Follow the Money ACCME PROPOSES FIREWALL TO PROTECT CME The Accreditation Council for CME has proposed a policy to clarify the boundaries between accredited CME providers and commercial supporters, and to help ensure that CME activities are unbiased. It is specifically aimed at CME providers that are owned by, or do business with, "interested companies"--defined as corporate entities with proprietary or pecuniary interests in health care products or services. Addressing two areas of potential influence--staffing and funds--the guidelines stipulate, among other provisions, that:

* Staff, consultants, and board members of the "interested company" do not exercise control over CME activities.

* All in-kind support or funds supplied by the "interested company" are considered commercial support as defined in ACCME policy and the Standards for Commercial Support.

While the ACCME's Essentials and Standards for Commercial Support already regulate the relationship between industry and providers, the new policy was developed because the CME world has changed since the ACCME first issued those guidelines, says executive director Murray Kopelow, MD. "[In the past] most CME providers--medical schools and specialty societies--were on one side. On the other side were the funders of CME, producers of devices or pharmaceuticals," says Kopelow. "Now there are more dimensions. There are providers that have products."

The ACCME's policy has always been to accredit any provider that meets its criteria, even if the provider is a for-profit organization such as a pharmaceutical or communications company. The accreditation of for-profits has sparked contentious debate in the CME community recently, with some members of the academic CME community calling on the ACCME to restrict accreditation to licensed medical institutions, specialty societies, and state medical societies. The issue has also generated coverage in the mainstream press; for example a March 9 USA Today article questioned whether CME offered by communications companies was really promotion in disguise. The ACCME, however, is not changing its open-door policy.

"This [proposal] reestablishes what the boundaries are so we can continue to include all of our providers, rather than exclude anybody," says Kopelow. The goal of the policy is not to stop the flow of funds, Kopelow stresses, but rather to make explicit how that flow is managed and disclosed. "When an accredited provider is nested inside a larger company, and funds flow from one to the other, we need to look at how much was spent and for what purpose."

The firewall also proposes that after each activity, providers ask faculty and learners if they believed the activity was commercially biased. That feedback will be "incredibly important," says Kopelow, because, if, for example, data shows that 99 percent of activities are free from bias, it will help support the position that compliance with the ACCME Essentials and Standards is "enough to meet the needs of the nation."

The Alliance for CME called for input on the firewall from its members, and as of this writing, had received more than 200 responses, says Bruce Bellande, PhD, executive director. While there is overwhelming support for the policy's intent, Bellande says, there are divergent opinions about how to execute it. Surprisingly, he adds, there is not a significant difference in the responses of for-profit versus not-for- profit providers.

As for his view, Bellande thinks the policy is unnecessary. The ACCME's new Essentials (System 98) require that providers define their missions and organizational structure, including staffing and budgeting, he points out. It would be more effective to integrate the firewall stipulations into the Essentials rather than have a new policy 'isolated somewhere, not linked to anything."

The ACCME is gathering feedback on the proposal through early summer. By the end of this year or early in 2001, the ACCME will decide whether or not to adopt the policy. For more information, visit www.accme.org. --Tamar Hosansky

e-Health, e-Ethics INTERNET SPAWNS NEW MEETINGS What do doctors, lawyers, policymakers, and dot-com company executives have in common? The Internet, health care, and and ethics--and from that confluence of forces springs a new type of medical meeting.

Case-in-point: The Symposium on Healthcare Internet and E-Commerce: Legal, Regulatory and Ethical Issues, held in March in Washington, D.C., sponsored by the fledgling Health Care Compliance Association, the American Health Lawyers Association, and several other groups. The symposium drew 550 attendees, according to event organizer Peter Grant, a law partner in the San Francisco and Seattle offices of Davis Wright Tremaine, and co-chairman of the firm's Health Law Group.

The sweeping array of program participants included staff members from the U.S. Department of Health and Human Services, the Federal Bureau of Investigation, the Food and Drug Administration, and the Health Care Financing Administration.

