Contents

  1. 1Message from the Executive Vice President

    1. 1.1 Letter from the EVP

  2. 2Celebrating 100 Years

    1. 2.1 ACP’s Centennial Celebration

  3. 3Knowledge

    1. 3.1 Annals of Internal Medicine
    2. 3.2 MKSAP
    3. 3.3 IM Essentials
    4. 3.4 MOC Navigator
    5. 3.5 DynaMed Plus
    6. 3.6 Internal Medicine Meeting 2015, Boston
    7. 3.7 Internal Medicine In-Training Examination
    8. 3.8 Publications

  4. 4Setting Clinical Standards

    1. 4.1 New ACP Clinical Policies and Recommendations
    2. 4.2 High Value Care
    3. 4.3 Adult Immunization
    4. 4.4 Ethics & Professionalism

  1. 5Advocacy and Public Policy

    1. 5.1 Advocacy for an Improved Payment System
    2. 5.2 Advocacy to Reduce Administrative Complexities
    3. 5.3 Advocacy to "Put Patients First"
    4. 5.4 ACP’s Leadership Day
    5. 5.5 Reducing Firearm Injuries and Deaths

  2. 6Practice Support

    1. 6.1 Physician & Practice Timeline
    2. 6.2 ICD-10
    3. 6.3 ACP Practice Advisor
    4. 6.4 ACP Practice Transformation & Quality Improvement Support
    5. 6.5 MLE

  3. 7Collaboration

    1. 7.1 International Relationships
    2. 7.2 Center for Patient Partnership in Healthcare
    3. 7.3 Affiliate Membership with AMWA
    4. 7.4 Connecting with Your Peers
1

Message from the Executive Vice President

  1. 1.1 Letter from the EVP

Letter from the EVP and CEO

Dear Colleagues,

Since the founding of the American College of Physicians (ACP) in 1915, ACP leaders have made it their mission to advance medical science, serve the profession and its patients, and secure the future of internal medicine.

Over the years, numerous changes have affected where and how internists practice medicine. Large group practices are replacing solo practitioners and younger physicians are choosing different employment settings. Online diagnosis forums, minute clinics, electronic health systems that still fall short of what practitioners need, and administrative complexities and regulatory requirements are making it difficult to navigate the terrain of today’s primary care environment.

Despite the changes and challenges, one thing remains clear. Internists and internal medicine subspecialists—who provide and coordinate the best care for an array of complex and complicated issues and integrate the highest level of scientific evidence and reasoning with patients’ needs, goals, and preferences—are essential to medicine’s future.

Equally clear, ACP remains committed to helping you, its members, stay ahead of the curve on all issues related to medical science, patient care, and practice improvement. And we will continue to advocate on behalf of our members to address administrative mandates that do not improve quality of care and deplete physicians’ most valuable resource—time.

A major priority for ACP over the past year has been the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. We have strongly advocated to ABIM about the need for significant reform, and ABIM has begun to make changes. There’s still work to be done. ACP leadership is committed to advocating on your behalf and representing your concerns, and we’ll continue to work toward ensuring the MOC process evolves for increased relevance and value.

The recent repeal of Medicare’s Sustainable Growth Rate (SGR) formula (H.R. 2) and transition to a new value-based system represents a historic moment, and we applaud the efforts of so many in Congress who worked in a bipartisan fashion to develop this legislation. The legislation does more than remove yearly payment cuts, it also provides strong incentives for physicians to engage in activities to improve quality. It streamlines existing quality reporting programs and provides additional support to physicians who participate in Patient-Centered Medical Homes and other alternative payment models shown to improve outcomes.

Lessons from the past shaping the future

This year, ACP is celebrating its 100 year anniversary. Our history is evidence that ACP has adapted, evolved, and defied the odds, surviving multiple recessions, two World Wars, the Great Depression, and a seamless transition into the Digital Age.

Today, as we find ourselves fully immersed in a high-tech world, surrounded by a knowledge-based society and a global economy, the landscape may be different but the qualities that have made the College a lasting and durable entity are with us still:

  • Mission
    • Our mission is to enhance the quality and effectiveness of health care by fostering excellence and professionalism in the practice of medicine continues to unite us. We work diligently to improve and expand our portfolio of educational resources by extending their scope and embracing emerging technologies to better meet the needs of the entire internal medicine community—general internists, subspecialists, hospitalists, educators, residents and fellows, medical students, allied health professionals, and patients.
  • Leadership
    • ACP Regents, Governors, and committee members continue to take a grass-roots approach to addressing the issues that will impact our patients, our members, and our profession.
  • Relevance
    • ACP is continually expanding the scope of its educational products, publications, initiatives, and clinical guidelines, and finding innovative ways to deliver their content. Our goal is to help our members succeed in their practices by meeting requirements, reporting on quality of care measures, and transforming their practices into patient-centered medical homes.

In a culture that worships everything new and young, ACP is proud to proclaim we are not new. We are 100 years old. Mindful of the past, but with feet firmly planted in the present, our goal is to secure a satisfying future for internists and forge a lasting legacy of Leading Internal Medicine, Improving Lives.

I welcome your feedback and thank you for your continued support.

Sincerely,

2

Celebrating 100 Years

  1. 2.1 ACP’s Centennial Celebration
⇧

ACP's Centennial Celebration

To honor ACP’s 100-year anniversary, a series of articles and events are being offered throughout the year to celebrate ACP's commitment to excellence and its dedication to internal medicine and patient care.

