Presentation to the

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Facilitating Medical Licensure Through
Information Sharing and Technology

• Presentation to the
• HRSA Health Information Technology Grantees
  Meeting
• November 6, 2007

2
FSMB Organization Mission

• Organization
• 70 member state medical boards
• Non-Profit Association since 1912
• Located in Dallas/Fort Worth
• www.fsmb.org

• Mission
• Improve the quality, safety and integrity of
  health care in the U.S. through the development
  and promotion of high standards for physician
  licensure and practice.

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Streamlining the Medical Licensure Process

• Objectives
• Facilitate telehealth practice across state lines
• Reduce burden faced by applicants in seeking
  licensure in multiple states
• Reduce administrative redundancies and encourage
  uniformity
• Facilitate the mobilization of physicians to
  disaster-affected areas
• Maintain the same level of public protection as
  the current regulatory system
• Assure state medical board revenues sufficient to
  fulfill regulatory responsibility to protect the
  public

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Facilitating Interstate practice

• United States Medical Licensing Examination
  (1992)
• Common evaluation system for initial medical
• Required by all jurisdictions for MD applicants
• Federation Credentials Verification Service
  1996
• Required and/or Accepted in 65 jurisdictions
• Model Act to Regulate the Practice of Medicine
  Across State Lines (1996)
• Abbreviated licensure process based on full and
  unencumbered licensure in another US jurisdiction
• Adopted in 11 jurisdictions/implemented in 9
• 38 states require full and unrestricted license

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Facilitating Interstate practice

• Report of the Special Committee on License
  Portability (2002)
• Expedited endorsement process for qualified
  physicians
• Use of common tools
• Utilize FCVS or equivalent information profile
• Develop and implement online common license
  application
• Share complaint and investigative information
  among jurisdictions
• Require criminal background checks as a part of
  the licensure process

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Federation credentials verification service(FCVS)

• Goal To create and maintain a high quality,
  permanent file of a physicians core credentials
  for use in meeting licensure and privileging
  requirements
• Benefits
• Repository of core credentials required by state
  medical boards for licensure
• Common standard for primary source credentials
  verification
• JCAHO/NCQA primary source equivalent
• Expedites endorsement of licensure
• Cost efficient
• Reduces duplication of effort (physicians and
  state medical boards)

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Federation credentials verification service(FCVS)

• Key Features
• Primary Source Verification
• Identity
• Medical education, postgraduate training
• Examination and disciplinary history
• ECFMG certification
• ABMS specialty certification
• Discrepancies identified, summarized and provided
  to the state medical board
• Profiles provided in electronic or paper format
• FCVS application available online
• Status report available online

8
License Portability Demonstration Project

• A 3-year demonstration project, funded by HRSA
  and FSMB
• to develop and implement a centralized
  information data management system in two regions
  of the U.S. to allow interstate sharing of
  physician credentials
• to conduct, assess and report on legal and
  technical variations, barriers, and solutions to
  determine the feasibility of expanding the system
  nationwide
• to evaluate the utility of special telemedicine
  licenses utilized by 9 states
• Participating state medical boards
• Colorado, Idaho, Iowa, Kansas, Minnesota, North
  Dakota, Oregon, Wyoming
• Connecticut, Maine, Massachusetts, New Hampshire,
  Rhode Island, Vermont

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License Portability Demonstration Project

• Year One Milestones
• Medical board legal and policy profiles completed
• Technical assessments completed
• Consensus
• Shared credentials
• Credentialing standards
• Technical platform
• CLAF utilization ME, RI, NH
• Interstate Agreements Finalized
• Telemedicine License Evaluated
• Mutual Recognition Agreements (ID and WY)

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License Portability Demonstration Project

• Current Status
• Software (FileControl) purchased
• Integrating data from FSMB database
• Searchable by multiple data elements
• Training manuals for participating boards
• High Speed Scanner purchased and roll out
  scheduled December 2007
• On-site training

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Technical Platform

• Trusted Agent Platform (TAP)
• Project in collaboration with National Board of
  Medical Examiners Center for Innovation
• Create the infrastructure to support real-time,
  virtual data sharing from multiple sources
• Pilot determined successful

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Common License Application Form

• Online Common Medical License Application
• Developed by
• Standard application form addendum to
  accommodate individual state requirements

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Trusted Agent Specific Example
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(No Transcript)
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Ohio Experience

• Benefits from Board Perspective
• Promotes paperless environment
• Reduces data entry through XML stream
• Reduces incomplete applications
• Eliminates inconsistencies between FCVS and CLAF
  applications
• Increases accessibility of license applications
  for staff/board members

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Ohio Experience To Date

• Limited live with OSU MC Oct. 6, 2006
• On-line state application Dec. 14, 2006
• 2,466 applicants authenticated
• 1,974 applications submitted
• Applicant Benefits
• Easy to use and readily available
• Eliminates repetitive data entry
• Stores application for later retrieval and use
• Decreases licensure processing times by
• Requiring applicants to complete the FCVS
  application first
• Notifying applicants immediately of any need for
  a subsequent FCVS
• Submitting the application instantaneously

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FSMB Priorities

• Improving license portability adopted by FSMB
  Board of Directors as a strategic priority.
• Implement regional demonstration projects to
  facilitate telehealth practice across state lines
• Mobilizing physicians in the event of a public
  health emergency
• Emergency Preparedness workgroup established June
  2007
• Increase utilization of FCVS and CLAF

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FSMB Priorities (cont.)

• Develop model telemedicine policy
• The FSMB recognize the value of telemedicine
  technologies in current and future medical
  practice
• The FSMB believes that a common and consistent
  definition of telemedicine should be adopted by
  all member boards
• The FSMB direct a task force be formed and
  charged with establishing a telemedicine model
  policy for use by all member medical boards
• The model policy statement should be ready for
  distribution to member boards at the 2008 annual
  meeting.

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Next Steps

• Results of regional portability projects will be
  used to design sustainable system
• Implement system for license portability among
  jurisdictions for purposes of emergency
  preparedness
• Increase number of state medical boards utilizing
  CLAF
• Comprehensive review of FCVS
• Explore viability of mutual recognition for
  eligible physicians
• Support technology enhancements for individual
  state medical boards to improve data sharing
  capabilities

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Lisa Robin Senior Vice President Member
Services PO Box 619850 Dallas, TX 75261-9850 Tel
817.868.4053 ? Fax [phone] Email
lrobin_at_fsmb.org