The Formula for Building a Better Compliance Training Curriculum!

Editor’s Note (September 13, 2022): this post has been updated to include additional suggestions for foundational, reinforcement, and performance support compliance training solutions.

In its guidance related to the evaluation of corporate compliance programs, the Department of Justice repeatedly stresses the importance of appropriately tailored and risk-based training. The guidance suggests prosecutors should “assess the steps companies have taken to ensure policies and procedures have been integrated into the organization.” I can still almost hear the pleas of compliance professionals wondering exactly how they are going to accomplish such integration. The solution is found in a straightforward formula: foundational + reinforcement + performance support = integration (F+R+PS = I). I know, it’s not as simple as the Properties of Equality we all learned in junior high school, but we’ve seen it work time and time again.

Reset the Forgetting Curve

As the Ebbinghaus Forgetting Curve illustrates, the information humans remember after a learning event drops steeply soon after completion of that event. In fact, that loss of recall continues to increase until it finally flattens around 30-days post event. So, F+R+PS = I to the rescue!

Starting with a Strong Foundation

Let’s start with the first elements of the integration formula, foundational training.

Industry-specific foundational training should be used to cover topics such as interactions with health care professionals.

Any successful journey toward integration begins with effective foundational, training. In its guidance, the DOJ instructs prosecutors to consider the form, content, and effectiveness of that training. But what is “effective” foundational training? It begins with relevancy. Does your eLearning feature content to which your learners can relate? Are the scenarios based on interactions and situations your learners are likely to face? Is the content written in plain language? Has the content been vetted by subject matter experts who understand the nuances of interactions with HCPs, HIPAA, or product promotion? For all those reasons and more, broad-based, cross-industry training doesn’t work and is frankly a waste of time and budget. As you know, your sales representatives aren’t benefitting from scenarios featuring ethical discussions between two insurance employees.

Effectiveness also requires a fresh graphic design and user interface. Modern training development tools allow for the use of illustrated images to represent characters such as doctors, sales representatives and MSLs. Let’s be honest, stock photos scream stock photos – or as I call them, “shiny happy doctors and sales reps.” Illustrated characters also offer more opportunity for inclusion of characters that ALL employees can relate to. Your learners want to see representations of themselves in their training.

Finally, effective foundational training is built with proven instructional design strategies in mind. Are the learning objectives specific enough to be meaningful?  Is the content logically organized? Are knowledge checks and interactive exercises appropriately woven into the training? Can the questions in the assessment be mapped directly to the content in the module?

The Compliance Foundations Suite of eLearning modules includes HIPAA for Pharmaceutical Employees .

This isn’t to say effective eLearning always has to be custom developed. Industry-focused, creative, engaging, and modern off-the-shelf training is a great solution for establishing an effective base. So, if you’re with an emerging pharmaceutical or medical device company with limited time and resources, off-the-shelf training is a viable option. Just do your homework and talk to your peers to make sure it’s the right off-the-she solution. (Shameless pitch – we can help!) Of course, custom development does present an opportunity to take your curriculum to another level with more options for branded training laser-focused on your policies if the budget is available.

Also, don’t fall into the current trap of thinking all training has to be short to be effective. Yes, you want to keep foundational eLearning modules no longer than 30 minutes or so, but if 30 minutes are necessary to cover a comprehensive overview of the topic, the learners can sit through it. After all, if we can binge-watch our favorite streaming series, we certainly have the attention span to complete a 30-minute module, assuming it is relevant and engaging.

Reinforcement Drives Retention

Integrate microlearning modules to cover more targeted topics like the 2022 updates to the PhRMA Code.

The second element of the formula for more effective training is reinforcement. When strategically deployed following the initial workshop or eLearning, reinforcement solutions in the form of microlearning modules serve to boost learning, reinforce key topics, and help flatten that nasty Forgetting Curve. For example, if gifts and meals are a high risk for your HCP-facing employees, a scenario-based mini module built around a common situation they face in the field, deployed soon after the foundational training on interactions with HCPs, is an ideal way to increase retention of critical information.

Microlearning modules aren’t the only effective tools for making training more effective, though. Reinforcement learning nuggets could include quizzes and games deployed repeatedly over time. Look for games that can be completed individually or in a multi-player virtual workshop. The Compliance JEOPARDY! game from PharmaCertify, for example, is available in both formats and is easily customized with your content. By the way, it’s the only officially licensed JEOPARDY! game on market and it’s an instantly recognizable way to pull learners into an important reinforcement activity. They’ll even thank you for it.  

The Virtual Compliance Reality Escape Room features a series of customized scenarios and challenges.

Other reinforcement approaches could include virtual or live workshops with content built around the situations sales representatives are likely to face in the field. Why not create a a virtual escape room, for example, with challenges customized for the situations your learners can expect to face in the their daily interactions? (Let me know if you’d like to see a demo of the escape room we built for a client, which recently won a gold Brandon Hall Award for Best Compliance Training!)

The effective integration of compliant practices and policies requires the continuous deployment of a variety of reinforcement solutions. Government agencies like the DOJ and the OIG have made it clear in their guidance, and recent industry settlements and corporate integrity agreements highlight the need as well.

Supporting Their Performance

We’ve come to the ”PS” in the equation that holds the key to achieving integration in a life sciences compliance equation: performance support. Performance support includes those just-in-time resources that people need when they are in-the-moment and can’t remember compliance guidance.

Digital support tools like electronic banners support compliance training messages and themes. When splashed across the company intranet and incorporated into digital messaging from the compliance department and the C-Suite, they remind everyone of the key messages from the foundational and reinforcement training.

Video launched on the company intranet is an effective way to support key messages.

Don’t shy away from the use of video either. Despite what some high-end production companies will tell you, you don’t need to use your entire training budget on a high-end video. You’re not creating Compliance: The Live Action Musical. You’re looking for ways to support your efforts with a creative and engaging video. Tools like Vyond are affordable and easy-to-learn way to accomplish those goals. Many of our clients are developing short (1-3 minute) videos that are pushed out via hyperlink and housed in a library on the compliance page of their intranet. Some even use platforms like Microsoft Stream as an internal YouTube, so that people can rate and comment on the videos.