  • An online timeline features historical facts, images, and anecdotes about ACP in a decade-by-decade format, and an inspiring video pays tribute to ACP’s past, our mission, and our members.
  • A commemorative history book, Serving Our Patients and Profession: A Centennial History of the American College of Physicians (1915-2015), edited by ACP EVP/CEO Emeritus Dr. John Tooker and ACP President Emeritus Dr. David Dale, includes contributions from many past and current officers, leaders, and staff.
  • Annals of Internal Medicine is publishing historical articles corresponding to current topics in the journal. Several History of Medicine articles were also included, and photographs of internal medicine physicians were featured on the cover.
  • ACP Internist is featuring articles focusing on each decade of ACP's history.
  • A social media campaign throughout the year is highlighting key historical facts and images (#ACP100YRS), and a series of member profiles, featuring multi-generational internists, are being highlighted in ACP IMpact, the medical student newsletter.
    • 3

    Knowledge

    1. 3.1 Annals of Internal Medicine
    2. 3.2 MKSAP
    3. 3.3 IM Essentials
    4. 3.4 MOC Navigator
    5. 3.5 DynaMed Plus
    6. 3.6 Internal Medicine Meeting 2015, Boston
    7. 3.7 Internal Medicine In-Training Examination
    8. 3.8 Publications

    Providing educational resources, news, and information to enhance clinical practice and support, ongoing clinical education, and high quality patient care

    Annals of Internal Medicine

    Annals of Internal Medicine, one of the top four most widely cited peer-reviewed general medical journals in the world, continues to provide physicians with the latest evidence-based, practice-relevant information and research available while offering new formats to deliver content and captivate readers.

    Annals of Internal Medicine now has an impact factor of 17.810—the highest of any specialty journal in the Thomson Reuters' General and Internal Medicine category. The Impact Factor is a measurement of the frequency with which the "average article" has been cited. Annals has risen in rank to 4th among 153 general medicine journals. It is one of the most highly cited and influential journals in the world.

    Beyond the Guidelines

    This year, Annals of Internal Medicine launched a new multimedia educational series that goes Beyond the Guidelines to focus on the care of a patient who "falls between the cracks" in available evidence and for whom the optimal clinical management is unclear. Each Beyond the Guidelines session is presented in a moderator-led debate format and includes print and video components. The Beyond the Guidelines sessions are eligible for CME and MOC credit.

    Visit www.annals.org/grandrounds for more information about the Beyond the Guidelines series.

    High-profile Studies

    Several articles published in Annals of Internal Medicine were among the most talked-about health stories of 2014. An article on the effects of low-fat and low-carbohydrate diets made the list of top 100 academic papers of the year. Articles on breast density, pelvic exams, and the effect of pill appearance on patient adherence also appeared in top national newspapers and TV news broadcasts. An article on the health hazards of sitting too long even caught the attention of late-night comedian Jimmy Kimmel, who used a humorous sketch to explain the study to viewers during his popular monologue.

    Keeping You Updated on Current Issues

    Several articles on such topics as the Ebola virus and the earthquake in Nepal were published in Annals of Internal Medicine and featured on an emergency access initiative page. Readers were additionally directed to the Centers for Disease Control and Prevention website for all of the latest news and information on Ebola.

    Annals Virtual Patient Cases

    Annals Virtual Patients, the digital medical education tool that tests a physician's decision-making skills through examination, diagnosis, and treatment of a virtual patient, released the third and fourth series of cases.

    Series 3 Cases include:

    • Gastrointestinal Bleeding
    • Chlamydia and Gonorrhea
    • Delirium
    • Painful Hip
    • Lyme Disease
    • Common Skin Disorders

    Series 4 Cases include:

    • Parkinson’s Disease
    • Migraine
    • Pulmonary Hypertension
    • Hyperthyroidism
    • A Woman with Dyspnea and Edema
    • Avoiding Problems in Transitions of Care

    The Consult Guys

    Physicians continue to laugh while they learn with The Consult Guys, a monthly video series featuring Geno Merli, MD, MACP, and Howard Weitz, MD, MACP, who use humor and draw on evidence as they address clinical problems. These brief videos are open to all to view. Some of the episodes feature "stumper" questions and slides sets, and all are accompanied by links to selected resources cited in the video and an opportunity for ACP members and Annals subscribers to earn free CME credit.

    New videos released this year include:

    • Too Close for Comfort? For How Long Must I Stop This Anticoagulant for an Epidural?
    • Clearing the Air: When to Stop Smoking Before Surgery
    • Clean Coronaries But a Broken Heart
    • Spinal or General Anesthesia?
    • Balancing the Medication Portfolio 5 Years After a Heart Attack
    • Dressed to Kill? Can Neckties Spread Infection
    • Is that Hemoglobin High Enough?

    Annals for iPad

    An updated version of the Annals of Internal Medicine iPad Edition includes redesigned pages, more ACP content, a statistical glossary, and improved navigation and linking.

    The Annals iPad app is free to download through iTunes, and selected articles are free to all users. ACP members and individual subscribers to Annals will have access to all content as part of their membership or subscription.

    MKSAP®

    MKSAP® 17

    This year marks the release of the College’s leading self-study program. The 17th edition of ACP's Medical Knowledge Self-Assessment Program (MKSAP® 17) is available for pre-order in both print and digital formats.

    This new version of MKSAP® features 1,200 multiple-choice questions covering 11 internal medicine subspecialties and is aimed at helping physicians update their knowledge, earn CME credit, and prepare for their certification or recertification exams.

