One of the primary missions of the American College of Cardiology (ACC) has been to provide means and opportunities for cardiovascular care providers to continually refine their clinical performance and keep abreast of the latest developments in the field. This year, the College is expanding its educational palette with the new Lifelong Learning Portfolio (LLP), a first version of which was soft-released in August on CardioSource. The College's vision and strategy for both the LLP and the proprietary technology delivering answers at the point of care has been led by Rick Nishimura, MD, MACC. Through this LLP, the ACC aspires to become the primary source for maintaining and documenting the highest level of physician competence in terms of patient care.

The LLP will provide a greater number of opportunities for individuals to evaluate and improve the quality of care provided to patients. The American College of Cardiology Foundation (ACCF) is the first specialty society to develop and publish core cardiovascular competencies by disease state across the 6 American Boards of Medical Specialties. Eric Williams, MD, FACC, has led an intensive process with thought leaders from each cardiovascular subspecialty area to define competency across each cardiovascular disease state. These competencies, which also align with the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Internal Medicine's (ABIM's) domain competencies, are:

• •Professionalism: a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to diverse patient populations.
• •Patient Care and Procedural Skills: care that is compassionate, appropriate, and effective for health problems and to promote health.
• •Medical Knowledge: intellectual depth and breadth that cover established and evolving biomedical, clinical, and cognate sciences and their application in patient care.
• •Practice-Based Learning and Improvement: the ability to investigate and evaluate one's patient care practices, appraise and assimilate scientific evidence, and improve one's practice of medicine.
• •Interpersonal and Communication Skills: effective education and partnership with patients, their families, and professional associates (e.g., fostering a therapeutic relationship that is ethical, empathetic, and collaborative).
• •Systems-Based Practice: awareness of and responsibility to a larger context and systems of healthcare. Being able to call on system resources to provide optimal care (e.g., coordinating care across sites or serving as the primary case manager when care involves multiple specialties, professions, or sites).

These competencies set out high professional standards for us as cardiologists and will become the baseline for the College's annual competency-based curriculum planning process starting with the 2013/2014 curriculum year. This planning process will address practice gaps identified through data from the National Cardiovascular Data Registry (NCDR), 5 years of review of ACCF self-assessment products, member assessments of every learning initiative over the preceding 18-month period, as well as surveys, proprietary research, and literature searches. For the first time ACC members will have access to a blended learning curriculum (sequential learning experiences across learning channels) to help construct self-directed programs that align with their specific practice profile, learning style, and any self-identified opportunities to improve practice outcomes. Through the LLP, the College will have the depth and breadth of content to meet the different and changing needs of its membership.

As of the end of August, each ACC member will have his or her own LLP that stores personal data. The LLP will enable members to design, access, and fulfill their own personalized curriculum based on their own interest areas, preferred learning formats, and practice gap areas. There are currently 150 activities that individuals can incorporate into their activities list to access for future reference and curriculum development.

The “My Transcript/My MOC Tool” will also help members understand changing certification requirements and track their continuing medical education (CME), continuing education (CE), and maintenance of certification (MOC) progress. Any credits earned through the ACC will be automatically transmitted into an individual's portfolio, while any credits earned outside the ACC can be manually entered and scanned to maintain a complete transcript.

Harlan Krumholz, MD, FACC, will serve as the LLP's new Editor-in-Chief beginning in January 2013. He and his editorial team are planning to increase the online product portfolio to 300 activities, to provide even more options for maintaining and enhancing competency. The wide variety of new learning formats are not only engaging and easy to use, but provide individuals with the flexibility necessary to provide superior, individualized instruction to various learner groups. Starting next year, the LLP will also launch 6 interactive, novel learning formats: Self-Assessment Products, Meetings on Demand, Expert Analysis and Opinions, Interactive Cases, Live Cases, and Case Vignettes.

The LLP site will be a dynamic site that customizes an individual's experience as he or she uses it. For instance, if a user engages in one of the many self-assessment quizzes, the responses to the quiz will be used to recommend appropriate learning interventions and quality tools to help close any gaps in care. The recommendation engine is driven by an individual's self-assessment scores, CardioSource profile, learning format preferences, and scores from other online activities. Through this algorithm, ACCF-recommended activities will be placed into the personalized LLP for consideration.

Perhaps the most exciting aspect of the LLP will be the release of CardioCompass, a semantic tool that will help users navigate guidelines, appropriate use criteria (AUC), and other clinical documents. By simply entering an open-ended question into CardioCompass, individuals will be pointed to the specific portion of the guideline, AUC, or clinical document that addresses their needs. In the future, CardioCompass will also be available as a pop-up user tool while learning activities are in progress in order to provide immediate access and answers to clinical documents. CardioCompass will also be available as a mobile application for use at the point of care. By the ACC's Annual Scientific Session and Expo in 2013, we hope to add additional source documents to CardioCompass, such as self-assessment programs, consensus documents, the clinical trial database, and journal scans.

In late 2013, we plan to link related MOC Part II questions to the open-ended questions entered into CardioCompass, so that users can select those questions they want to answer and store them in their portfolio until a bank of 30 Part II-approved ABIM-style board review questions is created. Once a user has compiled 30 questions, he or she can request the ACC to submit them directly to ABIM on their behalf in order to receive MOC Part II credits. This will ensure an individual's ACC portfolio and ABIM diplomat status is updated and complete.

With increasing adoption of electronic health records, particularly in the outpatient setting, it will be possible in the not-so-distant future to flow personal NCDR registry data/performance measures alongside national performance benchmarks into the LLP. The College will link performance to those measures to MOC Part IV activities enabling users to track and report performance improvement over time. In 2016, we hope to link the open-ended questions entered into CardioCompass, to a reflective learning section where individuals can detail what they have learned and how they plan to change practice. Individuals will also be able to track improvement through their NCDR data, then submit to the ABIM for Part IV credit directly from the LLP—truly a personalized Part IV practice improvement approach in line with an individual's practice work.

The ACC is committed to enhancing and facilitating cardiovascular education and targeting it to individual practice needs. We hope that you will enjoy the many features and resources available during the soft launch of the LLP. In early 2013, we will hard-launch the Portfolio, which will contain all the features and functionality needed to simplify the many challenges of a clinician's day-to-day activities.