Grant says the most important developments to emerge were reports from two groups, the Internet Health Coalition and Hi-Ethics, that are working on ethics codes for Internet health care. The codes include guidelines for information for professionals and consumers, disclosure, and professional business practices. Industry leaders say that such codes may stave off government regulations.

At one session, Grant reports, "[Government] regulators were saying that we don't need new laws to govern ethics, but their hope is that ethics codes are broad, practical, and have some teeth." (Visit www.healthwise.org/Hi-Ethics Home.htm; and www.ihealthcoalition.org/.)

Such developments are causing a boom in the new Internet health care meeting industry. IHC meeting planner Chris Pentz, CMP, president, Pentz Communications Group, Levittown, Pa., says, "In my first meeting for IHC two years ago, we expected 80 and we got 150 attendees. The second year we closed registration at 400." So far, 800 people have registered for the third annual meeting in October in Las Vegas. "I've never seen anything like it." Pentz says.

Doctors Unite! A CME FIRST: CREDIT FOR UNIONIZATION TUTORIAL When the American Medical Asso- ciation created a physicians' labor bargaining unit last December, the Massachusetts Medical Society said it was time to take up the issue and, along with the Massachusetts Bar Association, offered a four-credit CME course, "Physician Unionization: A Risk Man- agement Program," earlier this spring. It was a first for MMS and appears to be a first in medical education. Dennis K. Wentz, MD, director, division of continuing physician professional development, AMA, says he knows of no other unionization tutorial, anywhere.

The result, according to program co-chairman and MMS General Counsel Dean P. Nicastro, was a well-attended and lively one-day seminar designed to help doctors understand who has the right to organize and to explore alternative practice procedures that may allow collective bargaining without violating fed- eral antitrust laws.

MMS programs typically draw about 40 attendees, according to Nicastro, who also moderated the event. The unionization seminar attracted more than double that number--about 90--and, although Nicastro says he hasn't yet seen the post-seminar evaluations, a number of attendees approached him right after the event to express appreciation for the course. "Unionization is extremely topical for doctors," he says.

A Striking Difference At its annual meeting last summer in Chicago, AMA delegates voted to reverse its anti-union stance and established a recognized labor organization called Physicians for Responsible Negotiations.

At its Interim Meeting last De- cember, AMA Board of Trustees gave an update on PRN, which is its own legal entity and funded by a loan of $1.2 million from the AMA to support its operation through 2000. PRM is divided into three divisions: physicians employed in national, state, and county governmental organizations; physicians employed by private institutions; and residents.

PRN is banned from striking in contract negotiations and that, Nicastro says, is where the medical community splits in two. "There are doctors who believe (striking) is a perfectly appropriate way to go; others think it's just not good for the medical profession," Nicastro says. He said he got a good sense of this polarization during a session called "What Role Does Medical Ethics Have in Physician Unionization?" Doctors who have served in academic medicine, Nicastro says, by and large oppose unions especially for residents, because their position is that residents are students, not employees.

prescription "NO TEMPS, NO BOXES, NO PAPER INVOLVED." The call for papers for annual meetings can be a monstrous endeavor, especially when submissions number in the thousands. The American Speech-Language-Hearing Association, Rockville, Md., has tamed the beast this year with its "virtual call for papers," a totally electronic submission process. According to Cheryl Russell, ASHA director of meetings and conventions, the new method has made everyone's life simpler--and saves money, too.

"The initial investment to develop the online tools was big," Russell says, "but the savings in the long run are astronomical." By receiving and distributing papers online, Russell estimates she saved about $50,000 this year.

In the past, Russell had to hire about 10 temporary workers to do data entry and make copies of about 2,000 papers, which were then snail-mailed to 200 committee members. But now, the click of a mouse has changed timelines for ASHA's meetings department, and the staff can refocus their objectives and goals to provide better service to members, she says. Although ASHA's Web development is done in-house, including the electronic call for papers, the organization does outsource special projects to outside vendors.