    • MKSAP® 17 Print includes 11 books, each focusing on a specific area of internal medicine and including High-Value Care recommendations and integrated High Value Care key points, hospitalist-focused content, tables, and full-color images.
    • MKSAP® 17 Digital includes all the text content and questions included in MKSAP® 17 Print, delivered online and as an app for use on a computer, tablet, or smartphone. Digital text updates and 200 update questions are included. New features include a user-driven interface, improved custom quiz functionality, and the pretest feature, which allows users to focus their study approach.
    • MKSAP® 17 Complete includes MKSAP® 17 Print and Digital; 1200 digital flashcards linked to the related self-assessment questions; an updated version of Virtual Dx, including 450 image-based questions; and a new edition of the study-strategy guide, Board Basics.

    IM Essentials

    ACP collaborated with the Clerkship Directors in Internal Medicine (CDIM) to develop IM Essentials, an integrated suite of educational materials to help third-year medical students care for patients, prepare for clinical rounds, and study for the end-of-rotation and USMLE Step 2 examinations.

    IM Essentials combines the self-assessment questions (formerly in MKSAP for Students) and the textbook content of Internal Medicine Essentials for Students in a single, updated, and integrated suite of educational materials with a variety of new enhancements for use by clerkship directors and students.

    MOC Navigator

    Over the past year, ACP launched a new interactive tool, the ACP MOC Navigator, to help guide ACP members through the ABIM’s Maintenance of Certification (MOC) process and help them select ways to meet requirements and earn points. The MOC Navigator provides an easy-to-use, step-by-step interface to make decisions about participating in the program, learn about enrollment in the program, understand the requirements, and discover resources to earn points and prepare for the final examination. It also provides recommendations for ways to meet the requirements that fit best with a physician’s specific preferences and professional situation.

    DynaMed PlusTM

    Clinical content that is current, concise, and easy to search

    Beginning August 3, 2015, ACP members will have free access to DynaMed Plus, a new, enhanced version of the leading evidence-based point-of-care clinical reference tool owned by EBSCO Health. DynaMed Plus includes overviews and recommendations for more than 750 topics, 2,500 searchable images, and numerous calculators — all in a responsive design and including mobile apps for Android and iOS.

    Internal Medicine Meeting 2015, Boston

    ACP's annual scientific meeting, Internal Medicine 2015, held in Boston, MA, April 30 - May 2, featured more than 200 scientific sessions and broke a record for highest attendance, drawing more than 10,000 attendees, including over 7,700 physicians.

    ACP's 2015 Internal Medicine Meeting featured several events designed to help ACP celebrate its Centennial. Special sessions included "Defining Internal Medicine: The History of ACP," "History of Politics in American Medicine," "The History of Annals of Internal Medicine and the Future of Medical Journals," and "Award-Winning Innovations in High Value Care."

    Tom Daschle, the former U.S. Senator and Senate Majority Leader from South Dakota, delivered the keynote address at Opening Ceremony. The topic of Senator Daschle's speech was "Decades of Daschle: An Insider's View on President Obama's Public Policy." Daschle advocated for a single-payer healthcare system and co-wrote the 2008 book Critical: What We Can Do About the Health-Care Crisis.

    To celebrate ACP’s 100th anniversary, medical students, residents/fellows, and practicing physicians were invited to express their unique vision of medicine through visual and literary art for the ACP Art Exhibition & Competition: The Past, Present, and Future of Medicine.

    At this year's meeting, ACP named 55 new Masters (MACP) and inducted more than 500 members as new Fellows of the College (FACP). The College also recognized the achievements and contributions of 76 Chapter Laureates, 20 National Awardees, two Annals of Internal Medicine Junior Investigators, and granted the Herbert S. Waxman Clinical Skills Center Teaching Scholarship Award to six chief residents. Hundreds of ACP Young Achievers—students and residents who participate in ACP’s Poster and Abstract competitions and the extremely popular Doctor’s Dilemma contest—were also recognized.

    Make plans now to attend ACP's 2016 Internal Medicine Meeting in Washington, DC May 5-7, 2016.

    Internal Medicine In-Training Examination™

    ACP's Web-based Internal Medicine In-Training Examination (IM-ITE) was developed in collaboration with the Alliance for Academic Internal Medicine™ (AAIM). The IM-ITE is designed to:

    • Give residents an opportunity for self-assessment.
    • Give program directors the opportunity to evaluate their programs.
    • Identify individual resident knowledge gaps to guide learning.

    The 2015 IM-ITE will be available for administration from Friday, August 28, through Monday, September 14, 2015 (excluding Labor Day, September 7, 2015).

    The IM-ITE content is targeted to residents at the midpoint in their training, but residents frequently take the examination during each postgraduate year to track the progress of their medical knowledge over the course of their training. In addition, faculty members, program directors, and other physicians and health care professionals with an interest in internal medicine may take the examination to test their medical knowledge against that of residents or to prepare for the Maintenance of Certification exam.

    More than 26,000 residents from 11 countries participated in the 2014 exam. This was the first administration of the examination in Web-based format.

    The IM-ITE is written by a committee of 11 expert physician-authors. Questions are written at the level of proficiency expected from second-year residents and cover a wide spectrum of knowledge in internal medicine, including acute and chronic care, inpatient and ambulatory problems, and essential clinical skills.

    Publications

    ACP Internist and ACP Hospitalist

    ACP’s award-winning publications keep readers informed and current with all of the latest information vital to internal medicine and hospital medicine. The articles featured in these publications cover breaking news, provide clinical and policy updates, and offer in-depth analysis of issues that affect patient care and physician satisfaction. Diabetes Monthly is a comprehensive wrap-up of news about diabetes and related topics.

    ACP Internist won two awards this year from the American Society of Healthcare Publication Editors, an association that recognizes excellence in healthcare reporting and writing: Gold for Best Newsletter overall and Gold for Best Cover Illustration for its September 2014 issue.

