Important OAR CBMD Milestones

• January 2007 - OAR presents proposal to Osteoporosis Canada in full for a province-wide BMD facility accreditation program
• March 19, 2007 - OC and OAR agree to partner to undertake the Canadian Bone Mineral Densitometry (CBMD) Facility Accreditation Pilot Project
• March 29, 2007 - OC and OAR sign the Pilot Project Letter of Understanding
• March - May 2007 OAR establishes CBMD Facility Accredited Quality Team (FAQT) advisory committee; OAR develops CBMD in full program materials in support of Pilot Project
• April 2007 - OAR and OC announce an important partnership regarding a significant new Pilot Project to fund facility accreditation for 20 BMD facilities in Ontario
• April 1, 2007 - OAR holds first CBMD Facility Accreditation Seminar launching the first educational programming of its kind in Canada with support from OC and Alliance for Better Bone Health
• May 2007 - Pilot Project Application packages distributed to all interested sites
• June 2007 - OAR works with FAQT to develop a Reviewer’s Checklist to standardize the review and grading of all site applications
• July 3, 2007 - FAQT Teleconference reviews project progress and plans for on-going educational programming
• August 2007 - OAR recognizes the need for regular communication with FAQT members and develops a monthly FAQT newsletter
• August 2007 - Grandfathering packages are sent to the 10 sites previously accredited by the former CAR program, offering “grandfathered” accreditation and re-accreditation support, all 4 Ontario sites responded
• September 2007 - OAR revises the CBMD Facility Accreditation Application Form (part of course materials for CME programming) based on knowledge gained from on-going questions/discussions with pilot project sites
• September 10, 2007 - Regional lecture by FAQT member, Dr. Alexandra Papaioannou, to 50 radiologists and technologists in Scarborough is well received
• October 13, 2007 - OAR announces selected Pilot Project sites at second CBMD Facility Accreditation Seminar and follows up with written notice to each site
• October 14, 2007 - FAQT meeting held to review project and educational component and strikes a sub-committee to review and revise course content to keep it current for phase 2 Pilot Project sites
• November, 2007 - Port Perry Imaging is the first Pilot Project site to complete and submit an application for accreditation
• November, 2007 - Radiologists at the OAR’s Fall General Meeting recommend that the OAR make the creation of a CBMD certification program a top priority
• December 2007 - FAQT approved revised CME program content and two new speakers for April 2008 program
• December 2007 - A telephone inquiry was received from the Alberta Society of Radiologists to obtain more information about the CBMD and its educational program
• December 2007 - First Pilot Project Application received from Port Perry Imaging and distributed to FAQT review panel for review and grading

Highlights 2008

• January 2008 - Northumberland Hills Hospital and Hamilton Wentworth X-Ray sites submit their applications for accreditation
• January 14, 2008 - Port Perry Imaging became the first approved application authorized by the physician, physicist and technologist review committee
• January 21, 2008 – The British Columbia Radiological Society request information and assistance to sponsor a CBMD educational event in BC
• January 21, 2008 - The OAR received a letter from the Ontario Association of Medical Radiation Technologists (OAMRT) strongly urging a made-in-Canada BMD certification program for radiologists and technologists be created by the OAR and OAMRT
• February, 2008 - CBMD Facility Accreditation Program Application and Users’ Guide updated to make it more user friendly.
• April, 2008 - CME Program sold out months in advance – Over 200 radiologists, technologists, medical physicists and specialists participate in revised program introducing two new speakers and speakers agree to conduct second program in October for 175 on wait list.
• May 2008 – Pilot Project 2 (PP2) Funding Announced
• June 2008 - PP2 Sites Selected – 14 hospitals and 23 clinics
• October 2008 – Almost 200 radiologists, technologists and physicists participate in CBMD CME event

Highlights 2009

• April and June 2009 - The OAR participated in a multi-stakeholder Ontario BMD Program Working Group seeking ways to link interrelated BMD initiatives within the Osteoporosis Strategy
• The OAR prepares a business case proposal and other supporting documentation with respect to the development of an Internet-based common reporting software system to ensure greater consistency in reporting and to provide the basis for data mining of relevant information with respect to patient outcomes
• May 2009 - Approval of additional funding for Phase Three of the Pilot Project adding an additional 13 hospitals and 23 IHFs
• June 2009 - The OAR’s CBMD’s senior consulting medical physicist initiated discussions with the Canadian Organization of Medical Physicists (COMP) and confirmed that COMP’s official position requires physicists to do on-site inspections as a routine component of a physicist’s service in any medical imaging activity, such as the quality control and precision of DXA equipment and technologists for CBMD accreditation
• Summer 2009 - the CBMD’s senior consulting medical physicist continues to provide support and BMD documentation in response to requests from physicist in other provinces to set up a BMD program based on the CBMD protocol
• Fall 2009 - A number of Pilot Project 1 (PP1) Sites begin First Anniversary Review Process
• Fall 2009 - The OAR and OC placed a stronger emphasis on working together in promoting the components of the Ontario Osteoporosis Strategy and met with hospitals that had a fracture clinic in preparation for the expansion of the CBMD program
• Fall 2009 - The CBMD began preparing a communications package to be used by all sites once they have been approved for CBMD facility accreditation
• November 2009 - Two compulsory workshops were held on November 14 & 15 for all BMD reading radiologists, medical specialists, and technologists who enrolled in PP3
• November 2009 - Two representatives (CEO and the Director Continuing Education) from the Ontario Association of Medical Radiation Technologists (OAMRT) attended the fall CME as observers

