A N N U A L R E P O R T 2 0 0 5

From the Chairman of the Board.......................................................1

From the Executive Director ................................................................................2

Member Stories.......................................................................................................4

Summary of Accomplishments.........................................................5

Education .................................................................................5

Competency..............................................................................7

Certification and Licensure ..........................................................7

Publishing.................................................................................8

Communications and Standards Education ........................................9

MELD.......................................................................................9

Workshops and Presentations........................................................................9

Annual Conference ....................................................................9

Reports and Guidelines .............................................................10

Members ....................................................................................11

Board of Directors .......................................................................12

T A B L E O FC O N T E N T S

F R O M T H EC H A I R M A N O F T H E B O A R D

As healthcare educators and assessment organizations move forward with new visions of continuing education and maintenance of competence, it becomes increasingly evident that our organizations cannot continue to function in communication silos. Education and competencyframeworks must be interconnected to allow clinicians to identify and address gaps in competency.Maintenance of certification requires certifying boards to track more information about clinicians,and clinicians need to track more information about their own professional development activitiesto ensure that they are current and meet the new expectations. Educators must measure the shortterm and long term outcomes of their offerings and programs. Collaboration and cross-organizationdata exchange are essential to succeed in reforming professional education and competenceassessment, and the work of MedBiquitous is essential to enable these collaborations and realizethese reforms.

In 2005, many MedBiquitous members made great strides in using MedBiquitous standards toimprove their educational programs and offer new services to their constituents. The AmericanAcademy of Family Physicians has implemented Medical Education Metrics (MEMS) to standardizeevaluations across its many Continuing Medical Education (CME) offerings, including live, print andonline activities. The Association of American Medical Colleges has used Healthcare LearningObject Metadata (Healthcare LOM) in the development of a submission form for MedEdPORTAL, anonline venue for the dissemination of peer-reviewed educational works by medical school faculty.The American Board of Medical Specialties uses MedBiquitous Professional Profile not only tocollect data from several member boards, but also to make certification data available to others for credentialing purposes, including the verification of physician credentials forHurricane Katrina relief efforts.

Creating a common language for collaboration is only one part of our reform efforts, but it is a critical part. I thank you for your time, your energy, and the collaborative spirit which you bring to our work together in MedBiquitous.

Sincerely,

Bruce Spivey, M.D.Chairman

To advance healthcare education through technology standardsthat promote professional competence, collaboration, and betterpatient care.

M E D B I Q U I T O U SM I S S I O N

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In parallel with the advancements in education and competence assessment realized by ourmembers in 2005, MedBiquitous standards development activities made great progress. Ourworking groups have increasingly broad and talented participation. In addition, working groupshave continued to garner input from key stakeholders, including the Accreditation Council forContinuing Medical Education. Much of this progress is due to the unwavering commitment andeffort of our working group chairs, Chris Candler, M.D. of the Association of American MedicalColleges, Nancy Davis, Ph.D. of the American Academy of Family Physicians, Rachel Ellaway, Ph.D.of University of Edinburgh, Todd Tischendorf of the American Board of Medical Specialties, andCraig Van Dyck of John Wiley and Sons, Inc.

As part of our ANSI-accredited standards development process, in 2005 we convened a StandardsCommittee to serve as the official consensus body for MedBiquitous standards. In accordance withANSI requirements for openness, balance, and due process, this committee is open to membersand non-members, commercial organizations and not-for-profit organizations, developers andconsumers of educational technology for healthcare. All MedBiquitous members are entitled to appoint a representative to this committee, and non-members may apply to participate.

Existing working groups made great progress in 2005. • The Professional Profile Working Group, with the participation of the Federation of State

Medical Boards, has worked to incorporate disciplinary action and license information, which will allow for better tracking and dissemination of this important information to appropriate entities.

• The Learning Objects Working Group, with input from the Accreditation Council for ContinuingMedical Education, has worked to allow Healthcare LOM to describe all types of educationalactivities, not just e-learning. These enhancements will facilitate discovery of all types oflearning activities that meet a learner's needs.

• The Metrics Working Group developed standards-based surveys to facilitate collection of learner reaction data in a consistent manner.