    ACP Hospitalist won a 2015 EXCEL Award from Association Media & Publishing for its September 2014 cover story, "The telehospitalist: Will your next job be inside a robot?" The EXCEL Awards honor and represent the best publishing products of the association industry.

    Books

    ACP published the second edition of Fenway Guide to Lesbian, Gay, Bisexual, and Transgender Health, written by leading experts in the field of LGBT health in conjunction with The Fenway Institute at Fenway Health. This updated edition addresses the important issues facing patients and practitioners, including:

    • Principles for taking an LGBT-inclusive health history
    • Caring for LGBT youth, families, and older adults
    • Behavioral Health Care: coming out; intimate partner violence; drug, alcohol, and tobacco use
    • Understanding health care needs of transgender people
    • Development of gender identity in children and adolescents
    • Sexual health and HIV prevention
    • Policy and legal issues
    4

    Setting Clinical Standards

    1. 4.1 New ACP Clinical Policies and Recommendations
    2. 4.2 High Value Care
    3. 4.3 Adult Immunization
    4. 4.4 Ethics & Professionalism

    Providing recommendations and evidence-based resources to help clinicians stay current and navigate complex clinical issues

    New ACP Clinical Policies and Recommendations

    ACP's clinical policy papers are developed by the Clinical Guidelines Committee (CGC) and the High Value Care Task Force (HVCTF) and aim to help physicians deliver the best possible care to their patients. Clinical recommendations are based on a systematic review of the evidence or a review of existing guidelines. The HVCTF addresses the value of tests and interventions by evaluating their benefits, harms, and costs. The following policies were published over the past year:

    High Value Care

    ACP continues to expand its High Value Care initiative, which includes components of clinical, educational, and public policy recommendations and resources aimed at providing the best possible care to patients while simultaneously eliminating unnecessary costs to the health care system. ACP's High Value Care programs are designed to help physicians, health care professionals, medical students, and patients understand the benefits, harms, and costs of tests and treatment options for common clinical issues. For example, ACP is currently collaborating with the American Association of Nurse Practitioners (AANP) to create a model for physicians and nurse practitioners to learn to practice High Value Care in an inter-professional way. This work is being supported by a grant by the Josiah Macy Jr. Foundation.

    High Value Care course for medical students

    ACP and MedU created an online High Value Care course for medical students based on a curriculum developed by ACP and the Alliance for Academic Internal Medicine (AAIM).

    The online course helps medical students evaluate the benefits, harms, and costs of tests and treatment options so they can make high value care a reality in clinical practice. The course has 6 modules that include short interactive virtual patient cases, brief instructional videos, embedded links, and key teaching points. The course is available to any school or student with a subscription to MedU.

    ACP High Value Care module on managing conflicts of interest

    ACP continues to expand its resources with the addition of the latest ACP High Value Care module, Managing Conflicts of Interest in Interactions with the Pharmaceutical and Medical Device Industries, which is part of ACP's High Value Care curriculum. It offers three 10-minute lectures covering basic topics and three "unfolding cases" for in-depth learning about direct-to-consumer drug advertising, industry sponsorship of clinical trials, and the art of communicating with patients about sample medication.

    All content is accessible via desktop, laptop, tablet, or mobile device. Free online CME credits and Maintenance of Certification (MOC) points are available for both the lectures and the cases.

    Online High Value Care Cases

    A series of free online High Value Care Cases and questions are available to help clinicians weigh the benefits, harms, and costs of tests and treatment options for common conditions in order to improve health and eliminate waste.

    Each of the five topics can be completed in 30 to 60 minutes on desktops, laptops, tablets, or mobile devices.

    Internal Medical Residents and High Value Care

    A study co-authored by ACP staff and published in Annals of Internal Medicine in October 2014 showed that High Value Care sub-scores from the Internal Medicine In-Training Examination reflect the importance of training medical residents to understand the benefits, harms, and costs of tests and treatments.

    A survey and analysis co-authored by ACP staff and published in Academic Medicine in June 2015 showed that it is important for faculty to discuss High Value Care concepts during patient care to help residents increase value for patients. Only about one in four internal medicine residents agreed with the statements "I know where to find estimated costs of tests and treatments" and with "I share estimated costs of tests and treatments with patients."

    Smart Testing Series

    ACP and Cleveland Clinical Journal of Medicine collaborated on a new series, Smart Testing, to help physicians provide high value care by presenting clinical scenarios in which diagnostic tests are commonly ordered in the absence of supporting data. The articles use evidence-based recommendations to clarify when testing is appropriate. ACP articles included in the series addressed the topics of appropriateness of cardiac stress testing in low risk patients and strategies for avoiding malpractice litigation while providing evidence-based care.

    Adult Immunization

    A new, free training module from ACP’s Quality Connect teaches residents about the science of adult immunization and provides evidence-based strategies for increasing vaccination rates. Residency programs can use the program materials in ambulatory and inpatient settings to meet the Accreditation Council for Graduate Medical Education requirements for quality improvement.

    Ethics & Professionalism

    CME & MOC

    • Ethics CME credits are available for completion of ethics case studies. CME credit and Maintenance of Certification (MOC) points are available with the English version of the ACP Ethics Manual, Sixth Edition.
    • Continuing Medical Education (CME) and Maintenance of Certification (MOC) activities associated with ACP’s Ethics Manual have been renewed through January 3, 2018.

    ACP provides valuable resources to help physicians maintain ethical standards and navigate difficult clinical situations, with policy development on clinical ethics and professionalism issues, as well as research ethics and human rights issues.

