At the end of our fiscal year, I traditionally present a year-end recap of the new projects and initiatives that are helping us advance ACEP’s mission during the June Board of Directors meeting. Here is a quick summary.

50th Anniversary

Our anniversary celebration reached its crescendo at ACEP18 in San Diego, which had nearly 8,000 registrants. It was a beautiful celebration in which we honored long-time veterans of our specialty, heard panels and “Titan” talks, displayed a clever museum of dozens of panels depicting our history through the decades, released the Bring ’Em All book of dramatic photos and essays that was honored with an award, and much more.

Advocacy

This was a very strong year for our federal advocacy efforts. We saw enacted into law two opioid bills spearheaded by ACEP, the Alternatives to Opioids (ALTO) in the Emergency Department Act and the Preventing Overdoses While in Emergency Rooms, or POWER Act, as part of the large omnibus opioid legislation.

We also developed and introduced the Improving Mental Health Access from the Emergency Department Act in time for our Leadership & Advocacy Conference (LAC) in May. ACEP and our chapters are also working with the Coalition on Psychiatric Emergencies to advocate for state-based solutions on mental health.

There has not been a time in the past 15 years when ACEP has been directly in the middle of an important advocacy issue in Congress like we have been with the out-of-network issue, also known as “surprise billing.” Our staff and leadership have aggressively lobbied the Senate and House, and we’ve closely collaborated with the American Medical Association and other specialties. We have strongly supported the Protecting People from Surprise Medical Bills Act, and we will keep working to change or oppose proposals that are not to our liking. It’s unrealistic to expect to get 100 percent of what we want out of Congress, but we’ll continue to try.

LAC was a huge success. We made 551 visits on Capitol Hill to discuss surprise billing legislation and access to mental health care.

We filed suit against Anthem in Georgia for violating the prudent layperson standard embodied in the law, and we expect a ruling from the judge soon. We are working with our chapters in several other states where insurers are retroactively denying claims and coverage for patients.

Quality

Our Quality Line of Service continues to hit on all cylinders. ACEP’s Clinical Emergency Department Registry (CEDR) has continued to grow in every major metric we track. It has exceeded our goals in the number of patient visits, number of hospital emergency departments, and number of clinicians, plus has seen continued growth in revenue. We continue to gain large hospital systems and billing companies as customers.

We began developing a Quality Measure Consortium. Development of quality measures is expensive, so we have invited other organizations with registries to jointly develop measures with us and share the cost.

With more than 1,200 emergency departments in 46 states and more than 40,000 clinicians participating, the Emergency Quality (E-QUAL) Network is growing and helping improve patient care for sepsis and chest pain as well as promote avoidance of unnecessary imaging and treatment of opioid use disorder.
We held an ACEP/EMF Data Summit earlier this year to begin developing a plan to build a data analytics platform to enable research with CEDR data for more than 50 million patient visits.

In July, we held a Health Information Technology Summit, bringing together around 100 electronic health record (EHR) vendors, payers, government agencies, and thought leaders. We know your administrative burden is constantly growing; we want to help make EHR systems more efficient and less burdensome for you.

Clinical

We pushed back on an inappropriate policy for sedation promulgated by the American Society of Anesthesiologists, instead producing our own Unscheduled Sedation Policy specific to our specialty. We’re going through the same process for sepsis because the Society of Critical Care Medicine released a sepsis protocol that does not consider the unique nature of emergency medicine.
We got the Occupational Safety and Health Administration and The Joint Commission to clarify that our members are allowed to have food and drink at their ED workstations, and we developed a members-only toolkit to help you educate your administrators about this clarification.

We launched a new members-only emergency medicine Point of Care (emPOC) app.

We produced many opioid-related resources (www.acep.org/opioids), including the ALTO boot camp and the first EM-specific Medication Assisted Treatment (MAT) waiver training. We’re doing state MAT waiver trainings with our chapters pursuant to a grant.

Publications

We are developing a second journal that will be open-access and online only and selected Henry E. Wang, MD, MS, to be its new Editor in Chief. The first issue is planned for February 2020.