• The Journal Working Group released Journal-based Continuing Education Guidelines, which will facilitate the implementation of new journal-based education programs and the integration of MedBiquitous standards to track learner data. The group also released RSS Content Syndication Guidelines, which provide guidance for the dissemination of news and new content.

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F R O M T H EE X E C U T I V E D I R E C T O R

In addition, 2005 saw the establishment of two new working groups.• The Activity Report Working Group, which is developing standards to facilitate tracking

of professional education and certification related accomplishments across systems and organizations.

• The Virtual Patients Working Group, which is developing standards to enable the interoperability and exchange of Virtual Patients, interactive computer programs that simulate real life clinical scenarios.

And in 2006 we will start a Competency Working Group to develop standards that allow educationalresources and activities to be tied to a competency framework.

MedBiquitous provides an opportunity for us to focus on our common goals and advance togetherfurther than we could advance in isolation. Thank you for your continued participation in thisendeavor. Your support is vital for our shared success.

Sincerely,

Peter Greene, M.D.Executive Director

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M E M B E RS T O R I E S

the Army, Air Force, and Navy on a Web-based training course,“Prevention Management and Disruptive Behavior.” In addition, a FrontEnd Analysis is underway for a cross-agency pharmacy techniciantraining curriculum that will be primarily Web based. The group's collabo-ratively developed courses are conformant with SCORM for Healthcare toenable sharing of content across different learning management systemsand enhanced search and retrieval of content.

ON DEMAND CREDENTIALINGAmerican Board of Medical Specialties

In 2005, the American Board of Medical Specialties (ABMS) launchedXML Web services leveraging the MedBiquitous Professional Profile toallow Primary Source Verification of physician specialty certification forcredentialing professionals. The service, called Direct Connect Select TM,provides quick, efficient access to primary source physician certificationinformation for emergency response teams. Part of a state-based initia-tive to develop an emergency credentialing system, Direct ConnectSelect TM was used by the Department of Health and Human Services tosupport emergency verification of volunteers as part of hurricane disasterrelief efforts. The ABMS had already been using the MedBiquitousProfessional Profile to collect certification data from member boards. Theavailability of systems already implementing the MedBiquitousProfessional Profile significantly reduced production time and costs forthe new credentialing service and helped to ensure that the product wasavailable when it was needed.

PROTECTING INVESTMENTS IN LEARNING TECHNOLOGIESAmerican Heart Association

In 2004, the American Heart Association began the process for identifyinga learning management system (LMS) to manage the myriad courses andprograms for the wide range of healthcare professionals that they serve.Using MedBiquitous ”Considerations for Selecting a LearningManagement System“ and a set of internally defined system require-ments, Jackie Mayhew, Director of Continuing Professional Education,chose KMX by Knowledge Management Solutions, Inc. in part becausetheir knowledge of MedBiquitous standards ensured her that the productwould evolve with the healthcare education industry and MedBiquitousstandards. American Heart Association is now using the LMS to deliverSCORM-based courses. The ability to reuse test items across multiplecourses enables American Heart Association to quickly aggregateresponses to specific questions across their many courses, greatly facili-tating evaluation of the program as a whole. In addition, they aredeveloping online courses in a modular fashion. This modularity allowsthem to reuse content, such as the basic life support module, therebyreducing content development costs and time. American HeartAssociation plans to implement learner categories based on theHealthcare LOM lists of professions and specialties in the near future tofacilitate demographic tracking of their learners.

SHARING COSTSDepartment of Veterans Affairs

As a hospital system and large employer, the Department of VeteransAffairs (VA) faces many of the same healthcare education challenges asother government agencies that provide health services. However,providing training to the tens of thousands of busy health care profes-sionals within the VA is taking on a new dimension. To reduce costs andduplicative efforts across government agencies, the VA has established amulti-agency group called the Collaborative Healthcare Training Group.The group identifies healthcare education needs faced by multipleagencies and establishes development projects where the agenciesinvolved share the costs associated with developing content. The VA isleading development within this collaborative and has started work with

HOW IS IT USED?Healthcare LOM can be used in several ways.• Allows learners and content developers to search content

collections and catalogs based on subject, keyword, competency, and other criteria.

• Allows content developers to communicate course information to other organizations.

• Enables clinical systems and patient systems to identify and offercontent relevant to a specific clinical situation.

