests. Convey is in late stage testing and onboarding subscribers.

The API Architecture Program Information Curriculum Inventory xAPI On top of that, we are layering API standards for communicating smaller chunks of that data so that systems can work together more easily, getting targeted information from one another when they need it. We have API development efforts related to the Curriculum Inventory, Program Information, and learning experiences using the xAPI.

Initial API Development Curriculum Inventory Initial API Development Connecting Curriculum Management & assessment, content, scheduling, portfolio Creating an integrated ecosystem Give me content and assessments for this competency Show me the details for this course or event Our Curriculum Inventory Working Group is developing Curriculum Inventory APIs is to allow the curriculum management system to exchange data and content within an educational technology ecosystem. So instead of retyping data from one system into another, data can flow when it needs to, connecting curriculum data with portfolios and scheduling systems, and allowing assessment and content systems to query the curriculum management system, delivering the most relevant content and assessments for that point in the curriculum. We have a few APIs documented for the curriculum inventory around competencies, curricular content, and event details that would allow one application to query another using the questions you see here.

Program Information Approved Proposal Education/Training Program information changes frequently Cumbersome to get data in real time Discussions at this meeting The Professional Profile Working Group is now working on a Program Information API that will allow credentialing bodies, associations, and others to get up-to-date program information much faster. Current exchanges of this data are infrequent, and any verification or lookups between updates are labor intensive and cumbersome. There are discussions happening at this meeting regarding this work.

Virtual Patient xAPI Profile Enables compilation of learner performance in a VP with other data for analysis Where did they go? How long did they spend? What did they ignore? What happened outside the VP system? Our Learning Experience working group has developed a virtual patient profile of xAPI that provides common practices for documenting learner actions in a virtual patient using xAPI. This enables details fo learner performance and actions in a VP to be compiled with other data from xAPI enabled tools. So you can look at where the learer went in the VP, what choices they made, what signs they ignored, and also look at data form outside the VP system. The Learning Experience Working Group is turning their sights towards other types of scenario-based learning, including multi-faceted simulations.

Draft Security Guidelines Increasingly our enterprises involve multiple connected applications, on multiple platforms, with users accessing those applications from a range of devices. Our Technical Steering Committee has been working on Security Guidelines to guide single sign on across this range of devices and applications. This is essential as our standards enable greater integration across organizations and systems.

Remember our Focus Remember our Focus Added in case you don’t like to “spotlight effect” on the previous slide. As we work to improve health professions education by enabling with technology innovations, we need to remember our focus. We need competent healthcare providers delivering the care, and we need their focus to be on the patient. We have some fabulous presentations and opportunities to interact with a mix of incredibly smart people from many countries and professional backgrounds. Take advantage of the opportunity! Learn, enjoy, and be inspired.

Remember our Focus As we work to improve health professions education by enabling with technology innovations, we need to remember our focus. We need competent healthcare providers delivering the care, and we need their focus to be on the patient. We have some fabulous presentations and opportunities to interact with a mix of incredibly smart people from many countries and professional backgrounds. Take advantage of the opportunity! Learn, enjoy, and be inspired.