We hired a new medical Editor in Chief for ACEP Now, Jeremy Faust, MD, MS, MA, after former medical Editor in Chief Kevin Klauer, DO, EJD, FACEP, accepted a new role as CEO of the American Osteopathic Association.

Workforce Studies

ACEP is taking on two important and complex situations affecting emergency medicine. The Nurse Practitioner/Physician Assistant Utilization Task Force will help us provide leadership on the scope of practice and appropriate protocols for use of nurse practitioners and physician assistants in the emergency department. The delivery of health care is changing with freestanding emergency departments, the growth of urgent care centers, telemedicine, and the consolidation and employment of emergency physicians. The Emergency Medicine Workforce Task Force will help us better understand the current ED workforce environment and predict future needs.

Workplace Violence Initiative

ACEP is launching a new Campaign to End Workplace Violence in the ED with the Emergency Nurses Association (ENA) this fall. This will be a robust collaboration with different resources and deliverables examining all sides of this problem. We’re already working with ENA on the federal Workplace Violence Prevention for Health Care and Social Service Workers Act and are encouraging our chapters to collaborate at the state level.

Accreditation Programs

The Geriatric ED Accreditation Program is growing. More than 60 hospitals are accredited, including one in Spain, and we have more than 100 in the pipeline. We’ve agreed to accredit 20 VA hospitals next year to help improve care of our veterans.

Our new Emergency Department Pain and Addiction Management Accreditation Program strives to provide better care for patients suffering from opioid use disorder and pain. We will be rolling it out by the first of the year.
ACEP is setting the standards for accreditation of freestanding emergency departments. Another organization, the Center for Improvement in Healthcare Quality, will do the accrediting, but accreditation will be based on standards developed by ACEP.

International

ACEP is upping its efforts to grow internationally in a cost-effective way. We will have a Global Village at ACEP19 and are inviting international societies to attend, we’re hosting an International Summit to bring together EM leaders to discuss successes and challenges to support the growth of emergency medicine worldwide, and we established an International Committee focused on how we can grow our role in worldwide emergency medicine. We are developing a close relationship with the European Society for Emergency Medicine. I believe if we do this the right way, our whole membership will benefit by expanding our international reach and collaborations. We’ll be able to share our expertise and help others while gaining fresh perspective from other countries.

Public Engagement

Our Until Help Arrives program launched at LAC. Until Help Arrives training is similar to Stop the Bleed, but it’s a shorter course and its curriculum includes hands-only CPR. We’re excited to give our members this opportunity to make a positive impact in their communities by teaching bystanders these lifesaving skills.

Reimbursement

We’ve spent a huge amount of time and effort battling the out-of-network issue to prevent insurance companies from significantly reducing reimbursement to our specialty. At the same time, we’re working on other initiatives to prepare for our future reimbursement. We developed the Acute Unscheduled Care Model as a proposed alternative payment model (APM). This was a difficult and expensive project, and we’re proud that our APM is one of the few that has made it through the Physician-Focused Payment Model Technical Advisory Committee process and is sitting on the Secretary of Health and Human Services’ desk, waiting for approval. We plan to develop a toolkit, best practices, and other resources to help our members and their ED groups implement this APM. This model, or some variation of it, could be a significant payment methodology in the future, so we think it’s important ACEP continue to provide leadership and guidance on how it is used in our specialty.

We also launched the Reimbursement Leadership Development Program, a highly coveted opportunity for members interested in increasing their knowledge of reimbursement issues and serving ACEP in various ways. We had 72 applicants, and we selected some unbelievable people who are being groomed through this program.

Management Services

We just signed a new five-year shared services agreement with the Emergency Medicine Residents’ Association, an organization that continues to grow by leaps and bounds. We’re continuing to provide administrative support for the Council of Emergency Medicine Residency Directors and the Society of Emergency Medicine Physician Assistants, both of which had record-breaking years in terms of attendance at their meetings and their financial performance. We’ve been asked to provide management services and administration for the large, growing FemInEM conference.

ACEP is blessed to have a very engaged Board of Directors and talented, dedicated staff. We have active and productive chapters, committees, task forces, and sections. Through collaboration and teamwork, we have helped ACEP make significant progress in achieving our mission.

Mr. Wilkerson is executive director of ACEP.