SMCS CME Program CME Documentation

1. SMCS CME ProgramCME Documentation Kristine Wakefield June 23, 2011

2. Required Documentation • CME Activity Planning Form • Disclosure Statement from all program planners, speakers, and moderators • Flyer/Announcement • Evaluation Form • Summary Evaluation Form • CME Activities Outcome Measure Analysis • Budget Form • Content Validation Form (if applicable)

3. Required Documentation Continued… CME Activities with Commercial Support Request from SMCS for commercial support Signed Letter of Agreement Documentation of costs paid by SMCS Documentation of reimbursement by commercial supporter The commercial supporter may not recommend/determine speakers, topics or objectives. CME Activities with Honorariums Signed Speaker Contract Agreement Signed Independent Contractor Checklist Speaker’s W-9 Copy of check request submitted for reimbursement 2

4. Planning Process • Physician program planner, or representative, presents topic and needs assessment to Education Team • Once topic and needs assessment has been presented and approved by Education Team, planning may begin • Complete required planning form and supporting documentation • Work with Education Team Liaison for questions

5. Upon CME Approval Notice of approval is emailed to program planner with two certificates The certificates are to be distributed as follows: Certificate of Credit for MDs and DOs only To be given to non-SMCS physicians Certificate of Attendance for Healthcare Professionals To be given to all attendees other than MDs and DOs Note: CME attendance is tracked electronically only for SMCS medical staff members. All other attendees must use their certificates as proof of attendance. The CME Activity may be advertised as a CME approved course Note: CME activity may not be advertised as “CME approval pending” 4

6. Upon CME ApprovalContinued… A sign-in sheet must be utilized and submitted to Medical Staff/CME Services at conclusion of activity The sign-in sheet must contain: Printed name of attendee, including degree (MD, DO, other) Number of hours attendee plans to report Attendees signature Facility name Title of CME activity and date Evaluations are to be obtained for all Single Activities and at least 10% of Regularly Scheduled Series, summary is to be submitted to Medical Staff/CME Services at conclusion of activity The program planner or designee is required to summarize all evaluations The evaluation summary must indicate the number of people who responded to each question 5

7. Following CME Activity Submit following documents to Medical Staff/CME Services Sign-In Sheet Summary of Evaluations Budget Form Completed CME Activity Outcomes Measure Analysis Commercial Support Copies of check requests for expenses Copies of receipts for expenses Copies of invoice to commercial supporter 6

8. Education Team Assessment Education Team will review summary of evaluations and outcomes measure analysis. Based on these documents, the Education Team will complete their own evaluation of the CME activity. Any deficiencies will be identified and the program planner will be notified. All review and action will be documented in the Education Team Minutes. 7

9. SMCS CME Program Overview The SMCS CME Program, via the Education Team, is responsible for ensuring all approved CME activities meet the IMQ/CMA CME Accreditation Standards The SMCS CME Program must submit an annual report listing all CME activities approved, note those receiving commercial support, and the costs associated with the CME Program The SMCS CME Program must also apply for re-accreditation every four (4) years. SMCS was surveyed in October 2010 and was approved for another four (4) years, with submission of an interim report to address deficiencies. 8

10. SMCS CME Program Resources Education Team members have been assigned as liaisons and are able to assist the program planners in completing the required documentation Following resources coming to internet site – SMCS CME Program: http://www.suttermedicalcenter.org/forourphysicians/index.html 2011 calendar of approved CME activities 6/23/11 Presentations Education Team Liaison Roster Documentation – Single Activity Documentation – Regularly Scheduled Activity Education Team Chair Bary Siegel, M.D.; Phone: 916-733-8725; Email: SiegelB@sutterhealth.org Medical Staff/CME Services Manager Kristine Wakefield, CPMSM, CPSC, Phone: 916-454-6955; Email: WakefiK@sutterhealth.org 9

11. Questions 10