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Completing a specified number of hours of continuing education is required for professionals such as veterinarians and veterinary technicians to maintain their licenses.

South Carolina veterinarians and veterinary technicians are required as of this year to report their continuing education hours to state licensing authorities through a private tracking company, CE Broker.

Those offering CE courses to licensees in the state also must use the online platform operated by CE Broker.

The move to compel license holders to report their hours through a third-party for-profit business appears to be a first for veterinarians in the country.

CE Broker is not a newcomer to the veterinary profession, though. Since 2020, the Florida-based company has provided the digital platform for courses on the Registry of Approved Continuing Education. The registry, known as RACE, is operated by the American Association of Veterinary State Boards, a nonprofit organization representing veterinary regulators in all 50 U.S. states plus the District of Columbia, Puerto Rico, the Virgin Islands and nine Canadian provinces.

CE Broker provides the platform, dubbed RACEtrack, at no charge to the AAVSB, instead deriving revenue by upselling services to providers and licensees.

That arrangement caused consternation among some CE providers early on when they received marketing materials from CE Broker suggesting that the positioning and prominence of their course listings depended on whether they participated in a revenue-sharing arrangement with the company — what one provider called "pay to play."

Although the company did not directly acknowledge that was the case, CE Broker Chief Operating Officer Justin Mann told the VIN News Service in early 2021: "We have been making some adjustments to our offerings. Participation in premium provider programs will not impact course rankings on the RACEtrack course search."

Only bidder wins state contract

In South Carolina, the state Board of Veterinary Medical Examiners began using CE Broker in 2017, also without paying for the service. At the outset, neither providers nor licensees were required to use the platform.

It wasn't until the next year or so that the veterinary board opted to compel participation, according to Lesia Shannon Kudelka, spokesperson for the state Department of Labor, Licensing and Regulation. She noted in an emailed response to questions that using CE Broker was a decision of the department, "but the extent of use is determined by each board."

CE Broker has twice been South Carolina's selected vendor for a CE tracking system to serve its licensing department — first after it submitted the winning proposal in response to a state request for proposals in 2016; and again in 2021, as the first contract neared expiration. According to the 2021 document, the labor and licensing department oversees 42 boards governing some 475,000 professional and occupational licensees.

One specification of both 2016 and 2021 solicitations was: "The system must be provided at no cost to the State, licensees, professional associations, or continuing education providers."

Asked why the state believed it could obtain the service for free, Kudelka indicated that she did not know. "CE Broker was handled by two different employees at the Agency, and neither are still employed here," she said.

In previous communications with the VIN News Service, in early 2021, Kudelka said, "Licensees have the option to pay for an upgraded service with additional features," an apparent reference to CE Broker's willingness to provide the base service without charge in return for the opportunity to sell additional services to licensees.

The CE Broker website shows the option of a "professional account" for $39.99 per year that enables a user to, for example, digitally store documentation other than CE; manage multiple licenses; be informed when CE requirements are fully completed; and receive alerts from their regulatory agency, among other things.

By comparison, the free basic account enables users to report CE to their board; find board-approved courses; manage their official CE records; and check their compliance status, according to information on CE Broker's website.

A statement of award obtained by VIN News through a state Freedom of Information Act request shows that CE Broker was the only vendor to respond to South Carolina's 2021 request for proposals. The value of the contract is listed as $1. Its operative period is Oct. 14, 2021, through Oct. 13, 2026.

Judging from the state veterinary board's Proposed CE Broker Plan, which Kudelka said is enacted, licensees received reminders via e-blast on April 1, 2022, to activate their CE Broker account, followed in June by another e-blast reminder. Licensees were sent a reminder by mail on Dec. 31.

The board is directing veterinary and veterinary technician licensees to activate CE Broker accounts by March 31.

In apparent anticipation that some licensees may be shown by the CE Broker system as "not compliant" because they fail to submit records of their completed CE to the platform, the plan says the board office will "work with these licensees to get their documents properly uploaded ...."

Under the plan, licensees are required to use CE Broker for the 2024 renewal cycle and be unable to renew their licenses if CE Broker shows them as noncompliant.

Confusing and cumbersome, or convenient?

Veterinarians in South Carolina have mixed reactions to the mandate to use the platform, and some have been confused by the company sales pitches, leading them to sign up for paid services, according to Dr. Lorin Lawrence, vice president of the South Carolina Association of Veterinarians (SCAV).

"Quite a few have bought their subscription, thinking if they don't get the 'free trial' that rolls over to a paid subscription, that their CE credits would be lost. This, of course, is not accurate," Lawrence said in an interview by email. "The free account keeps the information just fine."

For his part, Lawrence said, "I personally find it a bit cumbersome to use. For any CE that is not SCAV-sponsored, you have to pick whether it is considered Veterinary Continuing Education Courses or Clinical Medical. The 'Learn More' for these is identical, so you don't know which category applies to what you are reporting. In addition, one has to scan a certificate to upload."

The state veterinary association does not have an official position on the mandate to use CE Broker, Lawrence said.

For this story, he offered to solicit views from colleagues. Lawrence reported:

• A veterinarian in his late 40s "thought it was fine," although he hadn't used the platform himself, having delegated the task of uploading his CE credits to his practice manager.
  
  
• A practitioner in her 50s "preferred the old system, where we signed a statement attesting that we had completed the CE requirements and kept certificates in a file. ... She said she would be unhappy if forced to use CE Broker."
  
  
• A specialist in laboratory animal medicine in her 50s "found CE Broker easy to use and preferred it to keep her office less full of paper. She thought it would be best if some DVMs were allowed to use a nondigital platform in case they were uncomfortable with computers and scanners."
  
  
• A veterinarian in his 30s said he was OK with the system but "wished it could be automated." Lawrence informed him that all SCAV-sponsored conferences are automated such that his credits would be uploaded for him.  (Completion of courses that are listed on RACE also will be automatically credited, according to Kudelka, the state licensing department spokesperson.)
  
  
• A practitioner in his late 70s has his staff upload his CE certificates. "He remembers previously emailing the board a list of his CE courses. He was good with either system."

Another veterinarian, Dr. Rebecca Moland, told VIN News that the platform is relatively simple to use but that "it is obnoxious to scan each individual CE certificate and answer multiple questions for each certificate."

Moland said she prefers the system in North Carolina, where she also is licensed. There, licensees report CE completion online, too, but "it is all done on their renewal website without involving a third party trying to sell me something that I neither want nor particularly need," she said.

According to Kudelka, before South Carolina began using CE Broker, the board office "conducted an in-house computerized audit, and licensees had to submit copies of their CE completion document via email or mail for review."

The state opted to switch to an outside vendor because doing so "significantly reduced the cost and amount of staff time it took track and audit licensees' continuing education hours," she said.

Although Moland would rather use a noncommercial platform to report her CE, she appreciates the convenience of a digitized system.

"In an ideal world, it would be great to entirely do away with paper CE certificates and automatically connect our individual license numbers with our earned CE credits for each state to audit as needed from a central website ..." she said.

In fact, part of the vision of the AAVSB for its RACEtrack system is to enable regulators to more easily track the CE completed by veterinary license holders in their respective states, provinces or territories, and enable licensees to forgo keeping paper or digital documents as proof of CE taken.

Disclosure: The Veterinary Information Network, parent of the VIN News Service, is a provider of CE.