Board Liaison Report

 KaplanJay Kaplan, MD, FACEP

The following is an update from your ACEP Board Liaison:

This section newsletter is about heroes. And you are my heroes. There are many professions where you would not have worked as hard or cared as much . . . and you chose to be an emergency physician. I am honored to be your colleague. As we continue on our individual journeys, we want to continue to grow and prosper. Part of my responsibility as your Board Liaison is to work with other College leaders to ensure that you have the opportunities to do so. I want to report to you what we have been involved in on your behalf . . .

ACEP14 in Chicago
ACEP14 is almost here. Whether you’re a seasoned veteran or a brand new attendee, ACEP14 will be an experience like none other. You will find new ways to learn, new opportunities to network, and new reasons to build a solid foundation for our specialty. Highlights include the following:

  • 350 educational courses, labs and workshops
  • 26 topic areas related to clinical issues and practice trends
  • NEW! An “EM Hackathon” to crowd-source health care solutions*
  • An Opening Session with the international bestselling authors of Freakonomics and SuperFreakonomics, Steven Levitt and Stephen Dubner,
  • Sessions designed specifically for residents and medical students
  • An expanded, case-based innovatED experience
  • Wellness Center for your annual check-up
  • Dine around events for quality one-on-one time with notable EM leaders
  • The ACEP14 Kickoff Party at the popular Navy Pier
  • A Closing Celebration at the Museum of Science and Industry

*ACEP has teamed up with Chicago Health Tech and Chicago Health 2.0 to have an emergency medicine problem-solving challenge during ACEP14. Set for Oct. 24-26, the EM Hackathon leverages out-of-the-box thinkers for an amped-up, all-night problem-solving session where emergency physicians can pitch a problem and then collaborate with a team of varied experts to develop a practical solution. Prizes will be awarded during ACEP14.

So come to Chicago at the last minute for ACEP14. You will have fun, learn a lot and spend time with colleagues from all over the US and the world.

ACEP’s Quality Efforts
Since the conclusion of the work of ACEP's Registry Task Force in January, ACEP and its Board of Directors have become increasingly aware of an imperative from CMS that our members and our specialty will need to report quality measures through a qualified clinical data registry (QCDR). Beginning in 2015, if our specialty is not reporting measures pursuant to a QCDR, we will be hit with a potential 6% cut in Medicare reimbursement. This could translate conservatively to $3,500 per physician and more than $120 million to our specialty. ACEP members are increasingly asking the College to develop a clinical data registry to prepare them for the changes that are coming that will affect every ACEP member.

ACEP has been vigorously working to develop quality measures (at a budgeted cost of approximately $50,000 per measure), with financial support from the Emergency Medicine Action Fund and the American Board of Emergency Medicine. A QCDR would allow ACEP to develop quality measures more quickly and easily and at less cost than currently. ACEP will be issuing an RFP to some proven vendors who have been approved by CMS to establish QCDRs with other medical specialty societies. ACEP leadership has appointed a Registry Review Group to help develop a recommendation. We expect to have a recommendation approved by the ACEP Board of Directors at its October meeting with a goal of having a QCDR application into CMS by the end of January to facilitate reporting in 2015. It is hoped that this QCDR can be utilized or done in conjunction with ABEM and AOBEM.

Patient satisfaction surveys either make us feel good about our work or terrorize us. With regard to the Emergency Department patient satisfaction survey currently in development, formerly referred to as ED CAHPS (Emergency Department Consumer Assessment of Health Care Providers and Systems, to be consistent with the inpatient HCAHPS), CMS just published its second version of the survey now referred to as the ED PEC, ED Patient Experience of Care survey. If you are interested you may find it at: . I have tried repeatedly to push for ACEP’s input into the survey development process by CMS. I was involved in a conference call in July with the project team at CMS which is responsible for developing the survey tool. I made several suggestions regarding the wording of the questions on pain management and also how other questions were being worded. I am hopeful that they listened when they wrote the following comment in their memo: “CMS plans to conduct additional testing on these instruments, which may include testing alternative items related to pain management, such as whether providers explained the side effects of pain medications; the use or availability of non-opioid treatments; and whether providers safely managed patients’ pain. The pain items in the current instrument were adapted from the HCAHPS instrument, which asks how often the patient’s pain was well controlled and how often hospital staff did everything they could to help the patient with his or her pain. However, the ED is a different environment than an inpatient setting, and alternative questions may be more appropriate. CMS may also explore alternative questions related to ED waiting time and the extent to which patients are kept informed of delays.” If you plan on downloading the survey v2.0, be aware that they do give the following warning: “Please note that these instruments should NOT be considered final instruments that are endorsed by CMS, and they are not ready for use. CMS plans to conduct additional testing on these instruments to determine how they would be implemented with the current HCAHPS survey and to test alternative wording for some items.”

We have many challenges in front of us, as “the future is ahead of schedule.” What has made us successful up to this point will not make us successful in the future. We have the choice: Play victim, or Feel empowered. One of my favorite quotes is from Leonardo Da Vinci: “It had long since come to my attention that people of accomplishment rarely sat back and let things happen to them. They went out and happened to things.” It has been my pleasure to work with you and assist in any way I can.

We are in the midst of exciting times. If you have any questions or concerns, please feel free to reach out to me by email.


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