    This year, the Ethics, Professionalism and Human Rights Committee published two new case studies, "Addressing a Colleague's Sexually Explicit Facebook Post" and "Wellness Programs and Patient Goals of Care."

    5

    Advocacy & Public Policy

    1. 5.1 Advocacy for an Improved Payment System
    2. 5.2 Advocacy to Reduce Administrative Complexities
    3. 5.3 Advocacy to "Put Patients First"
    4. 5.4 ACP’s Leadership Day
    5. 5.5 Reducing Firearm Injuries and Deaths

    Giving voice and guidance to the issues that affect the practice and future of internal medicine

    Advocacy for an Improved Payment System

    On April 16, President Obama signed a historic bipartisan bill repealing Medicare's sustainable growth rate (SGR) formula and transitioning to a new value-based payment system. ACP played a leading role in getting Congress to pass the Medicare Access and CHIP Reauthorization Act (MACRA) and ensuring that it creates positive incentives for high quality, patient-centered primary and subspecialty care by internists. Highlights of MACRA include:

    1. It permanently replaces the failed SGR formula, including a 21 percent SGR cut that went into effect on April 1, with stable and positive updates during a 4.5 year transition period to a new payment system based on quality.
    2. Starting in 2019, physicians will have more choice and control over how they are paid. Each year, they will be able to choose between participating in a new quality reporting program called the Merit-Based Incentive Payment System (MIPS), or an alternative payment model (APM), such as Patient-Centered Medical Homes (PCMHs) or Accountable Care Organizations (ACOs):
      • MIPS will consolidate and streamline the existing Physician Quality Reporting System (PQRS), Meaningful Use, and Value-Modifier reporting programs into one quality improvement program, potentially reducing administrative burdens. Physicians will be able to receive higher incentive payment adjustments based on measurements of clinical quality, use of electronic health records, resource use, and practice improvement, compared to their peers and based on their own improvement.
      • Physicians who choose the APM pathway will get 5 percent fee-for-service bonus payments each year from 2019 to 2024. Each APM will also offer physicians the opportunity to earn additional revenue if their APM is able to achieve cost-savings and/or quality improvements.
    3. Strong incentives are created for Patient-Centered Medical Homes, innovative models of care that have been shown to achieve better outcomes, improve patient experiences, and reduce costs. Physicians in qualified PCMHs will get the highest possible score for the practice-improvement category in the new MIPS program, or they can qualify as an APM without taking direct financial risk.
    4. MACRA also includes funding for the development of quality standards, technical assistance to small practices, and continued funding for the National Health Service Corps, Community Health Centers, Teaching Health Centers, and the Children's Health Insurance Program.

    The SGR repeal is finally finished but it did not come about easily. On behalf of all of us at ACP, we say thank you to Congress for seeing the wisdom of repealing this flawed formula and to our members for their tenacious advocacy over this long journey to SGR repeal.

    ACP’s legislative advocacy efforts for a better physician payment system will now focus on: extension of Medicare’s Primary Care Incentive Program beyond 2015, which pays internists and other primary care physicians a 10 percent bonus for office visits and other designated services, and reinstatement of the Medicaid Primary Care Pay Parity program, which for two years paid internists no less than the Medicare rates for designated services to Medicaid enrollees, until Congress allowed it to lapse at the end of 2014.

    And, as long recommended by ACP, this year marks the first time that Medicare has agreed to begin paying physicians for Chronic Care Management, using the new CCM code (99490) for treatment of Medicare patients with multiple chronic conditions. ACP created a CCM tool kit to help clinicians implement the CCM code in their practices, and will continue to advocate for improvements in the new CCM payments.

    Advocacy to Reduce Administrative Complexities

    ACP has long worked to alleviate specific regulatory and insurance requirements; it is now taking this up a notch by developing an evidence-based, comprehensive approach—called the Patients Before Paperwork initiative—to systematically:

    • Identify and prioritize which complexities are the top concerns for ACP members and their patients, and why. The top three concerns reported by members are electronic health records and meaningful use rules, quality reporting, and interactions with health plans.
    • Educate ACP members, other physicians, consumer advocates, and policy makers on what makes up administrative complexities, including the intent of the requirement and how each complexity impacts patients and physicians.
    • Implement the most effective advocacy, stakeholder engagement, and practice support approaches to help mitigate, eliminate, or otherwise address the top priority complexities.
    • Achieve results to reduce physician burn-out, help restore the joy of practice, and reinvigorate the patient-physician relationship.

    Our efforts are underway, including initial changes in the EHR meaningful use program, to reduce the burden on practices. ACP’s position paper, published in Annals of Internal Medicine, "Clinical Documentation in the 21st Century" offers a roadmap to redesign EHR clinical documentation so that it provides physicians with the most relevant and applicable clinical information that they need, in the most useful and least burdensome way possible.

    The College also is providing tools to members to help them with regulatory challenges, including the ACP Physician & Practice Timeline– a summary of upcoming important dates related to a variety of regulatory, payment, and delivery system changes and requirements. Members can sign up for text alerts from the Timeline by texting ACPtimeline (no space) to 313131 from your mobile phone. Stay tuned to learn more about Patients Before Paperwork later this year.

    Advocacy to "Put Patients First"

    While the College puts a high priority on advocacy to improve reimbursement and reduce administrative complexities, ACP also puts equal emphasis on championing positions relating to public health, health insurance coverage, and other issues that "put the patient first." The Lancet published a reflection on the ACP’s 100th anniversary and noted that internal medicine through ACP is the “conscience of the medical profession." Although admittedly a high bar, the College’s recent policy efforts to "put patients first" include:

    ACP’s Leadership Day

    ACP's Leadership Day is an annual two-day event held in the nation's capital that provides ACP members a unique opportunity to experience grassroots advocacy training, attend in-depth issue briefings, and meet with their senatorial and congressional representatives. This year, 287 physicians and medical students from almost every state came to Washington to increase the visibility of internal medicine issues and share with lawmakers how policy affects their practices and their patients. Watch a video about Leadership Day and see members speaking about their experience.

