Helping Medical Associations Avoid Conflicts of Interest: Case Study

In order to maintain their reputations for integrity and impartiality, medical associations for all kinds of specialties have to be vigilant about avoiding and identifying conflicts of interest among their members. When promoting the latest treatment or therapy for a specific condition it is imperative that science and outcomes data are the only influences about a change in standard therapeutic practice. If there’s even a hint of bias, the effect on a highly esteemed society or association could be devastating, in relation to members, their reputation, the field, and ultimately patient outcomes.

Case Study: The American Thoracic Society (ATS)

The American Thoracic Society (ATS) takes its conflict of interest responsibilities very seriously. ATS is an international professional medical association whose mission is to improve health worldwide by advancing research, clinical care and public health in respiratory disease, critical illness and sleep disorders. ATS has a membership of more than 15,000 physicians, research scientists, nurses and other allied healthcare professionals—25 percent of whom reside in countries other than the U.S. Multi-disciplinary specialties represented within ATS membership include pulmonology, critical care, sleep medicine, infectious disease, pediatrics, allergy/immunology, thoracic surgery, behavioral science and environmental and occupational medicine.

As many as 13,000 doctors, nurses and scientists attend the ATS international conference each year, where more than 300 medical and scientific symposia are presented after a competitive selection process. More than 300 reviewers of varying expertise evaluate and recommend appropriate sessions, which are taught by as many as 1,000 volunteer faculty members. As a part of this rigorous process, ATS has unique needs when it comes to managing conflict of interests (COI) disclosure among its large number of respondents and reviewers worldwide.

The organization also sponsors additional courses and activities worldwide throughout the year, along with numerous annual projects to develop clinical practice guidelines and policy positions. Moreover, panels of ATS experts meet in-person and online to develop official statements on a variety of topics.

Because of the size and scope of ATS, its initial paper-based COI processes were regarded as inefficient and prone to information security risks. In 2005, the group created two in-house automated systems to aid in COI disclosure. One was based on HTML and performed well in terms of efficiency and storage. The other incorporated rewritable .pdf files. However, neither system was capable of “speaking” to the other—nor were there any tracking or reporting capabilities. ATS was able to obtain information online, but there was a high level of duplication and redundancy. For example, previous years’ disclosures weren’t available to users.

Finding a COI Solution

In its search for a comprehensive software solution for COI management, ATS leadership evaluated three potential partners. Health Care Compliance Strategies (HCCS), a HealthStream Company, was the only one to offer a solution that met the comprehensive “wish list,” but also had the vision to develop a system flexible enough that it would not be limited to one area of disclosure operations—such as CME or research. Ultimately, the HCCS COI-SMART application was chosen because of its dual capabilities for both receiving and reviewing disclosures.

With COI-SMART, we were able to create “autocomplete” lists in the questionnaires that reduce the typing a respondent has to do,” says Shane McDermott, ATS Senior Director of Ethics and COI Management. “That allowed us to consolidate our questions and sub-questions, which is a real time-saver for our members.”

Impact of COI-SMART for ATS

Using COI-SMART, the American Thoracic Society:

• Satisfied their requirements to both report and review data efficiently
• Enables two people to manage conflict of interest for 3000+ busy physicians annually
• Adopted a solution that reduces the input requirements for individual reporting
• Benefited from system flexibility to encompass multiple purposes and audiences
• Increased members’ transparency about their relationships within the healthcare industry

Learn more about COI-SMART.