Finally, materials like quick reference guides support positive behavior and deliver critical reminders when people need them most…as they are about to engage in activities rife with the potential for compliance violation. And other print material like posters and comic books are a great and thematically fun way to drip the learning throughout the duration of a compliance training campaign.

Summary

The key to success and “effectiveness” in compliance training, foundational + reinforcement + performance  support = integration, will not be remembered among the great formulas in history (rest easy Albert Einstein), but any compliance professional would be wise to heed its power. At PharmaCertify, we’ve spent the last 15 years developing compliance training for the life sciences industry. We have the in-house compliance expertise, along with the instructional design and production skill, to help you implement this formula as a necessary step toward meeting the expectations of the regulators, your peers, and perhaps most importantly, your learners.

That’s why we are planning webinars, video-based chats, infographics, more blog posts, and other resources to showcase examples of how our clients are utilizing each stage of the formula to increase the effectiveness of their training. Subscribe to this blog and follow us on LinkedIn and Twitter to keep abreast of the details to follow as we continue to provide the information you need to help reduce risk through training. After all, it’s our mission.

Thanks for reading!  

Sean Murphy
PharmaCertify by NXLevel Solutions

Building Better Compliance Training: 5 Ideas for Reinforcement Training

Welcome to this installment in the Building Better Compliance Training series. Our mission at PharmaCertify is to help you reduce risk through better compliance training, and my goal in this series to provide you first-hand tips and ideas for creating a more effective compliance training curriculum.

In my last post, I revealed the formula for making compliance training more effective: Core Training + Reinforcement + Performance Support = Integration (C+R+PS = I). This time, I focus on the ”R” of that formula and offer five proven methods for reinforcing core training to help ensure your learners recall key concepts and policies when adherence is needed most, particularly during interactions with healthcare professionals.

Since studies show that as much as 90 percent of information learned during one event is forgotten within 30 days (remember the Forgetting Curve), here are five ideas to help ensure your learners don’t fall victim to this sad statistic:

The PharmaCertify PhRMA Code QuickTake focuses on the latest update to the Code.

Go “micro” to make it memorable.

Microlearning is all the rage, and for good reason. Targeted microlearning modules (we call them Compliance QuickTakes) are an ideal way to reinforce critical concepts introduced in core training. Launching a QuickTake on gifts and meals soon after core training on promotional practices, for example, helps improve retention of your company’s policies on a topic fraught with compliance risk.

In addition, today’s eLearning development tools (e.g., Articulate Storyline) make it easier and more cost effective than ever to create reinforcement modules from larger, foundational eLearning. So don’t fall into the trap of thinking one-and-done eLearning is going to meet the needs of a team facing the risk of the proverbial Forgetting Curve at every turn, especially when the opportunity to flatten that curve is just a few select reinforcement modules away.

Lights, camera, animation!

Animated video, featuring illustrated characters, is a compelling method for developing modern videos and a welcome relief for audiences steeped in the disappointment of reinforcement programs populated with dry content and unrecognizable stock photos. Illustrated characters offer a flexibility not easily matched with stock photography, and let you easily create a set of actors equal in diversity to your company’s personnel.

One of our clients regularly launches “Compliance Moments” videos to reinforce key topics from their core training. The programs feature serious content presented in a light (sometimes humorous) tone to help make the messages stick. Having a scriptwriter who combines a keen sense of instructional design with an awareness of how to create realistic scenarios is a must to make the training work. (P.S. we have these.) 

Videos with illustrated characters are an effective way to enhance retention.

Solve a compliance mystery.

Who doesn’t like a good mystery? And who wouldn’t prefer solving a compliance mystery over the typical slide-based presentation?

The Compliance Mystery opens with a series of clues in the form of emails, texts, and receipts from HCP meals.

The days of a compliance officer speaking to a PowerPoint deck are fading fast and your learners expect a higher quality of workshop training. As importantly, a strategically scheduled compliance mystery workshop gives you the opportunity to take a “deeper dive” into the content and immerse participants in the learning, whether the environment is live or virtual.

It’s the ideal reinforcement opportunity as learners act as compliance detectives, work together to identify red flags and determine the best course of action for each scenario. To ramp up the learning even more, try sharing team scores from a leaderboard during the workshop.

It’s engaging, it’s modern, and it’s a great way to make the training relevant as you enhance retention of compliance policies and best practices.

Play a game…virtually, or in a live workshop.

Scenario-based games make the training more relevant.

Games work for reinforcement. In fact, according to a recent study, 80 percent of US workers believe game-based learning is more effective. And if they believe it, they welcome it, especially over the standard compliance training formats.

While games such as JEOPARDY! (which we also offer), come with the built-in advantage of being familiar to the learners, the format and gameplay doesn’t have to be recognizable to be effective. The key is simplicity, fun, and flexibility to customize the categories with your content.

Customize the content to focus on the topics and questions that need reinforcement.

Put simply, games work for reinforcement because they require participants to retrieve information from the long-term memory, process it in the working memory, then re-encode it back into the long-term memory (okay, maybe that wasn’t put simply).

“Escape” to more effective reinforcement training.

Escape rooms are a familiar concept for your audience. And familiarity breeds learning.

A Compliance Escape Room interface.

So, why not create a virtual compliance escape room to help reinforce the rules and policies around topics like virtual sales calls, speaker programs, and medical conferences? The virtual rooms we have created for clients feature a series of clickable clues followed by a series of knowledge checks based on those clues.

An important note: the knowledge checks should be challenging enough that learners will need to revisit the clues to think through the correct answers. Make it subtle and challenging. Returning to the clues to recall the correct information helps the knowledge retention process and serves to strengthen reinforcement of the messages.  