    Reducing firearm injuries and deaths

    Deaths and injuries related to firearms constitute a major public health problem in the United States. In response to firearm violence and other firearm-related injuries and deaths, an interdisciplinary group of leaders from ACP, seven other national health professional organizations, and the American Bar Association called for measures to reduce firearm-related injuries and death. The group's recommendations were published in Firearm-Related Injury and Death in the United States: A Call to Action from 8 Health Professional Organizations and the American Bar Association, which appeared in the February 24th issue of Annals of Internal Medicine.

    The healthcare organizations that joined ACP in this effort were the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Emergency Physicians, the American Congress of Obstetricians and Gynecologists, the American College of Surgeons, the American Psychiatric Association, and the American Public Health Association. Broadly, the organizations support a public health approach to reducing firearm injuries and fatalities, similar to approaches used to reduce tobacco use, motor vehicle fatalities, and unintentional poisoning.

    From left to right: Dr. JudyAnn Bigby, Dr. Ali Raja, Daniel Conley and Dr. Steven Weinberger serve on a press briefing panel.

    In May, more than two dozen additional organizations joined ACP in calling for policies to help mitigate the rate of firearm injuries and deaths in the United States by endorsing Firearm-Related Injury and Death in the United States: A Call to Action from 8 Health Professional Organizations and the American Bar Association. A press briefing announcing the additional endorsing organizations was held at ACP’s Internal Medicine Meeting in Boston. Dr. Weinberger led the panel, which included Daniel Conley, Suffolk County District Attorney and representative for Prosecutors Against Gun Violence; JudyAnn Bigby, MD, Senior Fellow, Mathematica Policy Research and former Secretary of the Executive Office of Health and Human Services of the Commonwealth of Massachusetts; and Ali Raja, MD, MBA, MPH, FACEP, Vice Chair for Clinical and Strategic Affairs, Massachusetts General Hospital and Associate Professor, Harvard Medical School.

    For news and opinions about current public policy issues affecting internal medicine, read The ACP Advocate and The ACP Advocate Blog.

    For a detailed review of ACP’s advocacy efforts, go to: http://www.acponline.org/advocacy/ and to our Dynamic Health Care Guide for Congress and the Media.

    6

    Practice Support

    1. 6.1 Physician & Practice Timeline
    2. 6.2 ICD-10
    3. 6.3 ACP Practice Advisor
    4. 6.4 ACP Practice Transformation & Quality Improvement Support
    5. 6.5 MLE

    Offering practice support tools to enhance the efficiency, quality, and delivery of care

    Physician & Practice Timeline

    ACP’s Physician & Practice Timeline helps physicians stay on top of important dates and track deadlines for a variety of regulatory, payment, educational, and delivery system changes and requirements.

    New this year, a service was added to allow members to sign up for timely text alerts. Alerts will cover the Physician Quality Reporting System (PQRS), Medicare and Medicaid EHR Incentive Programs (Meaningful Use), the Medicare Value-Based Payment (VBP) Modifier program, ICD-10, the Physician Payment Sunshine Act (Open Payments), transitional care management codes, and the new chronic care management code. To sign up, text ACPtimeline (one word, not case sensitive) to 313131.

    ICD-10

    On October 1, 2015, the ICD-10 codes will replace ICD-9 for reporting medical diagnoses and inpatient procedures. In an effort to help practices transition as smoothly as possible, ACP offers a wide variety of free tools and resources to help clinicians understand, train for, and implement ICD-10.

    ACP also reviewed and assembled a list of many ICD-10 resources and partnered with content developers to make the following products available at discounted rates for ACP members:

    • TurboCoder is a downloadable coding resource that is similar to a traditional coding book, but electronic. It allows you to search and compare codes in both ICD-9 and ICD-10.
    • AHIMA's Clinical Documentation Training is an online training resource to help clinicians learn the documentation needed to support the specificity of ICD-10. (CME available)
    • Ready10 is a project management system that acts as a “virtual consultant” to guide practices through a step-by-step transition to ICD-10.
    • ICD-10 Documentation Training for Physicians is a video course developed by AAPC that teaches ICD-10-CM documentation requirements at the physician level. (CME available)

    ACP Practice Advisor

    ACP Practice Advisor helps physicians analyze the workflow of their clinical teams and office staff, and improve their ability to provide efficient, coordinated patient-centered care. Over the past year, two new free modules have been added: "Motivational Interviewing" and "Addressing Substance Use." A new clinical care module, "Assessing Cardiovascular Risk," has also been added. ACP Practice Advisor is free to internal medicine residency training programs. Contact practiceadvisor@acponline.org for information.

    ACP Practice Transformation and Quality Improvement Support

    ACP offers physicians, their practice teams, and health systems many resources and programs to help them improve patient care through practice transformation and quality improvement. Clinicians not only learn the basics of quality improvement but are supported in the practice transformation journey so as to create improved outcomes and efficiencies for their busy practice. Furthermore, many programs link to registries and performance reporting requirements, such as the Physician Quality Reporting System (PQRS), Bridges-to-Excellence (BTE), ABIM MOC Practice Assessment points, and residency program ACGME QI requirements. Opportunities for training to become a practice transformation champion also are available.