Last year, authors had the option of submitting their papers electronically--it was a sort of beta test. Participants were positive in their reactions, so this year, electronic submission was a requirement, says Russell. Papers were then e-mailed to committee members, who reviewed the submissions online, and electronically sent their recommendations to the topic coordinator who accepted or rejected the submission. With a March deadline for papers, Russell says that by May she and her staff "had a good handle on the program" for ASHA's November 2000 annual meeting.

CORRECTION NOTED *In the opening photograph for the story "Rediscovering Medicine's Mission," March/April issue, pages 36 and 37, Marty Hotvedt, PhD, was incorrectly identified as Joseph S. Green, PhD.

Promise Kept BIO2000 A SUCCESS WITH PEACEFUL PROTESTS It could have been another World Trade Organization/Seattle, but protesters at Bio2000, held in Boston in March, kept their promise with peaceful--and theatrically colorful--demonstrations.

The annual biotechnology meeting drew more than 10,000 attendees--and 3,000 protesters--from around the world to the John B. Hynes Veterans Memorial Convention Center and was considered a success by Jean Mills, director of meetings for Bio- technology Industry Organization (BIO), Washington, D.C., sponsor of the event. Protestors, who called their counter- gathering BioDevastation 2000, aim to make biotechology the subject of social debate, claiming that decisions are made behind closed doors in board rooms with the only motivation being profits. They also say biotechnology is a threat to human health and the environment.

While the Boston Police Depart- ment and the Massachusetts Convention Center Authority took strong security measures, such as shutting down streets around the Hynes and removing newspaper boxes to prevent bombs being stashed in them, Mills says BIO had its own security plans and procedures in place.

"We never thought it would get to be a WTO situation," she says, "because we had intelligence from all over the world and we worked with about 12 committees in the local area that frequently reported to us. We were well prepared and in a responsive mode."

This local committee structure is a regular part of BIO's meeting planning process and starts 18 months out. Mills credits the committee structure for the organization's 14 years of successful--and relatively trouble-free--annual meetings. About 200 people meet regularly; one of their functions is to gather information about possible protests and funnel the information back to meeting organizers and security personnel.

The success of Bio2000 mirrors the industry explosion. Registration for the show almost doubled from 5,700 in 1999 to 10,280 this year. International participants increased from 1,650 in 1999 to 2,000. This year, there were 770 exhibit booths, up from 450 last year.

Planners in Paradise Several medical meeting planners were among the guests of the Guam Visitors Bureau on a recent tour of the island's offerings for group events and meetings. "It was paradise," says Arnold Schrader, A.C. Schrader Medical Conference Int., who is planning two events in Guam. "They are fantastically good hosts and Americans haven't discovered it yet. I think it's going to surpass Hawaii as a destination." Making the trip were, front row, left to right, Donna Leon, L&A Meeting Management; Kristin Hesse and Janice Caine, Guam Visitors Bureau; Dorothy Schrader, A.C. Schrader Medical Conferences Int.; Candice Burroughs, Kustom Incentive Concepts; Gale Cossey, Gale Cossey & Assoc.; back row, left to right, Toni Ramirez, Guam tour guide; Bernard Heller, Mara Assets Management; Wesley Lui, Nationwide Real Estate and Commercial Lenders; Denis Jensen, travel writer; Schrader; Jack Eilrick, Life Research Corp.; and Pierre Haber, The Psychology Association.

Dot-Coms Deliver E-MEETING MANAGEMENT MORPHS "Another day, another dot-com press conference." So Tom Flanagan quipped in April at the Millennium Broadway Hotel in New York. Flanagan, vice president of marketing for Philadelphia-based StarCite (www.starcite.com), a fast-evolving meeting Web site, then announced StarCite's latest offering: customized sites for suppliers. But wait, there's more. StarCite is handling the biggest practical problem with online RFP use--that many hotels are not equipped to receive and respond to RFPs electronically--by giving free computers and free ISP service to hotels that sign up for marketing agreements.The computer giveaway is part of a partnership with com- puter-maker Dell, which will ship notebooks pre-loaded with a StarCite icon.