ADOPTIONThe Veterans Administration, the Centers for Disease Control, the American Medical Informatics Association, the Association of American Medical Colleges, CTSNet, HEAL, IVIMEDS, and others are in the process of implementing Healthcare LOM to support discoveryof content.

RESOURCES• A sample metadata creator tool (http://service.medbiq.org/lomform.html)• Draft specifications and schemas (http://ns.medbiq.org/lom/extend/v1/)

Reusing Content: SCORM for HealthcareWHAT IS IT?Created by the Advanced Distributed Learning Initiative(http://www.adlnet.org), SCORM is a collection of standards and specifications to provide a comprehensive suite of e-learning capabilities that enable interoperability, accessibility, and reusability of Web-based learning content. SCORM for Healthcare modifies theSCORM model to include the healthcare specific metadata elementsdefined by Healthcare LOM.

HOW IS IT USED?SCORM for Healthcare provides a consistent way to describe, run, and package healthcare e-learning content and lets developers easilytransfer e-learning content across systems. Because SCORM uses amodular approach to content development, e-learning components canbe disaggregated and reused in multiple courses and contexts, savingdevelopment costs and time.

MedBiquitous standards development efforts focus on education, compe-tency, certification and licensure, and publishing. Together, these create atechnology blueprint for professional healthcare education designed toaccomplish the following goals:

• Better tracking and evaluation of professional educationand certification activities.

• Easier discovery of relevant education and information resources when and where needed.

• Interoperability and sharing of high quality online education.• Coordination and tracking of competence assessment data.

EDUCATION

Discovering Content: Healthcare Learning ObjectMetadata (Healthcare LOM)WHAT IS IT?This draft standard facilitates search and discovery of healthcarelearning activities and resources by providing a consistent way ofdescribing those activities and resources. Healthcare LOM customizesthe IEEE Learning Object Metadata (LOM) standard included in theSCORM reference model for e-learning. In addition to the generaldescriptors provided by LOM, such as title, author, and keyword,Healthcare LOM includes information critical to healthcare education,such as credit allocation, off-label use disclosure, disclosure of financialrelationships, and strength of evidence supporting the content.Healthcare LOM is designed to support education for many health profes-sions as well as patient and caregiver education.

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S U M M A R Y O F A C C O M P L I S H M E N T S

ADOPTIONThe Centers for Disease Control, the American Board of MedicalSpecialties, the Department of Veterans Affairs, the American MedicalInformatics Association, the American Association for Thoracic Surgery,the American Heart Association, IVIMEDS, Johns Hopkins Medicine,Radiological Society of North America, and University of Miami havedeveloped or are currently developing SCORM for Healthcare content.The Association of American Medical Colleges is collecting SCORMcontent through MedEdPORTAL. Several MedBiquitous members offerSCORM-conformant products and services, including AcceleraRomar,CECity, Elsevier Science, KMSI, Local Origination, Medantic, and Silverchair.

RESOURCES• SCORM for Healthcare Templates and sample content package(http://www.medbiq.org/resources/scorm_workshop/index.html)

• A version of the RELOAD content packaging tool supporting SCORM for Healthcare (http://www.lsal.cmu.edu/adl/scorm/tools/reload/)

• SCORM specifications and resources from ADL(http://www.adlnet.org/scorm/index.cfm)

• Draft SCORM for Healthcare specifications(http://www.medbiq.org/working_groups/learning_objects/SCORMforHealthcareSpecification.pdf)

Sharing Content: Virtual PatientWHAT IS IT?Virtual patients are interactive computer programs that simulate real lifeclinical scenarios for education or training purposes. MedBiquitousVirtual Patient standards will allow organizations to exchange theseexpensive resources to reduce costs and enhance the quality of educa-tion and assessment offerings.

HOW IS IT USED?Virtual Patient is comprised of several components, including data, activi-ties, and resources, that may be used independently or together to createa rich learning experience. These components can be packaged togetherand exchanged with other institutions, which can use the componentswithin their own systems and modify them for their learners.

ADOPTIONThe Virtual Patient Working group is conducting tests of virtual patientexchange across institutions. A draft standard is in development.