Throughout 2022, we will continue to post articles on this blog, as well as infographics and tips sheets on the Insights page of our website to help you build a better compliance training curriculum. In the meantime, if you’d like to see demos of the products referenced in this article and discuss how we can help you reduce risk through training, contact us at info@pharmacertify.com.

Thanks for reading!
Sean Murphy

A New Year, a New and Improved Compliance Training Curriculum

Welcome to 2022 and a brave, new (and hopefully more effective) world in life sciences compliance training! Over the last two years, the industry has had to navigate the convergence of new and important regulatory documents (DOJ’s Evaluation of Corporate Compliance Programs, OIG’s Serious Fraud Alert on Speaker Programs), as well as updates to leading industry guidance (PhRMA Code, AdvaMed Code). Mix in a series of corporate integrity agreements and settlements focused on key topics, along with a global pandemic, and you have a perfect recipe for a shift in how risk is evaluated and remediated.

So, what’s the appropriate method for recalibrating your compliance training curriculum in response to these events and forces? The solution is as easy as A, B, C, and D:  

Assess Your Company’s Compliance Training Curriculum

Regular risk assessment is a long-time best practice for building and maintaining effective compliance programs. It’s nothing new, and as usual, the major conferences from Informa and PCF in 2021 included multiple sessions where risk assessment was a major topic of discussion. But this time, the regulatory guidance and industry code updates added a sense of urgency to the importance of this best practice.

The Compliance Curriculum Analysis Tool

But what good is a risk assessment if you don’t then assess your training curriculum against that risk? When we work with clients, we evaluate where they are in the product development process, and what training they’re already delivering on which topics, in what form, and at what frequency. It is often a revealing process, identifying gaps and redundancies in topics, and when and how the information is covered.

Good news! It doesn’t have to be a complicated process. Using tools like our Compliance Curriculum Analysis Tool (CCAT) can help.  And it can also be as straightforward as evaluating compliance risk for the product you are about to launch and establishing a baseline of online foundational curriculum around topics like HIPAA and Interactions with HCPs. No matter where you are in the product development cycle, know your risk levels as they relate to topics and audiences. Then look for opportunities to effectively address those risks in your curriculum with a continuous stream of foundational and reinforcement training.

Blend the Formats

The 2022 PhRMA Code Changes QuickTake eLearning Module

The days of using one large PowerPoint deck to train on all things compliance during onboarding sessions are long gone. Good riddance. Effective, well-designed training covering critical topics like bribery, kickbacks, HCP interactions, and speaker programs is readily available.

But the curriculum all stakeholders now expect doesn’t stop at eLearning modules covering foundational topics. You should also plan reinforcement training to help ensure that proper behaviors are integrated into your learners’ daily practices.

If your risk assessments show speaker programs to be a big risk area, don’t count on that one eLearning module or live training session to quell that risk. Why not launch a mini module specifically covering the selection and training of speakers? We call them QuickTakes. In fact, today’s development tools allow for smaller, more focused sections to efficiently and cost effectively be pulled from the larger modules.

Virtual workshops and games can be utilized to train on topics best discussed in live environments, where follow-up discussions and dialogue strengthen the core lessons. For example, if your assessments identify off-label promotion as high risk due to the nature of your company’s products, design a “compliance mystery” workshop, with scenarios replicating real-life environments sales representative can expect to experience in the field.

Compliance JEOPARDY!

Or, ramp up the competition and raise the level of learning with an online or virtual game like our Compliance JEOPARDY!, which is currently the only officially-licensed Jeopardy game on the market.

Finally, does your curriculum include performance support and just-in-time tools to help guide the learners before and after training events? Print and digital support materials can be designed in conjunction with the training and delivered to learners where they need it most – at their fingertips in the field.

A blended curriculum is not only the best approach for “making the learning stick,” it’s what the government, the industry, and perhaps most importantly, your audiences, now expect.

Communicate Across the Company

I admit that every time I heard the phrase “tone from the top” over the last ten years, I found myself wondering why the same topic was covered ad nauseum and seemingly at every conference. Then, a variation on that mantra started to seep into the presentations: “tone from the middle.” The reality is that key messages and lessons in compliance are delivered from the middle, more specifically, managers. And bringing those managers into the communication process helps ensure those in the field are reminded of the importance of compliance every day. It’s why presenters at conferences constantly stress the need to “partner with the business” and why compliance needs to be integrated throughout the company.

Speaking of communication, what does your plan look like? If you don’t have one, you should. Digital banners, animated video, and posters help reinforce the themes related to training and carry the messages across the company. For example, a QuickTake module covering kickbacks can easily be exported into a video for hosting on the company’s intranet. Or consider the approach we’ve taken with a number of clients to portray the compliance department in a more approachable light and produce lighthearted videos showcasing the risks involved in engaging with your company’s HCP partners.

Deliver It Continuously

One of my previous blog articles asked what a 170-year-old German psychologist had to do with compliance training and learning. The answer then, and even more so now considering the forces at work in the industry, is “everything.” Hermann Ebbinghaus is credited with theorizing fundamentals of human learning, including the learning curve, the spacing effect, and the forgetting curve. The forgetting curve essentially states that what humans remember after a learning event drops steeply after the completion of that event.

Continuous delivery helps reset the forgetting curve.

What Ebbinghaus theorized is interwoven into the government documents and settlements we’ve witnessed in recent years: “one and done” just doesn’t cut it. Unless you are taking a continuous approach to the delivery of your company’s compliance training components, you’re probably not taking every step possible to maximize the learning.

Are you deploying training nuggets across the learners’ timelines? Does your training plan include ongoing assessments and quizzes to help flatten that forgetting curve and increase knowledge retention? Are you asking for feedback from the learners on the quality of the training materials and adjusting accordingly? Have you explored available platforms for repurposing and sharing your training content?

In the DOJ’s guidance, the agency noted that some “companies have invested in shorter, more targeted training sessions to enable employees to identify and raise issues to appropriate compliance, internal audit, or other risk management functions.” The possibilities for doing that extend well beyond the creation of shorter eLearning modules. The availability of video, animation, podcasts, quizzes, and games, as well the delivery platforms necessary to continuously deliver those components, all create the opportunity to envelop learners in a framework of minimized risk.