    ACP Quality Connect

    ACP Quality Connect programs allow physicians and their healthcare teams to implement quality improvement with help from ACP QI experts. Through live programming, virtual presentations, and coaching calls, staff can guide participants in using online QI tools and registries. Data for Physician Quality Reporting System (PQRS) submission can be uploaded from paper charts or electronic health records. Current projects focus on adult immunization, diabetes, and chronic pain.

    ACP Quality Connect Immunization Resources

    The ACP Quality Connect adult immunization initiative is part of a multi-state campaign – I Raise the Rates: Initiative to Raise the Adult Immunization Rates in Primary Care — to help physicians promote and implement adult immunizations. Contact the ACP Center for Quality to learn more about how you can become a part of the Initiative.

    ACP Adult Immunization Quality Initiative for Residency Programs

    A free program from ACP Quality Connect was launched with the goal of teaching residents about the science of adult immunization and providing evidence-based strategies for increasing vaccination rates. Residency programs can use the program materials in ambulatory and inpatient settings to meet the Accreditation Council for Graduate Medical Education requirements for quality improvement.

    ACP Practice Assessment Tools

    Using these free, web-based practice assessment products, physicians can earn both CME credit and ABIM MOC Practice Assessment points. Currently, assessment tools are available to help clinicians with the treatment of dementia, low back pain, and obesity.

    Near Miss Registry

    ACP facilitated the nationwide expansion of the Near Miss Registry, a program developed by the ACP New York Chapter. The Near Miss Registry offers educational resources and programs for residency programs and hospitals to identify safety risks and reduce medical errors, using a confidential and secure survey tool linked to educational and quality improvement resources.

    ACP Genesis Registry

    ACP developed, in collaboration with CECity, the ACP Genesis Registry, a quality reporting service to help physicians meet Meaningful Use requirements and improve patient care.

    The ACP Genesis Registry will accept data from EHRs and interested practices with continuous feedback reports presented through online performance monitors. Each monitor offers practices a user-friendly view of their performance results compared to national benchmarks, benchmarks established by ACP, as well as peer comparators, and a custom analysis of their measure gaps.

    Diabetes Collaborative Registry

    ACP, together with the American College of Cardiology, the American Diabetes Association, the Joslin Diabetes Center, and the American Association of Clinical Endocrinologists, launched the Diabetes Collaborative Registry, the first clinical registry aimed at tracking and improving the quality of diabetes and cardiometabolic care across the primary and specialty care continuum. The Diabetes Collaborative Registry will allow for a longitudinal study of diabetes presentation, progression, management, and outcomes, even as patients receive treatment from multidisciplinary care teams.

    Medical Laboratory Evaluation

    ACP’s Medical Laboratory Evaluation (MLE) program provides reliable, user-friendly proficiency testing services at substantial cost savings for laboratories that perform diagnostic testing where blood and bodily fluids are drawn. To improve quality patient care and ensure accurate diagnostic results, MLE offers technical and educational tools to assess, monitor, and improve the quality of laboratory testing.

    7

    Collaboration

    1. 7.1 International Relationships
    2. 7.2 Center for Patient Partnership in Healthcare
    3. 7.3 Affiliate Membership with AMWA
    4. 7.4 Connecting with Your Peers
    ⇧

    Joining other stakeholders in efforts to promote the value of internal medicine, improve patient care, and achieve better health for the population

    International Relationships

    S.B. Gupta, MD, FACP, Interim Governor of the new ACP India Chapter, presents a token of appreciation to ACP Immediate Past President, David Fleming, MD, MACP at the first ACP India National Conference.

    ACP Chair, Board of Regents, Tanveer P. Mir, MD, MACP, participates in a traditional lamp-lighting ceremony.

    ACP's Immediate Past President, Dr. David Fleming, was a speaker at the World Congress of Internal Medicine, held in Seoul, South Korea in October 2014, and is seated on stage, first row, far right.

    ACP India Chapter

    Effective January 2015, the ACP India Chapter became ACP’s 16th international chapter. ACP’s international chapters include Brazil, Canada (6 chapters), Central America, Chile, Colombia, India, Japan, Mexico, Saudi Arabia, Venezuela, and Southeast Asia. Total international membership is almost 12,000.

    First National Conference – New Delhi, India

    ACP hosted its First National Conference in New Delhi, India, September 5-6, 2014. The conference focus was "The Burden of Non-Communicable Diseases," and featured faculty speakers from both the U.S. and India.

    The meeting program included updates in: hypertension, diabetes, gastroenterology and hepatology, hematology and oncology, infectious diseases, and cardiology.

    ACP held its 9th International Forum during Internal Medicine 2015. ACP leaders and leaders of internal medicine from around the world met to discuss "Geriatrics: Care of the Elderly". The International Forum was moderated by Hans Peter Kohler, MD, FACP, Secretary General of the International Society of Internal Medicine. A panel of four physicians from Bangladesh, England, South Africa, and Venezuela commented on key questions related to the Forum’s theme, followed by a discussion by all attendees.

    Center for Patient Partnership in Healthcare

    ACP’s Center for Patient Partnership in Healthcare (CPPH) supports partnerships among clinicians, patients, and their families through shared decision-making, engagement, and education. ACP provides a number of tools and resources to support patient education, including chronic disease self-management guides, videos, and brochures. Additionally, through the CPPH, ACP works closely with patient advocacy partners at the national level to promote policies related to patient engagement and patient- and family-centered care. 