RESOURCESThe Virtual Patient Working Group page(http://www.medbiq.org/working_groups/virtual_patient/index.html)

Tracking Learners: Activity ReportWHAT IS IT?Activity Report provides a common format for reporting an individual'sprofessional education and certification related accomplishments. Withthis draft standard, education and certification activities can be trackedacross organizational boundaries.

HOW IS IT USED?Activity Report can be used to do the following:• Track learner CME/CE activities in a central location.• Track maintenance of certification or licensure activities

in a board database.

ADOPTIONThe American Board of Pediatrics (ABP) is using Activity Report to trackmaintenance of certification activities offered by the American Academyof Pediatrics (AAP). Diplomates complete a quality improvement programon the AAP website, and AAP sends progress reports to ABP when thediplomate begins or completes the program. In addition, Stanford'sHighWire Press uses Activity Report to send certificates for journal-basedCE to their society partners.

RESOURCESDraft specifications and schemas (http://ns.medbiq.org/activityreport/v1/ )

Evaluating Activities: Medical Education Metrics (MEMS)WHAT IS IT?MEMS provides a consistent format and data structure for representingaggregate evaluation data for a health professions learning activity. Withthis draft standard, healthcare educators can exchange evaluation datawith accrediting bodies, grantors and other supporters, and umbrellaorganizations, greatly simplifying how these organizations evaluate aprogram's reach and efficacy.

HOW IS IT USED?MEMS can be used in the following ways.• Healthcare educators can use MEMS as a set of best practices

regarding the types of evaluation data to collect.• Healthcare educators can use MEMS to compare the efficacy

of activities over time and across their program.• Supporters of education can use MEMS to measure the reach

and effectiveness of the programs they funded.• Accreditors can use MEMS to measure the success of a learning

activity or provider.

ADOPTIONThe American Academy of Family Physicians has standardized evalua-tions for its many CME offerings using MEMS. The Accreditation Councilfor Continuing Medical Education is planning to use MEMS to facilitateprovider reporting of CME activities and related metrics.

RESOURCESDraft specifications and schemas (http://ns.medbiq.org/mems/v1/)

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COMPETENCY

Establishing a Competency Framework: Competency MapWHAT IS IT?Competency Map allows educators to link content to specific competen-cies within a set of specialty or profession-specific competencies. Basedon the IEEE Simple Reusable Competency Map draft standard, this speci-fication will provide a way for healthcare educators to develophierarchical competency sets that may be electronically referenced andlinked to relevant content.

HOW IS IT USED?Educators and assessment organizations can create electronic descrip-tions of the competencies required for a particular area of practice,specialty, or profession and maps that show how the individual compe-tencies relate to one another. Content developers can cite targetedcompetencies directly in the description of the resource using HealthcareLOM, or other organizations can create an electronic list that associatesspecific content items with specific competencies.

ADOPTIONOregon Health and Science University and MedBiquitous have received agrant from the National Library of Medicine for discovering standards-based learning at point of care. The overall goal of the project is todesign, implement, and test an information technology system that allowsphysicians to discover online continuing medical education (CME) thatfills identified gaps in competence. To achieve this goal, the project teamis leveraging IEEE Simple Reusable Competency Map and HealthcareLOM to connect content to informatics and healthcare competencies.

RESOURCESInformation on IEEE Competency Data Standards(http://ieeeltsc.org/wg20Comp/)

CERTIF ICATION AND L ICENSURE

Exchanging Clinician Data: Professional ProfileWHAT IS IT?The Professional Profile simplifies the exchange of member or healthcareprofessional contact, education, training, certification, licensure, discipli-nary action, occupation, and membership information by providing acommon data format. Specifications for encoding name and addressinformation complement the Professional Profile and are included in theProfessional Profile schema.

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HOW IS IT USED?Specialty groups, certifying boards, and licensing boards must frequentlyshare clinician information with umbrella organizations and businesspartners. By using a common format, these groups can reduce the timeand costs associated with data exchange. Some examples of howProfessional Profile can be used follow.• To send certification information from one board to a partner board.• To send updated address information to a publishing partner.• In combination with Web services to verify a professional's identityacross organizations.