"We're focused on both sides of the equation, as a market-maker should be," explained John Lavin, StarCite president and COO. The supplier Web sites will allow hotel salespeople to better manage RFPs coming from StarCite's planner users. Benefits for planners: faster turnaround and no need to retype RFP responses to compare offers. Bene- fits for hotels: happier customers, and a way to track RFPs--by salesperson, customer segment, brand, whatever--and identify patterns.

StarCite also had news for planner users. A site redesign allows planners to track negotiated savings or "cost avoidance." That means you can point to a number as your organization's ROI in you. Also new are three specialized RFPs: forms for airlines, cruise ships, and CVBs.

EventSource: Site Selection Plus Another meeting management Web site on the move is Event Source, which at press time announced an equity with Sabre, a major travel company, that will, among other things, enable meeting attendees to book their air travel online.

EventSource (www.eventsource.com)has taken the third-party site-selection model and put it online. The company's revenue comes primarily from the 10 percent commission it gets from hotels on meetings booked through its site. Unlike StarCite, which has made partners of third parties such as HelmsBriscoe, EventSource is in direct competition with site selection companies.

Among EventSource's unique features is a forum for planner reviews of meeting properties. Some 500 reviews already have been posted, says President & CEO Ed Sarraille, who notes that hotels are allowed to post responses to those reviews.

The company has several other partnerships: with CommerceOne, for an auction-enabling product, Commerce Bid; with Extensity, for a "business-to-employee" platform, enabling conference planners to track meeting spending; and with Event411, for an online meeting registration interface. (Event Source and Event411 will share the per-attendee fee that will be charged for the registration service.)

Sarraille says that EventSource intends to partner with a housing provider as well. --Alison Hall

Passkey Partners with PlanSoft Passkey.com Inc., an online group housing service, and PlanSoft Corp., an online site selection database, have announced a cross-marketing agreement. PlanSoft (www.plansoft.com) will license Passkey.com's Internet-based housing software and offer it to its users, while Passkey.com (www.passkey.com) will provide its clients with the ability to launch PlanSoft's Internet-based site selection and online RFP from its planner desktop housing management tool. An icon will be incorporated in PlanSoft's database of more than 45,000 facilities and suppliers to identify those that are Passkey-enabled.

Philadelphia, Here We Come In Alison Owings' opinion, Philadelphia is the hot new East Coast destination, which is one reason why her group, the 80,000-member American Dental Association, will be taking its annual meeting there in 2005, a first for the 141-year-old organization--and the largest convention ever for Philadelphia, even bigger than the Republican National Convention scheduled there this summer.

Owings, who about 18 months ago joined ADA as assistant executive director of the division of conference and meeting services, says Philadelphia has been very much on the upswing in the last decade--more than a dozen new properties are scheduled to open in the next few years. "They have a new state-of-the-art convention center and they are rapidly building hotels," Owings says. Philadelphia's accessibility is another plus. "A huge percentage of the nation's population can get to it by air, car, and train." Owings hopes these factors will draw a better-than-average attendance--the annual meeting usually has 40,000 to 50,000 attendees. ADA will use 52,000 room nights in Philadelphia and the group is expected to spend $24 million on lodging, food, entertainment, and travel.

BEYOND BORDERS NUTS 'N' BOLTS Tackling the nuts and bolts of planning events in other countries, the fourth annual Beyond Borders Conference drew about 85 registrants to the New York Hilton Hotel and Towers in New York City in March for an information-packed two-day conference. Luminaries at the March Beyond Borders in New York City included (from left) Sarah Graham Mann, a New England travel consultant, who was a panelist on destination marketing; Martin Kinna, CMM, managing director, Martin Kinna Associates, London, who moderated a panel discussion on international site selection via the Web; and Virginia M. Lofft, vice president of Adams Business Media, who initiated the conference four years ago. Beyond Borders was produced by Adams Business Media, publishers of this magazine as well as the annual Beyond Borders magazine supplement.