Standardized Clinical Assessment & Management Plan SCAMP℠ Standardized Clinical Assessment & Management Plan PES Business Meeting May 4, 2013

Background: SNoPE Study Network of Pediatric Endocrinology Pilot program targeted to demonstrate feasibility 2 abstracts and 2 publications Presented this concept to NIH with follow up Nearly achieved acceptance of R10 RFA Duane Alexander resigned Delay in naming new director Not a priority for NICHD with their financial constraints

Background: Shift to Quality Improvement Quality improvement activity required MOC credit required for recertification Many institutions are requiring QI projects Our Challenge Develop a program that will Meet our members’ needs and Improve quality of care & outcomes for our patients

Background: PES Board Approach Reviewed possibilities Selected 3 for formal presentations to the full BOD in April 2012 Subsequently Series of negotiations & discussions Contracted with the Institute for Relevant Clinical Data Analytics (IRCDA) A not for profit corporation out of Boston Children’s Hospital and Massachusetts General Hospital

A SCAMP℠ A means to guide clinical assessment and management to learn more about conditions for which there is limited available evidence Created by a group of expert clinicians as an algorithm outlining current sound practice based on any available evidence Develop SOUND PRACTICES -- Not Clinical Practice Guideline Methodology to improvement in quality, cost & value of the care Fill specific “holes in our knowledge” Participates are encouraged to deviate from the algorithm As long as reasoning is provided These differences will lead to new understanding of sound practice

A SCAMP℠ A SCAMP℠ lasts ~ 2 yrs Data reviewed q 6 months (or every 200 patients) To permit revisions if needed Quarterly data review will occur for clinicians seeking MOC credit Once closed the data are available to all

A SCAMPSM A SCAMP℠ is considered QI Only de-identified data are used No IRB approval necessary for the SCAMP℠ But minimum risk approval may be necessary to use data for publication in a peer reviewed journal If necessary we will help you with this

Value of SCAMPsSM to YOU Use of expert algorithms developed by your PES colleagues to guide future sound practice Reduce variation in the care to be better able to assess outcomes Contribute to the knowledge base for conditions important to pediatric endocrinologists Opportunity to Meet your organization’s QI requirements Obtain MOC Level 4 QI credits Opportunity to be part of development SCAMPs℠ and/or quality improvement/outcomes research

Value of SCAMPs℠ to Patients & Families Improve quality, cost, and value of our care Focus on meaningful diagnostic testing and more appropriate follow up Reduce unnecessary care and testing

Value of SCAMPsSM to PES & Our Field Enhance members’ ability to collaborate Engage a greater number of us in a scholarly activity Improve Our knowledge of the conditions we treat Quality & cost-effectiveness of the care

AVAILABLE TO PES MEMBERS LEVELS OF PARTICIPATION IN SCAMPsSM AVAILABLE TO PES MEMBERS Enroll Patients in ≥ 1 SCAMP℠ # of Participating Ped. Endocrinologists Help Monitor & Interpret Data to improve the SCAMP℠ (Such involvement provides opportunity to meet MOC QI credit) Time Commitment Help Develop a SCAMP℠ and / or oversee data interpretation Disseminate Information Informing new SOUND PRACTICES

Current State and Timeline Contract signed for 3 SCAMPs℠ / yr for 3 years Because of IRCDA’s interest in PES participation they are funding half of our costs from their foundation. Initial Topics selected Estrogen replacement in hypogonadal girls Pre-diabetes Congenital Adrenal Hyperplasia EACH SCAMP℠ Will have a Chair (to be named) Committee of Experts from PES appointed (no more than 5) Training of Chair and SCAMP℠ committee members Develop SCAMP℠ materials and member confidentiality agreement Pilot all of the processes Anticipate the first three SCAMPs℠ to start within a year

SCAMP℠ Oversight SCAMP℠ Steering Committee Board of Directors Morey Haymond Siri Greeley Karen Rubin Erinn Rhodes Amy Wisniewski Board of Directors Periodically review progress

SCAMP℠ Handout You should each have a SCAMP℠ handout This outlines much of what was presented Participation of whole divisions or group practices Encouraged but not required Select a SCAMPs℠ CHAMP among the group Has answers to anticipated FAQ Provides contact information Morey Haymond Christy McGinty at Degnon Associates All members (including fellows) will be receiving an email with the trifold attached We will keep you informed via email & monthly Missive.

This will be an exciting new addition to PES Thank you for your attendance We look forward to working with each of you