ACTIVITY DISCLOSURE SUMMARY

In accordance with the disclosure policy of Dartmouth-Hitchcock Medical Center/Dartmouth Medical School as well as standards set forth by the Accreditation Council on Continuing Medical Education, continuing medical education course director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content have been asked to disclose any financial relationship* they have to companies producing pharmaceuticals, medical equipment, prostheses, etc. that might be germane to the content of their lectures, or companies who are supporting this program. Such disclosure is not intended to suggest or condone bias in any presentation, but is elicited to provide registrants with information that might be of potential importance to their evaluation of a given activity.

Disclosure is also to be made if off-label uses of products are to be discussed.

The following course director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content for Institute for the Ideal Medical Home, February, 2010 have reported the following financial interest or relationship* with various companies or discussion of off-label uses. The planning committee member(s), course director(s), author(s) and anyone in a position to control the content had their conflict(s) resolved by altering that individual’s control of content for that area of the activity or as noted below.

John Wasson, MD ~ Statement of Conflict of Interest (COI) Resolution for John Wasson, MD, Course Director of the Institute for Ideal Medical Home (IIMH) and Developer and Distributor of HowsYourHealth (HYH) family of tools under license with the Trustees of Dartmouth College.

Since 1994, John Wasson, MD has made commercially available HYH under license with the Trustees of Dartmouth College. These HYH tools were developed based primarily on intellectual property of Dr. Wasson, and his colleagues affiliated with the Dartmouth Primary Care Practice Research Network (The Dartmouth COOP).

The HYH builds on years of educational testing and dissemination by Dr. Wasson and colleagues who will serve as Faculty for the IIMH course. Central to the IIMH is the use of the HYH as the most comprehensive and efficient method to:

• Assess patient needs and provide them real-time, helpful information based on these needs

• Provide clinicians a summary of the needs for a particular patient

• Provide clinicians a summary of the needs and experiences of all practice patients

• Provide the clinicians with an electronic registry based on key patient needs.

Although HYH for patients is available without charge or advertising on the Internet, and a pedagogic, practical and non-commercial alternative to some aspects of HYH is used and stressed in the IIMH course (CARE Vital Signs), HYH is a central part of IIMH and Dr. Wasson has a genuine conflict of interest.

COI Resolution Process

The resolution of the conflict of interest of John Wasson, MD by the Center for Continuing Education in the Health Sciences (CCEHS) was as follows:

1. An independent content expert selected by the D-H Director of CME, determined that the proposed IIMH course is worthy of Dartmouth (DHMC) Continuing Medical Education credit.

2. The DMS Dean of CME and Chair of the Continuing Medical Education Advisory Committee (CMEAC), Richard Rothstein, MD, presented Course Director Dr. Wasson’s course and conflict to the CMEAC (on January 4, 2010) for approval of accrediting the course with the COI Resolution method outlined here.

3. Dr. Wasson altered his financial relationship with the commercial entity HYH, eliminating the possibility of gaining financially by sales of HYH, and removing the financial incentive to introduce bias into content.

4. Dr. Wasson waived his teaching stipend which is part of the course registration fee, and which will be contributed to a charity selected by the Director of the CCEHS.

5. Dr. Wasson made other competitors’ tools (e.g. Care Vital Signs) obvious in the course content, and provided literature and links about these tools within the course website and materials.

6. Dr. Wasson provided a complete disclosure to the CCEHS which the CCEHS provided to learners in advance of the IIMH course.

7. The CCEHS disclosed in advance to learners considering the Institute for Ideal Medical Home (IIMH) course that:

1. Dartmouth Medical School, of which Dr. Wasson is a faculty member, does not endorse any specific product, service, or device including HYH;

2. HYH products are produced and marketed by FNX Corporation, a company in which Dr. Wasson has an interest; and,

3. Dartmouth College receives a royalty on HYH products that are sold.

8. The CCEHS provided a summary of the resolution of Dr. Wasson’s COI in all IIMH course materials.

9. The CCEHS provided a clear statement to IIMH participants that they are under no obligation to use HYH after the course and that participants may receive a list of any patients stored in the registry, upon cessation of IIMH, from Dr. Wasson, without charge. (During IIMH, practices that are unable to implement HYH will use CARE Vital Signs. In this situation no patient registry exists).

10. The CCEHS registered all IIMH participants using DHMC’s CME Manager system.

11. The CCEHS managed the budget (income and expense) and accounting including:

    1. Faculty honoraria

    2. Conference line usage fees

    3. Internet hosting and content development of IIMH materials

    4. Miscellaneous

Other planning committee member(s), speaker(s), course director(s), author(s) or anyone in a position to control the content for this program report no financial interest or relationship* with any company(ies) whose product may be germane to the content of their presentations, or which are supporting this program, and no discussion of off label uses. There were no individuals in a position to control the content who refused to disclose.

* A “financial interest or relationship" refers to an equity position, receipt of royalties, consultantship, funding by a research grant, receiving honoraria for educational services elsewhere, or to any other relationship to a company that provides sufficient reason for disclosure, in keeping with the spirit of the stated policy.