    ACP supported the following patient education initiatives this year:

    • Stopping Stroke Through Engaged Patients- ACP received grant sponsorship to develop a program to help patients recognize the signs and symptoms of nonvalvular atrial fibrillation (NVAF). The "Stopping Stroke Through Engaged Patients" (STEP) program, which includes an advisory committee of clinical experts and patient advocate representatives with support from CPPH, will develop a comprehensive toolkit that includes a self-management guidebook, worksheets to engage and empower patients, and a video to simulate shared decision-making conversations between patients and clinicians.
    • Patient FACTS Series - ACP has developed a new patient education series to facilitate conversations between patients and healthcare professionals about a variety of common healthcare topics. The Patient FACTS (Patients & Families – Advice for Conditions, Treatments & Symptoms) stress the importance of prevention, medication adherence, and lifestyle modifications and are written at or below a 6th grade level. Over 50 Patient FACTS topics will be released in summer 2015. Content from Patient FACTS is also used to provide patient-appropriate information as companion pieces with ACP clinical guidelines, high value care recommendations, and Annals of Internal Medicine articles.
    • Ambulatory Practice Assessment Program - Supported by a grant from the Gordon and Betty Moore Foundation, ACP has developed a survey to assess ambulatory care practices for the integration of patient- and family-centered concepts of care into daily practice. The survey focuses on four domains of patient-and family-centeredness: dignity and respect, information sharing, partnership with patients and families as members of the care team, and collaboration in practice redesign and transformation efforts. The survey, including pilot testing, implementation, and analysis of results, will be completed by the end of 2015.
    • Health Professional Education - ACP received funding from the Arnold P. Gold Foundation to support a session at ACP’s Internal Medicine Meeting 2015 meeting. The session featured a patient who shared his perspectives on navigating the healthcare system with a chronic condition and how a positive relationship with his physician enormously changed his quality of life. The CPPH continues to identify opportunities to educate health professionals about patient- and family-centered care and was recently awarded, along with the Medical Education Division, a grant to promote shared decision-making for cancer screening.
    • ACP Healthcare Roundtable - Patient engagement and patient-centered care were the topics of discussion at the 2014 ACP Healthcare Roundtable. The ACP Healthcare Roundtable provides a forum for industry leaders and ACP governance and staff to discuss critical issues affecting healthcare.Roundtable attendees heard presentations and a panel discussion by selected participants who identified the challenges and priorities relevant to patient engagement in their industry, field of practice, or area of policy concern. In break-out sessions participants discussed ideas for innovative approaches to engaging patients in care, practice design, policy, research, and advocacy in their organizations and in health care overall, and identified those areas most promising for action by group members.

    Affiliate Membership with AMWA

    ACP is committed to communicating and collaborating with healthcare stakeholders who impact the quality of primary care. This year, ACP and the American Medical Women's Association (AMWA) created an affiliate membership agreement whereby ACP members can become AMWA Affiliate Members as part of their ACP membership at no additional charge.

    Benefits of AMWA Affiliate Membership include access to AMWA publications, opportunities to gain national leadership experience on one of AMWA's committees, networking, mentoring, and special discounts to AMWA local and national events. The AMWA is an organization that functions at local, national, and international levels to advance women in medicine and improve women's health.

    Connecting with Your Peers

    Connecting with peers and keeping up-to-date is easy with online communication forums and mobile platforms.

    Special interest groups

    http://http://acpsigs.ning.com/

    ACP offers members access to online communities in which physicians share experiences, questions, and creative solutions with like-minded peers. Separate discussion groups focus on such topics and audiences as maintenance of certification, hospital medicine, small practices, work/life balance, Accountable Care Organizations/new practice models, emerging technologies, physician educators, and many more.

    Social media

    ACP and Annals of Internal Medicine are using social media more than ever to connect with members and communicate information relevant to internal medicine. ACP members are encouraged to join the online conversations and connect with other members on Facebook, Twitter, YouTube, Google+, and LinkedIn.

    ACP on the Go

    Mobile versions of Annals and MKSAP make it easy for members to stay informed and connected to all of the latest news and clinical updates. New apps for Annals iPad edition, MKSAP 16 Digital, and ACP's Clinical Guidelines are now available.

    1. 1Message from the Executive Vice President

      1. 1.1 Letter from the EVP

    2. 2Celebrating 100 Years

      1. 2.1 ACP’s Centennial Celebration

    3. 3Knowledge

      1. 3.1 Annals of Internal Medicine
      2. 3.2 MKSAP
      3. 3.3 IM Essentials
      4. 3.4 MOC Navigator
      5. 3.5 DynaMed Plus
      6. 3.6 Internal Medicine Meeting 2015, Boston
      7. 3.7 Internal Medicine In-Training Examination
      8. 3.8 Publications

    4. 4Setting Clinical Standards

      1. 4.1 New ACP Clinical Policies and Recommendations
      2. 4.2 High Value Care
      3. 4.3 Adult Immunization
      4. 4.4 Ethics & Professionalism

    1. 5Advocacy and Public Policy

      1. 5.1 Advocacy for an Improved Payment System
      2. 5.2 Advocacy to Reduce Administrative Complexities
      3. 5.3 Advocacy to "Put Patients First"
      4. 5.4 ACP’s Leadership Day
      5. 5.5 Reducing Firearm Injuries and Deaths

    2. 6Practice Support

      1. 6.1 Physician & Practice Timeline
      2. 6.2 ICD-10
      3. 6.3 ACP Practice Advisor
      4. 6.4 ACP Practice Transformation & Quality Improvement Support
      5. 6.5 MLE

    3. 7Collaboration

      1. 7.1 International Relationships
      2. 7.2 Center for Patient Partnership in Healthcare
      3. 7.3 Affiliate Membership with AMWA
      4. 7.4 Connecting with Your Peers
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