Summary

The advent of new regulatory guidance documents and revised industry codes, as well as the implementation of recent industry settlements, affect the way risk is evaluated and judged in the life sciences industry.

We may be facing an onslaught of requirements and regulatory expectations during a time when the norms of business have been disrupted and disorganized, but using the instructional techniques and concepts outlined above, you have the opportunity to not only navigate your way through those changing expectations, but to elevate your compliance training curriculum to one that helps you rest easier on those waves of change.  

Thank you for reading! As always, my colleagues and I at PharmaCertify welcome the chance to discuss the compliance training challenges you may be facing.

Sean Murphy
PharmaCertify by NXLevel Solutions
smurphy@nxlevelsolutions.com

Reduce Compliance Risk: Play a Game

In this week’s post, Dave Correale, Senior Instructional Designer at NXLevel Solutions, discusses the benefits of using games to reinforce key compliance concepts and make training more engaging.

Imagine you’ve been given a 30-minute slot at an upcoming sales meeting. You’d really like to use the time to reinforce your company’s privacy principles, but you don’t want to just present a boring slide presentation. You know a game would be more fun, but would it be effective? How do you build a game around privacy principles, anyway? Besides, you’re not sure you even have the time or resources to build an effective game.

Let’s explore the first question: Would it be effective? While some of the more ambitious claims surrounding game-based learning are not yet substantiated by research, there is strong evidence that games can increase learner motivation and engagement, critical factors in the success of any learning program.

But how do you build an effective learning game around a topic like privacy? One mistake some people make when implementing a training game is they focus too much on the game and not enough on the objectives. Games are not a panacea. A game will likely not be effective for learning if it is not designed to meet specific instructional objectives. And just because a game is effective for one set of learners, in one specific circumstance, it not necessarily be effective for all learners in all circumstances. Just because you are using a game for learning, you cannot ignore valid instructional design principles and practices.

Fortunately, there are many types of games to meet many different types of learning objectives in a variety of circumstances. The level of participation itself can be diverse: games can involve teams or individuals playfully competing against each other in real time, or they can involve single players whose only competition is the game itself.

Let’s return to your 30-minute slot at a fictional sales meeting. Your goal is to reinforce learning on a topic your learners should already be familiar with. You could have employee teams play against each other in a “Jeopardy-style” contest. We’ve all seen the actual Jeopardy!® board – there’s room there to deliver a lot of content. But instead of bullet points, you’re leveraging familiar game show mechanics to raise curiosity among the learners and harness their competitive instincts. You can also build deeper connections between your employees and engage virtual employees in something more than just polling questions.

Single-player games also afford a number of possibilities. Perhaps your company is concerned with the number of recent settlements involving speaker programs. Players could work their way through an unfolding speaker program scenario where they need to engage with the speaker before the program and then respond to situations that arise during the speaker’s presentation. As they respond to each situation, the game moves forward, learners see the consequences of their decisions, and important lessons are learned or reinforced.

Finally, what about the time and resources required to design and develop an effective game? This is why PharmaCertify’s library of learning games is a good fit for ethics and compliance teams. Our collection of prebuilt games, which includes the only official Jeopardy!® game available, are easily customized to help you increase learner engagement and meet your learning objectives while requiring a fraction of the time and cost required to build a game from scratch. Contact Dan O’Connor at doconnor@nxlevelsolutions.com to see a demo and start planning your next compliance training success story.

And look for additional posts in the future that continue to discuss how game-based learning solutions can help you reduce compliance risk and strengthen your culture of ethics.

Thanks for reading!

David Correale, Senior Instructional Designer, NXLevel Solutions

Key Messages from the 2021 Virtual Pharmaceutical Compliance Congress (And How the Messages Affect Your Compliance Curriculum)

In what was hopefully the last of the “virtual” compliance conferences (fingers and toes crossed), the 2021 Pharmaceutical Compliance Congress (PCC) offered time-tested and established standards (insert “tone from the top” and “ethics-based approach” here), thankfully blended with new best practices, trends, and suggestions from an impressive list of industry executives and government representatives. Some of the key messages from the three-day conference are listed below, along with my thoughts on how those concepts affect your training curriculum in 2021 and beyond.  

1. OIG’s Special Fraud Alert on Speaker Programs still ripples across the industry.

The comments surrounding the OIG’s Fraud Alert released last November certainly were not revelatory, but the fact that industry insiders and regulators are still stressing its importance is meaningful. The Alert was referenced right out of the gate in the presentation by Jim Stansel of PhRMA, and one presenter in the Enforcement Trends presentation summarized its impact by saying, “OIG has thrown down the gauntlet on speaker programs with the Fraud Alert.” As the industry moves away from virtual engagements toward more in-person programs, expect intensified scrutiny.

Speaker programs remain a hot topic for enforcement, and as the industry emerges from the pandemic, your learners need refresher training on the foundational rules of compliant speaker programs and the key concepts associated with those programs. We can help, with our recently updated PharmaCertify Foundations eLearning module, Managing Speaker Program Risk.

2. Data is your friend. (Or should that be “Data are your friend? That one always confuses me.)

The need to scrutinize data has been a recurring topic of conversation, and this year’s PCC was no exception. Having access to data in the right form and unitizing that data to identify trends and outliers is key to an effective compliance program. “Be proactive to dig deep into the data,” one presenter at the Chief Compliance Officer Showcase on Day 1 suggested, “and identify field personnel who are consistently right at the meal limits.”

In life sciences compliance, the devil is in the data, and an informed evaluation of data is critical when updating and optimizing your compliance training curriculum. What is the data telling you? If you’re seeing concerning trends, you’ve got a training challenge. And if you’re not seeing any trends, you’re probably not looking hard enough, or you’re not gathering the right data. As my colleague, Dan O’Connor, pointed out in the Creative Compliance Training Solutions presentation, “when you send out post-training surveys, don’t ask the learners if they liked the training, focus on what they learned and ask them what they can apply in their jobs.” The data is out there, you just have to find it.

