Osteopathic Continuous Certification (OCC) American Osteopathic Board of Family Practice John R. Bowling DO, FACOFP dist. AOBFP representative to BOS TOMA/ACOFP Joint Annual Convention June 2012

What is OCC? The process through which all Osteopathic Physicians will maintain their specialty certification An assessment tool to enhance the quality of health care Will replace current recertification process

Why OCC? Single examination model for certification is no longer the standard demanded by the public. Will help Osteopathic Physicians meet and exceed industry and regulatory standards Will be accepted for Maintenance of Licensure (MOL)

Why OCC? Some specialty colleges are requiring OCC compliance as a requirement for residency faculty and program directors Some hospitals are requiring recertification to maintain privileges

Who is Driving the Train? Federation of State Licensing Boards will require MOL to maintain license AOA – BOS has secured OCC as: an acceptable route to MOL ABMS (allopathic) already doing this: Example: ABFM- MOC

When does the train leave? The AOA through the BOS has mandated that each specialty certifying board will implement OCC by Jan. 1, 2013

OCC Components Unrestricted License Lifelong Learning (CME) Cognitive Assessment Written, practical, and oral exams Practice Performance Assessment and Improvement (new) Continuous AOA Membership

Component 4 Only new component of the recertification process Each specialty board has specific requirements All data must be physician specific

What Next? If you have certification from a board other than AOBFP

I have a non time dated certificate Participation is not required If you hold a position of leadership in the AOA, your state association, or your specialty college, --BE A ROLE MODEL Your credentialing agency may require

AOBFP Component 4 The candidate will demonstrate performance improvement in knowledge and skills; Will be compared to national benchmarks and standards of care based on documented evidence.

OCC- 4 Requirements for Diplomat Each Certification Cycle (Years 1 thru 6 of 8-year certificate term) Each diplomat must complete a total of four (4) OCC modules. 2 in years 1-3 1 practice relevant clinical and 1 “professionalism” 2 in years 4-6

AOBFP Component 4 Three pathway options Full Scope Family Medicine Clinical Practice Limited Scope Family Medicine Practice Non Clinical Practice www.aobfp.org

OCC- 4 Requirements for Diplomat Modules available Jan 1, 2013 Clinical Diabetes Low Back Pain Professionalism Communication Cultural Competence

Professionalism Modules All 3 pathways will do: 1 in years 1-3 1 in years 4-6 Currently in development Communication Cultural competency

How Do I do this? A link to these modules will be posted on AOBFP web site under OCC section Go live Jan 1, 2013

Clinical Practice Modules

Full Scope Clinical Practice Two (2) OCCAP modules each 8 year cycle

Osteopathic Continuous Certification Assessment Program (OCCAP), A disease state management practice specific evaluation based on data abstraction of specific disease state management parameters such as is done in the AOA “Clinical Assessment Program” (CAP) submission.

AOA CAP program http://www.osteopathic.org/inside-aoa/development/quality/cap-for-pqrs/Documents/2011-aoa-cap-for-pqrs-tutorial.pdf

OCCAP vs. CAP the OCCAP data will be the sole property of the AOBFP and will not be used for reporting to other agencies. Physicians may extract the same patient data for NCQA but it will be the sole responsibility of the physician to interface with other agencies.

How DO I Complete a Module? An OCCAP measure set will be completed data from 20 charts is entered for the measure set for one module. Candidate and AOBFP will receive performance analysis from AOA Completion of one web-based AOBFP approved educational unit referable to this module ACOFP verifies to AOBFP completion of educational unit Completion of an AOBFP web-based exam based on the educational unit Score recorded at AOBFP

How Do I Complete the Module? If candidate passes online module exam, he/she will be notified they can proceed with post module chart extraction. Second chart extraction from additional 20 charts is done and data entered as before. Candidate and AOBFP will receive performance analysis report of 2nd chart extraction data from the AOA . AOBFP will trend the results of the performance analysis data.

How the Board will Provide Feedback to Physician Results of AOBFP web-based exam will be reported to candidate from AOBFP Candidate will receive a comparison report of pre and post performance analysis data.