ADOPTIONThe American Board of Medical Specialties (ABMS) accepts certificationdata from several member boards using the MedBiquitous ProfessionalProfile XML format. Their Direct Connect Select TM Primary SourceVerification service implements the MedBiquitous Professional Profile forcredentialing purposes. In addition, the American Board of Pediatrics andthe American Academy of Pediatrics use the Professional Profile toresolve the identify of physicians completing Maintenance ofCertificationTM activities so that the activities may be tracked by the board.

RESOURCES• Professional Profile draft specifications and schemas(http://ns.medbiq.org/member/v1/)

• Name draft specifications and schemas (http://ns.medbiq.org/name/v1/ )

• Address draft specifications and schemas(http://ns.medbiq.org/address/v1/)

PUBLISHING

Journal ServicesWHAT ARE THEY?Journal Services provide the common interface needed to connectjournal aggregators with one another and with the community they serve.They allow organizations to exchange lists of journals, journal issues, andarticles within an issue. Journal Services are based on Web ServicesDescription Language (WSDL).

HOW ARE THEY USED?Journal Services enable researchers to become aware of relevantresources across a spectrum of websites, publishers, and organizations.For example, Journal Services could allow a researcher to view a list ofmost recent articles from their favorite journals without leaving theirpreferred website for clinical information.

ADOPTIONElsevier Science and Wiley Publishing have piloted implementation of thisdraft standard. Their demonstration site provided a gateway to cancercontent, gathering selected journal information from both Wiley andElsevier and allowing the researcher to view a list of current articles andissues from within their home portal. In addition, researchers couldcustomize which journals they wanted to peruse for information.

RESOURCESSchemas, specifications, and WSDL files(http://ns.medbiq.org/journal/service/v1/ )

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WORKSHOPS ANDPRESENTATIONSSCORM for Healthcare WorkshopThis workshop introduces participants to SCORM and e-learning stan-dards, explaining where these technologies are best applied and thebenefits of their use. Topics include what SCORM for Healthcare is, whyit's important, when to use it, customizations for healthcare developed byMedBiquitous and tools and processes for using SCORM for Healthcare.View workshop resources at:http://www.medbiq.org/resources/scorm_workshop/index.html

Enabling the Tracking and Measurement of CME and Performance ImprovementIn this presentation delivered at the Repositioning CME Summit, Dr. PeterGreene identifies the current problems with CME tracking and measure-ment and describes a new system leveraging common technologystandards that helps learners identify gaps in competency, identifyrelevant resources, and track accomplishments. View the presentation at:http://www.cmss.org/images/Greene_RepositioningCME_Nov2005.pps

ANNUAL CONFERENCE

A broad range of healthcare education, competence assessment, and learning technology leaders attended the MedBiquitous AnnualConference April 6-7, 2005 in Baltimore, Maryland. Highlights included a keynote address on professional competence and patient safety fromCarolyn Clancy, MD, Director of the Agency for Healthcare Research andQuality, and a preconference seminar on the use of SCORM forHealthcare from Nina Pasini Deibler from Carnegie Mellon University'sLearning Systems Architecture Lab. Local Origination provided a videowebcast of the conference, available at:http://meld.medbiq.org/virtual_conference/index.htmDownload the presentations at: http://www.medbiq.org/events/confer-ences/annual_conference/2005/presentations.htm

The MedBiquitous 2006 Annual Conference is scheduled for April 25-27 in Baltimore, Maryland. Visithttp://www.medbiq.org/events/conferences/index.html for more information.

•••9C O M M U N I C A T I O N S& S T A N D A R D SE D U C A T I O N

To support development, adoption, and implementation of new technolo-gies, MedBiquitous creates resources to inform and educate its membersand the general public about its standards.

MELD

The MedBiquitous E-Learning Discourse, or MELD, is a community ofpractice, a place where healthcare educators can gather to learn aboutdelivering online healthcare education leveraging technology standards.MELD serves as a comprehensive resource for people who produce anddistribute online healthcare education for all levels of learners. Thisonline community provides information and collaborative opportunities on a range of topics in e-learning including pedagogy (i.e., instructionaldesign, assessment, distance learning, and curriculum development),technology standards, educational technology, education metrics, e-learning economics, and issues and methods specific to healthcareeducation. MELD serves the diverse set of individuals involved in healthcare e-learning, including instructional designers, healthcareeducators and administrators, publishers, IT system administrators, and web developers.