3. An ounce of compliance prevention is worth a pound of effectiveness.

In the Former Prosecutor Panel, one presenter emphasized the need to proactively address issues, whether a company is establishing its compliance program or reinforcing important policies as the business evolves. “Getting legal advice on the front of the program is important,” he says, “and when you move back to live interactions, refresh employees on the perils of speaker programs.”

No matter the topic, an adaptive approach to learning is the most effective way to ensure your audience is mastering the concepts and policies. Retention is enhanced when training is rolled out on a continuous basis, in the form of microlearning nuggets, where learners are asked to repeatedly demonstrate their knowledge and understanding. You will sleep better knowing you’ve taken steps to reduce risk.

4. Join in the innovation.

During the Chief Compliance Officer Luminary Panel, one presenter pointed out that the pandemic has forced companies to be innovative in how they navigate business activities, and she reminded the audience that the compliance department “should play a big role in that innovation.” The day of compliance and business operating in siloed fashion are long over. “A seat at the table” is no longer a hopeful cliché randomly mentioned at compliance conferences. To facilitate a true partnership under which compliance polices and best practices are integrated into the daily activities of the workforce, everyone involved needs to understand that risk tolerance in the industry has changed, and the only way to reduce that risk is through a unified spirit of collaboration and innovation.

That notion of cooperation and collaboration extends to training. When compliance training and concepts are integrated regularly into each employee’s full curriculum and daily work, learning is enhanced and stronger ethical cultures are forged. And as was referenced on Day 1 of the conference, statistics from the Ethisphere Institute, an organization focused on defining and measuring corporate ethical standards, show that companies with strong ethical cultures perform better.

5. Evaluate your vendors’ compliance programs as part of your due diligence.

The idea of conducting due diligence before hiring third-party vendors has long been espoused at compliance conferences. But I was intrigued to hear a presenter in the Fireside Chat with CCOs suggest an even deeper dive into a vendor’s compliance program to evaluate whether its practices and principles align with those of your company.

On the training front, that includes a thorough evaluation of the vendor’s compliance training program. Do they cover the high-risk topics pertinent to your company and its products? Do they conduct compliance training in general? How often do they train their employees? How accurate and focused is that training in terms of content? These are the type of questions that need to be incorporated into your third-party vendor risk questionnaire and considered before the contracts are signed.

6. The Sunshine Act rises again.

Too often, life sciences professionals regard Sunshine Act/Open Payments training as a “one and done” event. But as presenters in the Analysis of OIG Special Fraud Alert on Speaker Programs and Assessment of Future Activities session pointed out, Medtronic’s recent settlement with the OIG included a payment to resolve allegations that it failed to accurately report payments to CMS. This topic is too big and too risky to not being training more aggressively.

In addition to refreshing the content in our Compliance Foundations module, The Sunshine Act and Open Payments, we recently added The Sunshine Act Payment Categories QuickTake module to our library of customizable off-the-shelf products. The five-minute module is the perfect complement and reinforcement course to the foundational training, which covers the topic at a higher level.

7. The pandemic is not an excuse.

The notion that the pandemic does not give companies an excuse to lose sight of compliance was repeated daily throughout the conference. Industry leaders and government representatives reminded the audience that the shift to virtual interactions and programs will not be viewed as justification for breaking the law or acting in bad faith. Even though the way in which business is conducted has changed, the core principles and rules governing compliance have not.

The same holds true for your training curriculum. Don’t use the pandemic as an excuse to “put off” searching for ways to enhance training and increase engagement. In fact, you should be doing just the opposite as the industry shifts back to more live interactions. We can help with our Compliance Curriculum Analysis Process (CCAP), which is a comprehensive process to identify training gaps and reinforcement opportunities in your training components.

8. Expect continuing focus on foundations and copay assistance.

Enforcement trends around patient support programs and foundations are growing. It’s a topic on the minds of regulators and routinely on compliance conference agendas. As one of the presenters in the Keynote Enforcement Panel on Emerging Trends Enforcement put it, “we are seeing a ton of copay assistance cases in our district.”

Emphasis needs to be placed on patient program training. And to borrow a phrase, we’ve got a module for that. The Compliance Foundations module, Patient Programs and Their Risks, is a great starting point. Module topics include protecting patient privacy, discussing programs with HCPs, working with vendors, and a topic that is top of mind in life sciences – donations to foundations.  

Conclusion

The organizers of the virtual PCC have made the main stage and on-demand sessions available until May 29 for attendees. If you were there, I highly recommend you visit the conference site for content you may have missed or to revisit the sessions most relevant to you and your company. It’s one of the perks of attending a virtual event.   

While Informa made every effort to replicate the look, agenda, and networking opportunities associated with a live event, it cannot match the on-site conference experience. Fortunately, I am told Informa is planning a live conference for the fall, which will be welcomed news if the dates don’t conflict with those of the Pharmaceutical Compliance Forum’s conference. Bring on the real thing!

Thanks for reading; I look forward to seeing you “live and in person” at a conference before too long!

Sean Murphy
PharmaCertify by NXLevel Solutions

Jen Anderson of Vertex, Jackie Parris of Incyte, and Dan O’Connor of PharmaCertify present during the Creative Compliance Training Solutions session at the virtual 2021 Pharmaceutical Compliance Congress.

Compliance Training Lessons from the 2020 Virtual Pharmaceutical Compliance Congress

Part 3: Compliance Training in An Uncertain Time

This is the third and final post in a series covering the compliance training lessons learned at the 2020 Virtual Pharmaceutical Compliance Congress. Throughout the conference, regulators and industry professionals stressed the need for constant evaluation and modification of all aspects of a compliance program, including the training program. The successful mitigation of risk in a program requires continual careful documentation and evaluation of training topics, audiences, and deployment frequency, as well as the effectiveness of the tools utilized to deploy the training.   

