Fall 2021 Hospice and Palliative Care Advisory Committee Meeting

Laura E. Dingfield, MD, Chair, Hospice and Palliative Medicine Advisory Committee

The newly established Hospice and Palliative Medicine Advisory Committee met for the first time virtually on December 2, 2021 to discuss important issues facing the discipline.

Members of the new Advisory Committee and the Boards they represent are:

Laura E. Dingfield, MD, Committee Chair, ABIM
Martha Twaddle, MD, ABIM
Stephen Hays, MD, American Board of Anesthesiology (ABA)
Jessica Stetz, MD, American Board of Emergency Medicine (ABEM)
David Nowels, MD, American Board of Family Medicine (ABFM)
Christine Kistler, MD, ABFM
Christopher O’Hara, MD, American Board of Pediatrics (ABP)
Two public members will be added to the Committee prior to the spring 2022 meeting.

Below is a summary of the key takeaways from the meeting:

Leadership Update

Richard J. Baron, MD, ABIM President and CEO, kicked off the meeting and discussed the role of the Advisory Committee and its importance.

Dr. Baron said the advent of two new Advisory Committees – in Hospice and Palliative Medicine as well as Sleep Medicine – signals a significant achievement that should provide optimism for the future of these disciplines. He noted that for the first time there is a single body that can take on shared challenges and opportunities in a coordinated fashion, with the ability to address broader issues of policy, training requirements, and more within the discipline.

Dr. Baron said the new Advisory Committee can be seen as a force multiplier – leveraging the reach of each individual ABMS Member Board for the good of the discipline to more deeply engage with the community and ensure our programs and policies are meeting their needs. He noted that Advisory Committee members were selected from the Member Boards representing the discipline and will include important patient and public voices to provide the grounding and perspectives needed to ensure success.

Orientation

Anamika Gavhane, ABIM Director of Medical Specialties & Policy Coordination, provided a brief orientation outlining the pathways to certification in the discipline, the structure of ABIM Governance that surrounds Advisory Committees, the areas of oversight entrusted to them, and their roles.

When asked about what other organizations should this group be engaged with, members gave examples including the American Academy of Hospice and Palliative Medicine (AAHPM), the American Society of Clinical Oncology (ASCO), and geriatric medicine and palliative care groups and societies.

Committee members shared the reasons why they joined the Committee and expressed their passion for the field and their commitment to the betterment of the community. They agreed that the Committee has an important role to assess and assure quality standards, and should work toward always making the field better.

Longitudinal Knowledge Assessment (LKA^TM) Update

Alison Carey, Senior Director of Engagement and Digital Experience, and Jeffrey Miller, ABIM’s Chief Information Officer, gave the Advisory Committee a preview of the Longitudinal Knowledge Assessment (LKA) platform and updated the committee about how ABIM has engaged physicians throughout the development process to ensure it will meet their needs and provide a good user experience.

The engagement work included establishing a Physician Advisory Panel of 10 board certified physicians, who met on a monthly basis to share feedback on a variety of areas, such as the LKA assessment platform, communications materials, and other program design elements.

The Panel’s insights were enhanced through regular user-testing sessions, additional physician interviews, surveys and feedback gleaned from diplomate phone calls and emails. In addition, in August 2021, 26 physicians volunteered to serve as beta testers for the LKA platform to help identify bugs and any user experience issues; their feedback resulted in important improvements to the assessment platform prior to launch.

All of this physician feedback also helped generate a comprehensive LKA Physician Journey, outlining physician opportunities and challenges. Some of the top challenges were discussed during the meeting to help prepare members in case colleagues approach them with questions.

For example, one challenge identified was that enrolling and participating at the beginning of a physician’s assessment due year is a departure from how many ABIM diplomates engage with Maintenance of Certification (MOC), and may not be intuitive. To address this challenge, ABIM will communicate clearly through multiple channels, including emails, social media, its website and more to ensure physicians are informed about this new process.

ABIM plans to continue engaging with the community beyond the LKA launch and make improvements based upon physician feedback. All ABIM Board Certified physicians are encouraged to join the Community Insights Network where they may receive occasional requests to share their thoughts about various ABIM programs or topics.

Committee members applauded the feature that provides explanations of correct and incorrect answers and encouraged staff to make sure the explanations are concise to encourage physicians to read them. A follow-up presentation will be made to the Committee at the spring meeting.

Enrollment for the 2022 LKA is now open and the first quarter’s questions available in 12 disciplines, including Hospice and Palliative Medicine. The first quarter ends March 31, 2022, so enrolling early ensures physicians will have enough time to access and answer questions.

One way the LKA differs from ABIM’s traditional, 10-year MOC exam is that it better melds assessment and learning by providing regular feedback along the way that physicians can use to identify and address knowledge gaps. As a longitudinal assessment it’s scored differently too, allowing physicians to demonstrate improvement as they continue to answer questions over the 5-year cycle.

Diplomates of other co-sponsoring Member Boards (ABEM, ABFM, ABP, and ABA) should check with their certifying board about whether or not they will have access to the LKA at launch. Learn more about the features, benefits, and other important details of LKA at abim.org/lka.

Diversity, Equity and Inclusion: Progress Update

Pamela Browner White, ABIM Senior Vice President of Communications and Chief Diversity, Equity and Inclusion Officer and Lorna Lynn, MD, ABIM Vice President for Medical Education Research and the Staff Administrator for the Board of Directors Committee on Diversity, Equity and Inclusion, updated the Advisory Committee on ABIM’s progress in advancing DEI and presented an analysis of race and ethnicity data in internal medicine.

Ms. Browner White informed the committee of ABIM and ABIM Foundation’s Racial Justice statement: “It’s not simply enough to say passively we will do no harm; we pledge actively to do our part in opposing and dismantling systems and policies that cause harm to our patients and disproportionately affect those in Black and Brown communities.” Much of the work ABIM has accomplished has been guided by this statement. She encouraged Advisory Committee members to visit the year in review post on the ABIM blog.

There is a growing consensus that it’s no longer possible to ignore inequities in health care and the impact it has on certain communities. She presented statements on DEI and commitments to eliminate inequity in health care that were released by several other Member Boards, including ABEM, ABFM and ABA.

She invited the committee members to share how their organizations have worked to advance DEI and welcomed ideas on how ABIM can collectively partner with members’ organizations to help bring awareness to inequities in health care.

Members shared examples of their experiences with inequities within the field and spoke about the need for more community engagement, changes to policies and standards, and more hard conversations centered around DEI. Laura Dingfield, MD, Committee Chair, shared a resource called: Top 10 Tips on Antiracisim in HPM to add to the conversation.

Committee member Stephen Hays, MD, informed the group that ABA started collecting data in 2021, and at that time heard feedback from their diplomates about privacy concerns and the possibility of data being used to favor certain populations.

Dr. Lynn also provided a brief overview of ABIM race and ethnicity data. She noted that while the current reports rely on external data, in the future, ABIM will ask diplomates to self-identify their gender, race and ethnicity. To accomplish this, ABIM will collaborate with society partners and others to decide on what identifiers will be used.

As ABIM continues this work it will keep the community informed on its progress. More information can be found in a special section of our blog entitled ABIM’s Commitment to Health Equity.

Approval of Advisory Committee Members for Co-Sponsor Selection

Committee members reviewed candidates for two open positions on the Advisory Committee, and sent finalists to the Co-Sponsoring Committee for final selections. Candidates selected will join their first Committee meeting in Spring 2022.

In Closing

If you have questions after reading this report, please connect with us through the following channels: