CE and privacy

Art by Tamara Rees

Veterinary continuing education providers are being told to report the identities of licensed veterinarians and veterinary technicians taking their courses starting Jan. 1, despite ongoing concerns about protecting their privacy.

The mandate comes from the Registry of Approved Continuing Education, or RACE, a program run by the American Association of Veterinary State Boards, a nonprofit representing regulators in the U.S. and Canada. The aim of RACE is to develop and apply uniform standards to CE programs for veterinary licensees.

In 2020, the AAVSB contracted with the for-profit company CE Broker to operate a new online reporting system, dubbed RACEtrack. The purpose of the centralized system is to enable regulators to more easily track the CE completed by veterinary license-holders in their respective states, provinces or territories, according to the AAVSB. The system also enables licensees to forgo keeping paper or digital documents as proof of CE taken. However, licensees concerned about their privacy may elude the automatic reporting by not providing their license information to their CE providers.

As is usual in professions requiring licenses, veterinarians and, in some jurisdictions, veterinary technicians must complete a certain number of CE hours to maintain their licenses. While providers can apply directly to most jurisdictions to have their offerings approved as CE, RACE provides a one-stop shop for course approval.

Earlier this year, some CE providers raised objections to RACE's new directive, saying their privacy policies prohibit sharing participant information. They also worried that the company running the platform, CE Broker, would harvest valuable customer information to provide competing courses. They feared that the search tool for finding CE programs on RACEtrack might be used to list first those courses that directly profit CE Broker. And they wondered whether AAVSB was paying CE Broker to run the system or whether CE Broker, like so many online platforms, would make money by collecting and capitalizing on participant data.

The stipulation to upload course participants' license numbers and jurisdictions to the RACEtrack system was supposed to kick in this year, but the AAVSB postponed the effective date in light of providers' concerns. The new date to comply is the first of the new year — this Saturday.

James Penrod, AAVSB executive director, said in a recent interview that the organization added provisions to its contract with CE Broker to address the concerns. He declined to specify the contents of the addenda but said: "I can say that our contract with our vendor ensures for data privacy and data ownership by the AAVSB, that licensees can search for CE by topic and find RACE-approved courses for acceptance by all state boards, and that any provider cannot use our platform to market their program over another RACE-approved program."

Penrod would not share a copy of the contract, describing it as confidential, but he confirmed that AAVSB is not paying CE Broker.

"We never entered into the agreement with the vendor with that in mind," he said. "They have been in the business for about 15 years, and the way they earn revenues is through the upsell," he said. " ... We never really thought about the need to pay them, given their model has been successful."

CE Broker's website indicates that the platform tracks CE of 214 professions. It makes money by selling licensees upgraded "professional accounts" for $29 a year that provide add-ons including CE compliance transcripts, digital storage of relevant documents and alerts from their regulatory agencies, according to the website. By comparison, licensees using the free basic account may use the platform to manage their official CE records, see their CE compliance status and find board-approved courses, as well as have their CE activity reported to their respective boards.

The VIN News Service was unable to ascertain how frequently licensees choose to pay for the extra service; the company declined to comment for this article.

While veterinary CE providers will be expected to report license numbers and jurisdictions of their course participants, Penrod said, "If the attendee does not choose to provide that to the RACE provider, then there's nothing they can do about supplying that information" to the online platform.

He added that someone who declines to provide the needed information might run into a problem if regulators audit the participant's CE completion based on information in the online system.

For now, that potential consequence of opting out is largely hypothetical: So far, only one state, South Carolina, uses CE Broker to track its veterinary licensees, Penrod said, although others have expressed interest during AAVSB presentations about the platform.

South Carolina does not require CE providers to share attendee information; rather, licensees report their own CE, according to Lesia Shannon Kudelka, communications director and ombudsman for the South Carolina Department of Labor, Licensing and Regulation.

"The vet board still does not require CE providers to utilize CE Broker but does encourage it," Kudelka said by email. "Licensees self-report in the system and do not have an offline option."

Alternatives to RACE for CE approval?

Several CE providers expressed continued discomfort with the RACE directive, and at least one is researching ways around the system.

"We're working on a campaign to help educate people that there are alternatives to RACE," said Dr. Drew Olson, co-founder of a business called drip.vet, which provides continuing education online in "daily, digestible drips." Olson said the quest to raise awareness "is not anything against RACE. It's just educating people."