Highlights 2010

• CME Success - More than 1,300 reading radiologists, medical specialists and technologists had participated in CMBD CMEs by year-end 2010
• Evolving CME Content Programming continued to evolve from didactic lectures to a combination of lectures and workshops and the newest innovation, the introduction of interactive programming. The Accredited Densitometry Technologist (ADT) Program and designation with a written and practical examination for technologists is launched
• Increased Physicist Involvement - Additional physicists joined the program and recruitment continues through discussions with the Canadian Organization of Medical Physicists (COMP)
• Technologists Data Base - A substantial database has been developed from technologists who have attended CBMD CME and from contacts that they have provided regarding other technologists interested in the accreditation program
• Technical Discussions with BMD Vendors - Conference calls with BMD vendors about the latest equipment innovations resulted in better training materials and CME workshop content
• Liaison with Relevant Associations The Ontario Association of Radiology Managers invited CBMD staff to their annual meeting to outline the Facility Accreditation Program and on-going discussions continued with the Canadian Association of Medical Radiation Technologists to ensure that the CBMD Facility Accreditation Program continues to evolve to meet the educational needs of Ontario technologists
• More than 75 teleconferences with CBMD Management - Weekly internal teleconference meetings were held with the CBMD Management Team in addition to the regular teleconferences with program physicists and technologists to address questions raised by facilities undergoing the accreditation process to discuss ways to improve CME program content, and the on-going review and development of policies and procedures
• Centres of Excellence Forming In several areas throughout the province where sites have achieved accreditation, local clinic and hospital technologists have taken the time to develop and conduct mini-workshops for other local technologists so that they can share what they have learned in the CBMD program and encourage them to seek accreditation
• Several radiologists began developing similar programs with a view to assisting referring physicians and asked the CBMD program for assistance with communication support materials
• Technologist User’s Group Discussions began with experienced technologists at accredited sites to establish a user’s group to mentor technologists at new sites becoming newly involved in the facility accreditation process.
• Physicist User’s Group - Plans are made to expand the physicist user’s group established last year through a physicist workshop under the direction of the CBME chief physicist to mentor new medical physicists recruited to the facility accreditation program
• More interest and participation begins to occur thereby representing a fundamental change and demonstration that the CBMD program is working
• Requests for PP4 Sites continued to come forward requesting enrolment in the next phase of the CBMD Program

Highlights 2011

• CBMD CME Programs focusing on the new 2010 Osteoporosis Guidelines for reading physicians and technologists was held September 24-25, 2011 for close to 300 registrants
• An evaluation of the OAR CBMD facility accreditation pilot project, which was completed in 2011 with the involvement of University of Toronto Osteoporosis researchers, concluded that the program had a profound influence on improving the quality of scanning services provided by the participating sites between 2008 and 2010
• The widespread adherence to the then national reporting standard was also noted as a major change in quality in the evaluation report
• As a result of these findings, the OAR was subsequently asked by MOHLTC to prepare a business case for a permanent CBMD Facility Accreditation Program
• A business case was submitted September 24, 2011 demonstrating that a permanent program encompassing all of Ontario’s DXA units

Highlights 2012

• Senior Ministry staff looked favourably on the business case, and the OAR was asked to make some modifications and re-submit it
• MOHLTC re-organization occurs causing the Ministry to advise the OAR in March 2012 that funding was not available for the creation of a permanent accreditation program
• OC also advised the OAR that they had not received any MOHLTC funding through the Osteoporosis Strategy for CBMD re-accreditation
• As a consequence, the OAR was forced to put the accreditation program on hold, while it investigated other options including termination of this unique offering to Ontario hospitals and clinics. At the time close to one-third of the province’s 300 BMD services had been accredited as part of the joint OAR-Osteoporosis Canada (OC) pilot project, which received almost $1 million of MOHLTC funding
• The abrupt reversal of MOHLTC support for a permanent accreditation program and the loss of further pilot project funding created uncertainty and confusion for sites interested in re-accreditation as well as those wishing to join the OAR’s program
• The MOHLTC decision, which came without warning or appeal, forced the OAR to examine every avenue to obtain alternative sources of funding and to consider other ways to deliver accreditation
• In the end, no MOHLTC or OC money was approved and the OAR was left with no choice, but to reluctantly suspend the program in the spring of 2012

Highlights 2013

• The OAR board of directors unanimously agreed, at its March 21, 2013 meeting, to re-develop the Canadian Bone Mineral Densitometry (CBMD) Facility Accreditation Program, in an effort to maintain this vital QA/QC program which was put in jeopardy when the MOHLTC reversed its earlier indications to provide permanent funding for a provincial BMD accreditation program
• Dr. David Lyons agrees to lead the CBMD Program and develop a Proposal to Re-Launch CBMD Facility Accreditation Program and Continuing Medical Education for reading physicians and medical radiation technologists providing BMD services

Highlights 2014

• New CBMD continuing education courses are developed for reading physicians and technologists focusing on the 2013 Canadian Association of Radiologists Technical Standards for Bone Mineral Densitometry Reporting
• More than 600 radiologists and technologists registered for the October 24^th physician and November 1^st & 2^nd technologist courses
• CBMD online facility accreditation program developed

Highlights 2015

• New standard reporting tool is developed for reporting physicians
• CBMD CME programming continues to evolve to include a workstation course for reporting physicians
• CBMD Facility Accreditation Online Program and Application launched
• CBMD Quality Assurance Advisory Committee established