Transparency. Everyone’s talking about it—within medicine, the financial community, and government. Even teenagers and parents are asking for it from each other! The increasing need for transparency is also fueling a demand for a way to meet disclosure requirements more quickly and easily. The new AAOS disclosure database can save time for you and your support staff, while enabling you to meet new disclosure requirements.

Background
Two years ago, the Accreditation Council for Continuing Medical Education (ACCME)—the group that accredits organizations like the Academy to give CME credit—established new Standards for Commercial Support. The new standards require CME providers such as the Academy “to show that everyone who is in a position to control the content of an education activity has disclosed all relevant financial relationships with any commercial interest to the provider.”

The ACCME defines “relevant financial relationships” without respect to the dollars involved: They are relationships in any amount occurring within the past 12 months that create a conflict of interest. Although this doesn’t imply that the conflict will be used to the benefit of the person having the relationship, the relationship is, per se, a conflict of interest.

Disclosure—over and over and over again
As the Council on Education began to implement the new standards, we found that many Academy volunteers were completing more and more paperwork. A member would have to complete separate disclosures of the same information for participation as a presenter at the Annual Meeting, as a faculty member for a CME course, as a committee member, as a question writer, as the author of an article for the Journal of the AAOS (JAAOS), and as a contributor to an electronic media program or textbook. We felt we could do better.

In the past year, for example, I disclosed my conflicts of interest at least six times: as a requirement of my positions as chair of the Council on Education and as a person who attends all meetings of the AAOS Board of Directors, as a faculty member for the Annual Meeting and for a CME course, for an article I wrote for JAAOS and the chapter I prepared for Orthopaedic Knowledge Update: Musculoskeletal Tumors. In addition, I completed disclosures for specialty society and other educational activities I was involved in throughout the year. I am not alone; we found that many other volunteers had to complete numerous disclosures as well.

As a result, the Council on Education asked staff to develop an online program for all members with the following goals:

• increasing transparency
• simplifying the disclosure process
• reducing the requests made on members
• saving members’ time

Disclosure—just once!
The result was a new, online disclosure program, which was introduced in September following thorough testing. Now, using the online program, you can disclose “all potential conflicts of interest”—regardless of the subject matter of a committee assignment, lecture, article, chapter, examination topic, or multimedia program.

Rather than completing disclosure for each activity, you will be responsible for updating your disclosures at regular intervals. After completing the full disclosure, you will receive an e-mail every 6 months asking you to verify the continued currency of the disclosure information. If there are no changes, the update process is completed with, essentially, just one click of the mouse!

The new disclosure process includes 10 questions (see “Database disclosure questions”). If your answer to any question is “yes,” the program requests additional information. To make the process faster, questions that require listing company names have drop-down boxes that include the names of most companies, organizations, and publishers in orthopaedics.

To ensure consistency with all of the Academy’s disclosure requirements, we developed two separate programs: one for members involved in Academy councils, committees, CME programs, and publishing efforts, and a separate, more detailed program for members of the AAOS Board of Directors and volunteers for AAOS guidelines development workgroups.

Access to disclosure information
We also wanted to increase transparency. The online program provides 24/7 access to an individual’s disclosure information, which is available to all Academy members in a password-protected area of the AAOS Web site. The Academy will continue to include disclosure information in print or on the first slide of a CME presentation for all participants in every activity. In addition, any member can access the disclosure information of another member through the online program. Fellows and members are also welcome to provide disclosure of potential conflicts of interest even if they are not currently active volunteers for the Academy.

Orthopaedic unity
We will be offering each orthopaedic specialty society free access to the online disclosure program soon after it is fully operational. Each specialty society will be asked to designate two staff members who will be given access to download disclosure information. Using the same program creates additional time savings for all of the specialty societies, although each society will need to evaluate the program and determine whether the disclosure requirements are consistent with its own policies and procedures.

Finding the disclosure program
You can find the disclosure program on the AAOS Web site (www.aaos.org). Click on “Member Services” and look for “Disclosure Program” under the list of “Services” at the right of the frame. Log in using your AAOS member ID number or password and then complete the disclosure form. It’s simple, saves time, and ensures transparency for all Academy governance and programs.

We want your feedback on this program. Send your comments to the editor of AAOS Now or e-mail disclosure@aaos.org

Alan M. Levine, MD, is chair of the AAOS Council on Education.

The complete Standards for Commercial Support can be found on the ACCME Web site: http://www.accme.org.pdf

Disclosure database questions
The Orthopaedic Surgeon’s Disclosure Program asks 10 questions. For each “Yes” answer, the program requests additional information. The dollar amount of the conflict is irrelevant. The Accreditation Council for Continuing Medical Education defines a financial relationship as any amount of money, stock, equipment, or anything else of value.

• Do you or a member of your immediate family serve on any Board of Directors, as an owner, officer, or on a relevant committee of any health care organization (e.g., hospital, surgery center, medical and/or orthopaedic professional society)? Y/N
• If yes, please list organization and position held.
• Do you or a member of your immediate family serve on the editorial or governing board of any medical and/or orthopaedic publication? Y/N
• If yes, please list publication, publisher and position.
• Do you or a member of your immediate family receive royalties for any pharmaceutical, biomaterial or orthopaedic product or device? Y/N
• If yes, please list company(ies).
• Within the past 12 months, have you served on the speakers bureau or have you been paid an honorarium to present by any pharmaceutical, biomaterial or orthopaedic product or device company? Y/N
• If yes, please list company(ies).
• Are you or a member of your immediate family a paid or unpaid consultant for any pharmaceutical, biomaterial or orthopaedic device or equipment company, or supplier?
• Paid: Y/N —If yes, please list company(ies).
• Unpaid: Y/N—If yes, please list company(ies).
• Do you personally or, to the best of your knowledge, does your department receive research or institutional support from any publisher? Y/N
• If yes, please list company(ies).
• Do you personally or, to the best of your knowledge, does your department receive research or institutional support from any pharmaceutical, biomaterial or orthopaedic device or equipment company or supplier? Y/N
• If yes, please list company(ies).
• Do you or a member of your immediate family receive stock or stock options from any pharmaceutical, biomaterial or orthopaedic device or equipment company, or supplier (excluding mutual funds)? Y/N
• If yes, please list company(ies).
• Do you or a member of your family receive any other financial/material support from any medical and/or orthopaedic publisher? Y/N
• If yes, please list company(ies).
• Do you or a member of your family receive any other financial/material support from any pharmaceutical, biomaterial or orthopaedic device and equipment company or supplier? Y/N
• If yes, please list company(ies).