If you wonder why standards are important for e-learning, want to knowwhat SCORM stands for, or are interested in cutting edge use of virtualpatients, visit MELD.

http://meld.medbiq.org

Document Description

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REPORTS AND GUIDELINES

MedBiquitous has produced several reports and guidelines to address many pressing issues facing healthcare educators and technology developers.

Considerations for Selecting aLearning Management System inHealthcare Education

Implementing an E-learning Strategy

Journal-based Continuing EducationGuidelines

RSS Content Syndication Guidelines

Single Sign On Guidelines

Web Services Design Guidelines

XML Design Guidelines

Provides a list of important requirements that will help you select a learning management system(LMS) that supports technology standards for healthcare education. A standards-compliant LMSwill enable your organization to better leverage learning content and make that content moreaccessible to learners when and where they need it. See: http://meld.medbiq.org/experiences/ best_approaches/lms_choice_healthcare_smothers.htm

Proposes a series of strategies for implementing self-directed e-learning solutions in an organization focused on medical and health professions education. See:http://meld.medbiq.org/strategic_reports/implementing_e-learning_medbiq.htm

Provides technical and pedagogical recommendations for those wishing to develop Journal-based Continuing Education.http://www.medbiq.org/working_groups/journal/JournalCEguidelines.pdf

Provides recommendations for those wishing to use Really Simple Syndication (RSS) for creatingInternet-based content feeds and podcasts. http://www.medbiq.org/technology/tech_architecture/rssguidelines.pdf

Provides recommendations for those interested in using a consistent, standards-based approachto single sign on across their enterprise and across organizations. http://www.medbiq.org/technology/tech_architecture/ssoguidelines.pdf

Provides a consistent approach to Web services development that facilitates interoperabilityamong disparate systems and compatibility with Web Services Interoperability recommendations. http://www.medbiq.org/technology/ tech_architecture/webservicesguidelines.pdf

Provides a consistent approach to XML schema development that maximizes reusability ofcomponents. http://www.medbiq.org/technology/tech_architecture/xmldesignguidelines.pdf

The following organizations are members of MedBiquitous.

AcceleraRomarAmerican Academy of Dermatology American Academy of Family Physicians American Academy of Pediatrics American Association for Thoracic Surgery American Board of Medical Specialties American Board of Pediatrics American College of Chest Physicians American College of Surgeons American Heart Association American Medical Association American Medical Informatics Association American Psychiatric Association American Society of Clinical Oncology Association of American Medical Colleges Axiom Resource Management Baylor College of Medicine Carnegie Mellon University CE City Centers for Disease Control and Prevention Council of Medical Specialty Societies CTSNet Department of Veterans Affairs Elsevier Science European Association for Cardio-thoracic Surgery Federation of State Medical Boards HEAL—The Health Education Assets Library John Wiley and Sons Johns Hopkins University Johnson & Johnson Knowledge Management Solutions, Inc. Local Origination Medantic Moberg Research National Board of Medical Examiners National Library of Medicine Oregon Health and Science University Pfizer Radiological Society of North America Silverchair Society of Critical Care Medicine Stanford University Highwire Press ThomsonUniversity of Miami

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B O A R D O FD I R E C T O R S

Bruce Spivey, M.D., Chairman Deputy Executive Vice PresidentCouncil of Medical Specialty Societies

Roger Bulger, M.D. National Center on Minority Health and Health Disparities

Don E. Detmer, M.D., M.A.President and Chief Executive OfficerAmerican Medical Informatics Association

Robert Galbraith, M.D.Co-DirectorCenter for InnovationNational Board of Medical Examiners

Ronald Harden, M.D.Director of EducationIVIMEDS

Shahir Kassam-AdamsSenior Vice President of Strategy and DevelopmentThomson Scientific and Healthcare

Michael Magee, M.D. Chief Medical OfficerPfizer

Paul Miles, M.D. Vice President, Director of Quality Improvement & PracticeAssessmentAmerican Board of Pediatrics

Edward Miller, M.D. Dean and CEOJohns Hopkins Medicine

Robert Replogle, M.D. Executive DirectorCTSNet

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The World Trade Center Baltimore401 E. Pratt Street, Suite 1700Baltimore, Maryland 21202P 410.385.2367F 410.385.6055www.medbiq.org