Module Now Complete

Summary of OCC Process Apply to AOBFP – www.aobfp.org Upon approval – will be enrolled in OCC process Abstract chart data and submit to AOA-OCCAP Receive access code for educational modules Will access through AOBFP web site After verification of completion of educational unit, will receive access code for exam over educational unit content

Summary of Process (cont.) Exam score returned to candidate If passes-may proceed Abstract 2nd data set (20 charts) Submit data to AOA-OCCAP Candidate will receive a comparison report from the AOA Module complete

AOBFP OCC- 4 There are three (3) pathways in which a diplomat may meet this requirement based on their professional activity. Full Scope Family Medicine Clinical Practice Limited Scope Family Medicine Practice must provide documentation to AOBFP verifying limited practice Non Clinical Practice must provide documentation to AOBFP verifying non clinical practice

Limited Scope Family Medicine Practice Family Physicians devoting 90% or greater of time in clinical practice to non OCCAP areas (i.e. Occupational Medicine, Sports Medicine, Wound Care, etc), will be allowed to submit practice performance data specific to their area of clinical practice. The area of practice and the format of the data for the module relative to clinical practice must be submitted for AOBFP approval at the time of application. Completion process will be the same as full clinical pathway 2 practice relevant and 2 professionalism modules each 8 year certification cycle

Non Clinical Practice Pathway If you do not have access to a sufficient quantity of patient data relating to topics covered by OCCAP modules, you may qualify for this pathway includes, but are not limited to: Directors of Medical Education, Academic Deans, Associate Deans and Assistant Deans; Health Care Executives or Medical Directors; Federal employees (ie: Physicians employed by the Veterans Administration) and may be restricted by law from abstracting practice data; MBA or other administrative educational programs.

Professionalism Modules All 3 pathways will do: 1 in years 1-3 1 in years 4-6 Currently in development Communication Cultural competency

Non Clinical Practice Pathway At the time of application, the candidate will complete and forward to the AOBFP for approval, a module that includes an assessment tool that provides performance data that can demonstrate practice performance improvement in the specific content area of the module

Non Clinical Practice Pathway Process for completion Same as other pathways

ELECTRONIC DATA SUBMISSION Currently completed using the DO-Online web based entry tool and office based abstraction of medical records. This OCCAP will be a separate portal with information owned and controlled by AOBFP. Data would only be shared at the request of the candidate.

Phase in Requirements If your certificate is dated in 2011 or 2012 completion of four OCC modules will be required prior to your next recertification; If your certificate is dated in 2008, 2009,or 2010 completion of two OCC modules will be required prior to your next recertification; If your certificate is dated in 2006 or 2007 no modules will be required until next recertification cycle.

Phase in Requirements As of Jan. 1, 2021, this phase in requirement will sunset.)

I want to do limited or non clinical pathway Must apply in writing to the AOBFP during the first year of your recertification cycle Clear documentation of the inability to extract practice data is the responsibility of the candidate and must accompany the written application. Additional charges may apply for non-OCCAP modules.

What if I fall behind with OCC? If you fail to meet the first 3 year cycle requirement: Your certificate will lapse after the 4th year of your OCC process. If you fail to meet the second 3 year cycle requirement: your certificate will lapse after the 7th year of your OCC process.

Lapsed Certificates In order to be reinstated in the OCC process, You must complete two OCC modules in 1 year. After completion of two modules you will be eligible to apply to take the cognitive and performance examination. This must be done within one year of completion of the modules.

Lapsed Certificates Successful completion (including passage of both exams) will allow: you to be reenrolled in the OCC cycle

ACCEPTANCE OF NON-OCCAP ASSESSMENT Other activities including NCQA, Patient 360o, and similar programs offered by the AAFP or the ABIM will be vetted by the board relative to content deemed appropriate for inclusion in the continuous osteopathic certification process

DUPLICATION OF OCCAP The candidate may duplicate the OCCAP information (chart abstractions) for submission to the AOA CAP (CAP for PQRS) to be used for pay for performance criteria See AOBFP web site: www.aobfp.org

SUMMARY Satisfy State Licensing Board MOL requirements for physicians Enhance physician reimbursement through compliance with pay for performance program and maintenance of Provide improved care for our patients All data must be physician specific

Anticipated Physician Cost for AOBFP OCC $2600 Includes Final summative cognitive exam OMT practical exam 4 modules Pathway ii and iii may incur addition costs

Questions / Concerns? John R. Bowling DO FACOFP dist. AOBFP BOS Representative Office of Rural Medical Education UNTHSC-TCOM 3500 Camp Bowie Blvd. Fort Worth, Texas 76107 john.bowling@unthsc.edu