We’ll see you back in Washington D.C. for PCC2021!

To say 2020 has been an eventful and tumultuous year for the life sciences industry is an understatement. The COVID-19 pandemic has forced sudden change in the way in which business is conducted and created a milieu of unforeseen compliance concerns. Those issues were certainly not lost on the presenters at the 2020 Virtual Pharmaceutical Compliance Congress as timely suggestions for managing the “new normal” were blended with more traditional content related to building and managing an effective compliance program. One presenter summarized it interestingly when she said, “the plan you prepared in January does not make sense with what you need to focus on now.”

The need for on-going risk assessment was repeated throughout the conference, beginning in the Enforcement Docket Deep Dive session with one U.S. Attorney commenting, “programs must be updated over time to align with changes in the business and changes in settlements.” That risk assessment includes the on-going analysis and evaluation of a training curriculum, particularly as the way in which the industry interacts with each other and with HCPs continues to evolve.

A Rush to Roll Out New Training

The rush to cover new topics based on updated policies for virtual interactions can lead to a convoluted curriculum and do more harm than good. Regularly scheduled, comprehensive curriculum analysis helps ensure ongoing training covers existing and new topics with the right audiences, at the right level of detail, with the proper frequency based on the level of risk – and that analysis should not be pushed aside solely for the sake of expediency.

A “risk level” analysis has always been a foundational step in identifying content gaps and the need for updates in the topics covered. 2020 is no exception as the pandemic has forced a change in the way field teams interact with HCPs and conduct support programs. During the session, Look at How In-House Legal and Compliance Departments are Evolving in 2020 to Help Address Business Challenges, one compliance officer succinctly put it, “The way in which we do business has changed, so policies need to be more precise and training must be more engaging.”

Curriculum analysis begins with documenting a detailed list of topics covered in current training materials versus those required by the shift to virtual engagements. (Incidentally, PhRMA’s Statement on Application of PhRMA Code Section 2 During Emergency Periods is a good starting point for those changes). Your documentation should specifically include the target audience for each topic and indicate the level of risk each topic represents for each audience, as well as the frequency and level of detail at which each topic is presented.

Following the documentation phase, an analysis is necessary to determine whether the level of training versus the risk for the audience is sufficient. As a final step, solutions to address gaps and redundancies can be planned as new topics are added to the curriculum.

Increasing Retention and Enhancing Learning

An effective training curriculum also requires ongoing “engagement evaluation” to ensure learning is maximized. Let’s face it, the sudden onslaught of new and updated policies on virtual interactions is causing confusion. During the Candid Conversations on Key Themes and Industry Insights session of the conference, more than one panelist cited the movement to virtual programs as the topic keeping them up at night. The variables abound, and just updating foundational training programs with new policies is risky and flawed. More novel methods of training (quizzes, gamification, microlearning, etc.) offer opportunities to integrate nuggets of information into the curriculum and cut through the clutter of change to help raise engagement levels.

One industry speaker highlighted this best when he said, “You need to give them the tools to deal with awkward situations in this new way of conducting business, like how to respond to off-label questions.” That tool list begins with updated training components deployed repeatedly and strategically across the learner’s timeline. The changes wrought by COVID-19 only heighten the need to evaluate your curriculum for its power to change individual behavior – especially with updates to policies and changes in SOPs happening at such an unforeseen rate.

Unsolicited Change

The unknown can be daunting. The writer and poet Raheel Farooq once wrote, “The greatest fear in life is not of death, but unsolicited change.” We, as an industry, a country, and a world, have certainly seen our share of unsolicited change this year and it wasn’t lost on the presenters at this year’s conference. Panelists were quick to admit they didn’t have all the answers in terms of how training, and compliance in general, should be managed in these tumultuous times, but that’s okay. I’m confident most attendees would agree that the opportunity to share concerns, questions, and ideas was worthwhile, valuable, and reassuring. Kudos to all the presenters and conference organizers for making the 2020 Pharmaceutical Compliance Congress such a success under such difficult circumstances. I look forward to attending the 2021 conference “live and in-person,” as I am sure do you.

Thanks for reading!

Sean Murphy
PharmaCertify By NXLevel Solutions

Compliance Training Lessons from the 2020 Virtual Pharmaceutical Compliance Congress

Part 2: A Continued Focus on Speaker Programs and Patient Support Programs

This is the second in a series delving into compliance training lessons learned at the 2020 Virtual Pharmaceutical Compliance Congress. Before the sudden changes brought on by COVID-19, speaker programs and patient support programs were two of the hottest topics in the industry and the pandemic has only heightened the concern. Through live presentations and on-demand sessions available throughout the conference, regulatory officials and industry representatives offered suggestions for managing the programs.

Speaker Programs

During the Enforcement Deep Dive and the DOJ and SEC Insights sessions, panelists reviewed the recent settlements and CIAs related to speaker programs. The cases mostly focused on what one presenter referred to as the “hallmark red flags” he and his colleagues look for in an investigation: repeat speakers and attendees, speakers who were high-prescribing HCPs, alcohol being served, and less than adequate attendance. Alleged violations in the settlements were based on everything from the inappropriate fees paid to speakers and improper promotional activities at the programs, to some companies paying speakers for programs that never occurred.

While regulators provided the groundwork related to traditional topics like speaker criteria and compensation, and attendee management, industry professionals shared tips for effectively managing the programs during a pandemic. In the session titled, Operational Considerations for Speaker Programs During a Pandemic, presenters offered a list of considerations such as updating training on tracking and reporting attendance; adding up to an hour of prep time so all participants have the opportunity to get comfortable with using the technology; and reviewing existing HCP contracts and adjusting provisions for travel since travel to the programs is not currently required.

Not surprisingly, the practicality of providing meals during the pandemic was raised throughout the conference. During the DOJ Enforcement Trends Related to Speaker Programs on-demand session, the challenges with documenting and tracking consumption were raised as a unique risk associated with virtual programs. For example, “ensuring attendees stay for the educational component of a program,” and “providing meals in a way that accounts for COVID-19 related health and safety issues” are suddenly necessary considerations.

