With the May deadline for implementing the Accreditation Council for CME's updated Standards for Commercial Support breathing down their necks, participants at the 2005 Annual Conference of the Alliance for CME, held January 26 to 29, were hot to find some answers about how the rules will play out in their organizations. Attendees at Standards-related sessions found themselves packing into the meeting rooms at the San Francisco Marriott, even sitting on the floors and overflowing into hallways where they strained to hear how different organizations are handling some of the stickier areas of the new rules governing disclosure and conflict of interest.

Time to Tweak

At the Medical Specialty Society Provider Section session at the Alliance meeting, the biggest message was, “Don't panic.” Several panelists emphasized that you probably already are doing most of what you need to do to be in compliance with the updated Standards, which require CME providers to obtain disclosures from anyone controlling CME content, and resolve any conflicts of interest. You just need to codify, document, and perhaps tweak your current procedures — then build on what you already have. For example, the American College of Obstetricians and Gynecologists already reviews all disclosures; now they just need to do it earlier in the process, said Kathryn Bell, EdM, manager, educational programs, with the Washington, D.C. — based society. ACOG's committee selection process already has anti-bias protection built in through its policy of changing presidents — who select new committee members — every year. Disclosure is required after a new member is selected.

When the American Psychiatric Association reviewed its current procedures, it unearthed a board-member — disclosure process that, while in place for committee appointments, hadn't previously been used for this purpose. Now it will be, said Kathleen Debenham, director, department of CME, with the Arlington, Va. — based association. Also, evaluations can ask participants if they perceived commercial bias. Their responses will help to validate that you have a conflict-of-interest resolution system in place — as long as participants found the content objective, that is. In addition to sending monitors to satellite programs (APA has integrated satellites into its main program and made them subject to the same policies), the association has sanctions. On the first bias violation, APA sends a letter warning that if the problem happens again, that person will be banned from presenting at APA for three years. On the second violation, APA follows through. “It's checks and balances along the way, from soup to nuts,” Debenham said. “Do disclosure earlier, educate committee members, codify what's already on the books, and look at evaluations and outcomes to measure how well your system is working.”