For example, Olson said, he recently informed a group of surgical specialists in Nebraska who want to offer CE to referring veterinarians in the area that they could apply directly to the state for approval at no cost, rather than pay for RACE approval. "They had no idea!" he said.

Disclosure: drip.vet was sold this year to the Veterinary Information Network, parent of VIN News. Separate from drip.vet, VIN also provides CE, and its president, Dr. Paul Pion, likewise expresses uneasiness with the RACE mandate. Pion said that in keeping with VIN's privacy policies, it will not release data to CE Broker except for course takers who explicitly opt in and give their permission.

Dr. Lance Roasa, a veterinarian and lawyer who, with Olson, founded drip.vet, said every state has alternative routes for CE course approval. Two — Kansas and Montana — do not require approval at all, while 45 automatically approve courses offered through universities and veterinary medical associations, according to research by drip.vet staff.

In other words, "You don't have to use RACE," Roasa said.

"Bear in mind, the states probably want to go through RACE," he elaborated. "The state boards and state legislatures have delegated this responsibility [to approve CE courses] to AAVSB. AAVSB has created the RACE system to handle this delegation. ... And now AAVSB has, in turn, delegated it to a private entity. In my opinion, this is an important governmental task that is in the hands of a for-profit company."

In addition to spreading the word among CE providers that there are alternatives to participating in RACE, drip.vet is trying to raise awareness among licensees.

"Our strategy is to make our learners aware that their private data is being held in a third-party company, and they have a choice not to give up their privacy," Roasa said.

In an article on its website on having "audit-ready veterinary CE," drip.vet lays out the pros and cons of using physical and digital documentation and tracking systems by third parties. "In the end, it might be best to maintain a hybrid system — one in which you keep both digital and hard-copy versions of your documentation," the article concludes. "That way, you always have a backup and have peace of mind in the knowledge that your CE documentation is safe and secure."

Dr. Andy Roark, who provides CE through Uncharted Veterinary Conference and drandyroark.com, said he's already offering RACE-approved CE less frequently.

"The story is that we have not been using much RACE CE (almost none), but plan to stay on as a provider 'just in case,' " he said by email. "At this point, it's less about the data management piece (although I don't know that we have made headway in that regard) and more about the sea of free CE that virtual education has created."

Roark said several large CE providers now offer free or low-cost webinars regularly. "My inbox has free CE opportunities in it every single day," he said. "There's just so much out there; the demand from our customers for CE credit feels like it has gone down."

Dr. Sheri Berger, CEO of PetsVetSpace LLC, which provides online CE through the brand VetVine, laid out her concerns about the RACE directive in a Dec. 23 VetVine forum post titled "The cart before the horse — RACE's new CE reporting requirement."

"While this idea of a centralized system to coordinate CE providers, licensees and regulators seems like a good one, the implementation of it has totally lacked foresight and makes no sense," she wrote. "The rollout has been akin to putting the cart before the horse. Why is the requirement (aka burden) being placed on the CE providers when only one state board has adopted its use? Who thought it was a good idea to make the providers the instruments of this change? Shouldn't each and every one of the member boards have signed on in agreement to actually use this centralized system? Shouldn't each of those member boards have adopted use of RACEtrack and informed their licensees of this new reporting requirement ... before imposing a requirement on the CE providers?"

In an interview, Berger said her business is guided by what its CE takers need and request.

"Our highest priority is to accommodate our members and to do all that we can to ensure their privacy," she said by email. "If our members are self-reporting their CE fulfillment and require CE certificates to do so, then we will continue to oblige them by providing them their CE certificates. If any of our members request or direct us to report their CE fulfillment via CE Broker, then we will surely accommodate them."

Berger added, "We have not been hired nor do we see ourselves as agents of change to a system that is trying to reimagine itself through the enforcement of practices that have not been embraced or mandated by individual state boards of veterinary medicine ... These individual states determine whether individuals have met their CE requirements — not CE Broker or AAVSB RACE."

Correction: This article has been changed to correct the type of identifying information CE providers are being directed to provide on RACEtrack about their course attendees. The information is attendees' license numbers and license jurisdictions; their names are not requested.