Virtual speaker programs raise challenges the industry has not had to consider before the pandemic. Presenters offered an important reminder as to why diligence to how these programs are executed is more critical than ever, by reminding the audience that “government agencies have made it clear they will scrutinize conduct…companies should still comply with codes of conduct and government regulations. There is no COVID-19 defense.”

Patient Support Programs

On the patient support program front, the emphasis in investigations is on what one presenter called “good evidence of bad motivation.” As with speaker programs, the fundamental rules continue to apply. For example, the programs cannot be used to influence a provider’s or patient’s medical decisions and patient privacy must always be protected. Grants and donations to foundations cannot be driven by sales and marketing, or as one presenter put it, “the commercial side should never determine how much goes to foundations.”

With patient foundations being a focus in recent CIAs, presenters during the Enforcement Snapshot and Best Practices Related to PAPs, Coupons and Foundations session covered the important requirements established in those settlements, including the need for a governance committee that is solely responsible for activities related to copay foundations; the importance of establishing an annual budget for donations to foundations; the requirement that donations must be selected using a risk-based approach and random sampling; and the need to be aware of state limitations on copay assistance, such as Massachusetts and California not permitting assistance when a generic is available.

Presenters also pointed out that settlements involving patient support programs have changed for one significant reason: the foundations have also been targeted and have entered into agreements with the government. As one presenter put it, “that means the foundations have skin in the game. Gone are the days when manufacturers called all the shots around contributions to foundations, program design, and compliance controls.”

The requirements detailed in recent settlements point to the need for updated policies and practices, and subsequently, updated training around patient support programs. Not only does core training need to be modified, a new approach is needed to ensure pull through on the significant changes.

A New Approach to Training

Clearly, the fundamental rules related to speaker programs and patient support programs have not changed and still need to be addressed in training, as they were before the onset of the pandemic. speaker programs and patient support programs continue to be high-risk activities. When they are not managed properly, companies face the potential for off-label promotion, false claims, and Anti-Kickback Statute violations, to name just a few. But the nuances of how these programs are executed are now in flux and require serious consideration in terms of content updates and delivery modalities.

Foundational training remains an important starting point. Dedicated training on speaker programs should still include core topics such as program logistics, audience requirements, speaker compensation and training, and answering off-label questions. And patient support program courses must continue to focus on areas such as protecting patient privacy, working with vendors, and working with patient assistance foundations.

Clearly, COVID-19 requires changes to how both types of programs are planned and executed. To ensure targeted employees stay in compliance a supplemental approach towards reinforcement may be appropriate. For example, mini modules covering the provision of meals should be considered to stress the details of updated policies. In addition, microlearning components in the form of mini-assessments, videos, and podcasts are a valuable way to increase the retention of new and updated policies as well as the foundational topics. And custom scenario-based training is an ideal format for highlighting aspects of policies that are particularly relevant to conducting these programs during the pandemic.

Increasing the retention of compliance training is more challenging than ever given the changes in which your field staff and other employees conduct business. The information shared during the Pharmaceutical Compliance Conference serves as a reminder that speaker programs and patient support programs continue to be high areas for risk and a focus of investigations. The onset of COVID-19 has complicated that risk by forcing the industry to rethink how the programs are managed and how employees are trained on the details. Creating a continuous training curriculum, with new microlearning components integrated across learners’ timelines, is critically important to ensuring those details are not lost while understanding that the potential for violations are increased.

Thanks for reading!

Sean Murphy
PharmaCertify By NXLevel Solutions

Up Next: Enhancing Training Engagement in a Changing Industry and World

Compliance Training Lessons from the 2020 Virtual Pharmaceutical Compliance Congress

Part I: A Conference Overview and What It All Means for Your Training

State of the Art Compliance Training, with Dan O’Connor of PharmaCertify, was just one of the 14 on-demand sessions at PCC2020.

Welcome to the first in this multi-part series based on CBI’s recent Pharmaceutical Compliance Congress! For obvious reasons, the conference went virtual this year, yet it offered an impressive lineup of industry professionals, vendors, and government officials offering compelling tips and guidelines for building and maintaining an effective compliance program in the life sciences industry. In addition to the live presentations, organizers offered 14 “on-demand” presentations covering an impressive array of topics, so from a content perspective, the virtual format created even more opportunities for learning.

Over the next month, I will touch on some of the thoughts shared by presenters related to topics like speaker programs, patient programs, risk assessments, third-parties, patient advocacy groups, transparency, and strategies for field team compliance, to name a few. And since the mission of this blog, and the PharmaCertify team, is to help you reduce risk and strengthen your compliance culture through training, I will include suggestions for growing and modifying your compliance training practices and curriculum in response to the information shared during the conference.

Kudos to the team at CBI/Informa for their diligent efforts to replicate the learning and networking experience of the live conference. PCC 2020 was a busy conference, with an impressive volume of content scheduled throughout the week and in the on-demand sessions. If you attended and did not have the opportunity to review the on-demand sessions, I have been told these will remain available until September 14th. You will especially want to review the State-of-the-Art Compliance Training session, where my colleague Dan O’Connor and compliance professionals from Sage Therapeutics, Regeneron, and Akebia Therapeutics share creative approaches for increasing training engagement and adoption. You don’t want to miss that one!

While some of the topics were familiar to anyone who has attended the conference in recent years, the “elephant in the room” was not ignored, as a multitude of presenters addressed the overwhelming challenges of keeping an entire organization focused on conducting business in a compliant manner during these unprecedented times. The result was an interesting blend of traditional and familiar compliance conference topics and guidance on navigating the risk associated with conducting business in a highly regulated industry during a pandemic, or at least as much guidance as can be expected at this time.

From a high-level training standpoint, the presentations at the conference affirm the need for a more dynamic and blended curriculum, with microlearning and other components delivered across your learners’ timelines. The method by which life sciences employees conduct their daily activities has suddenly changed, and the level of risk and potential for violations has grown exponentially with that shift.

One of the more compelling presentations was the “Criticality of Compliance” session with John Crowley of Amicus Therapeutics. John shared his family’s moving story and his incredible journey as he pushed for the development of a product to help his two children (did you know his story was the basis for the feature film, Extraordinary Measures?). As he spoke, John reflected on what the commitment means to the patients battling the rare diseases his company’s products treat, “as life sciences professionals, we are an extension of the oath that doctors and nurses have taken, and it is a solemn oath,” he said, “if there is a compliance violation, everything we hoped for in the next several years is threatened.” It is a laudable approach to building a culture of compliance at Amicus and one worthy of emulation.

I look forward to sharing more ideas from the conference, as well as subsequent training suggestions you can utilize to strive toward similar ideals and goals in your organization.

Thanks for reading!

Sean Murphy
PharmaCertify By NXLevel Solutions

Coming Up: Speaker Programs and Patient Support Programs

Dear Connie, the Compliance Training Specialist, Tackles Return-To-Work Policy Training

Welcome to “Dear Connie, the Compliance Training Specialist,” where we answer questions about compliance training topics and present solutions for strengthening your compliance culture and reducing risk.

This week: Don’t forsake the fundamentals when building return-to-work policy training.

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Dear Connie,

As my company considers reopening our offices under the threat of COVID-19, I’ve been asked to create training based on our new back to work policy. The policy covers precautionary measures (wearing a mask, hygiene, social distancing, etc.) as well as the potential risk factors (international travel, living with someone who has tested positive, sore throat, shortness of breath, etc.).

What type of training do you recommend based on this unique content? Obviously, face-to-face training is not plausible right now, but is one eLearning module enough for a topic this important?

Signed,

Cautious in California

Dear Cautious,

Great question! As the life sciences industry, and the country in general, plans a careful return to work, now is the time to finalize a training and communication plan to help maximize the safety and well-being of employees. A topic this important deserves not to be rushed and framing the challenge within the context of the ADDIE model is important.

Analysis

You don’t want to miss any instructional challenges on a topic like this one. For example, what are the different roles of the learners? Do you have to consider different training tools for office staff versus lab employees? How about field employees? What pre-existing knowledge does each group bring to the training? Only after you’ve established the learner groups and identified the challenges of reaching each of those groups, can you start to design the proper training.

Design

Now you need to establish the learning objectives and think about how the content will be structured and what tools will be utilized. I would certainly consider a campaign approach, perhaps starting with an eLearning module, followed by other learning nuggets, to make it more memorable and engaging. You may want to also consider on-site posters to reinforce key messages, like the need for employees to follow the rules on washing hands and not touching their faces.

Development

In a case like this, development extends well beyond just creating a storyboard for an introductory eLearning module. The content needs to be organized in a manner that maximizes the engagement for each group, as determined in the design phase. The tools and media utilized to emphasize key messages are important. Animated video, for example, is a popular trend, but you need to be careful the animation doesn’t present such serious content in an inappropriate or humorous manner.

Implementation

Don’t fall into the trap of thinking that since this is critical to their safety and well-being, the learners are going to welcome the training with open arms and dive in enthusiastically. Implementing the training in a manner that optimizes retention is critical, perhaps more than ever. Consider the way in which lessons are “chunked” and delivered across each learner’s timeline.

Evaluation

Training intended to help employees learn the rules of returning to work during the COVID-19 crisis should be evaluated and adjusted accordingly. Gather feedback from the learners through surveys and personal outreach. You need to know it’s working, and you need to answer the learners’ questions. Consider sending out short updates as the Centers for Disease Control (CDC) issues new guidance. Don’t let the training get stale!

Summary

The COVID-19 pandemic has changed the life sciences industry, but the fundamentals of memorable and effective training stay the same. Now is not the time to abandon those principles and practices to expedite the development and launch of new policy training. In fact, when faced with the challenges of ensuring the health and safety of employees, just the opposite is true.

My friends at NXLevel Solutions have over 15 years of experience developing policy training that improves retention of content and changes learner behavior. Contact Dan O’Connor at doconnor@nxlevelsolutions.com to ask how they can help ensure your “Return to Work” training helps maximize the safety of your company’s employees during these uncertain and crazy times.

Thanks for the question and stay safe!

Connie

In a Virtual Detailing World, the Rules Regarding Good Product Promotion Still Apply

Life sciences detailing has changed, even if only temporarily, but the rules and best practices related to good product promotion have not. As field sales teams acclimate themselves to the reality of meeting with healthcare professionals through virtual means, they need to ensure those rules aren’t lost in the milieu of that change.

For example, no matter the means by which promotional speech is delivered, the FDA defines it as “any affirmative statement about a prescription drug or medical device.” Regardless of format, promotional statements made while meeting with healthcare professionals must always be truthful and accurate.

Representatives must never exaggerate or mislead the healthcare professional regarding the use, safety profile, or any other aspects of the product and any statements made about a product must include the benefits and the risks associated with the use of the product. They must never overstate the effectiveness of the product, make efficacy claims not supported by substantial research or misrepresent clinical study data. Fair balance cannot be ignored just because a rep is not meeting with the healthcare professional in person.

Products may only be promoted for uses approved by the FDA. In fact, if a healthcare professional asks a representative about an unapproved or off-label use, the rep needs to refer the question to the medical affairs department and, even during a virtual visit, a rep must never steer a conversation with the intent of prompting the healthcare professional to ask an off-label question.

Now is not the time to let the emphasis on good and compliant product promotion slip through the cracks. Updated training and microlearning covering topics like promotional speech, the Bad Ad Program, the use of social media, off-label marketing, and the dissemination of reprints and scientific publications is more important than ever to keep field sales teams compliant and effective.

Thanks for reading!

Sean Murphy
PharmaCertify By NXLevel Solutions

Note: the training content shared in this post is from our Good Product Promotion eLearning module, one of the 26 customizable modules available in our Compliance Foundations suite.