Health Affairs: Telehealth program sees positive results
Caring for patients with chronic conditions in rural and underserved areas is challenging, but a New Mexico-based program that uses telehealth technology and case-based learning shows promise, according to an article published online May 19 in Health Affairs.
Project ECHO (Extension for Community Healthcare Outcomes) pairs academic medical center specialists with primary care clinicians, training and supporting them in developing knowledge and self-efficacy on chronic diseases, stated Sanjeev Arora, director of Project ECHO at the University of New Mexico School of Medicine in Albuquerque, and coauthors.
The project enables providers to deliver best-practice care for complex health conditions, such as hepatitis C, asthma, diabetes, HIV/AIDS, pediatric obesity, chronic pain, substance use disorders, rheumatoid arthritis, cardiovascular conditions and mental illness, stated the authors.
The model was piloted for treatment of hepatitis C in June 2003. “Prior to Project ECHO, fewer than 1,600 New Mexicans had received treatment for hepatitis C and chronic liver disease, although an estimated 34,000 residents had the disease,” the authors wrote. As of March, 298 Project ECHO teams across New Mexico had collaborated via videoconference on more than 10,000 specialty care consultations for hepatitis C and other chronic diseases, they reported.
Partner sites receive a two-day, in-person Project ECHO orientation in Albuquerque, during which they learn treatment protocols and the model’s communications technology, along with the case-based presentation format for weekly two-hour telemedicine clinics. Primary care clinicians are then organized into disease-specific learning networks that meet weekly via videoconference “virtual grand rounds” or “teleclinics” led by a team of University of New Mexico Health Sciences Center specialists, who review cases with primary care providers, the authors wrote.
Web-based disease management tools facilitate consults, and specialists and primary care providers jointly manage complex chronic illness care for patients, who are treated in their home communities. A centralized database monitors patient outcomes.
Project ECHO has expanded to address asthma, chronic pain, diabetes and cardiovascular risk reduction, high-risk pregnancy, HIV/AIDS, pediatric obesity, rheumatology, substance abuse disorders and mental illness.
The Project ECHO model is being replicated at the University of Washington in Seattle, with an initial focus on hepatitis C, for providers serving Native American populations, then expanding to include rural sites such as migrant health worker clinics and family health centers. The University of Chicago also has launched an ECHO program to manage heart disease among African American men, wrote Arora and colleagues.
Financial support for Project ECHO was provided by the Robert Wood Johnson Foundation, the Agency for Healthcare Research and Quality and the New Mexico State Legislature.
Project ECHO (Extension for Community Healthcare Outcomes) pairs academic medical center specialists with primary care clinicians, training and supporting them in developing knowledge and self-efficacy on chronic diseases, stated Sanjeev Arora, director of Project ECHO at the University of New Mexico School of Medicine in Albuquerque, and coauthors.
The project enables providers to deliver best-practice care for complex health conditions, such as hepatitis C, asthma, diabetes, HIV/AIDS, pediatric obesity, chronic pain, substance use disorders, rheumatoid arthritis, cardiovascular conditions and mental illness, stated the authors.
The model was piloted for treatment of hepatitis C in June 2003. “Prior to Project ECHO, fewer than 1,600 New Mexicans had received treatment for hepatitis C and chronic liver disease, although an estimated 34,000 residents had the disease,” the authors wrote. As of March, 298 Project ECHO teams across New Mexico had collaborated via videoconference on more than 10,000 specialty care consultations for hepatitis C and other chronic diseases, they reported.
Partner sites receive a two-day, in-person Project ECHO orientation in Albuquerque, during which they learn treatment protocols and the model’s communications technology, along with the case-based presentation format for weekly two-hour telemedicine clinics. Primary care clinicians are then organized into disease-specific learning networks that meet weekly via videoconference “virtual grand rounds” or “teleclinics” led by a team of University of New Mexico Health Sciences Center specialists, who review cases with primary care providers, the authors wrote.
Web-based disease management tools facilitate consults, and specialists and primary care providers jointly manage complex chronic illness care for patients, who are treated in their home communities. A centralized database monitors patient outcomes.
Project ECHO has expanded to address asthma, chronic pain, diabetes and cardiovascular risk reduction, high-risk pregnancy, HIV/AIDS, pediatric obesity, rheumatology, substance abuse disorders and mental illness.
The Project ECHO model is being replicated at the University of Washington in Seattle, with an initial focus on hepatitis C, for providers serving Native American populations, then expanding to include rural sites such as migrant health worker clinics and family health centers. The University of Chicago also has launched an ECHO program to manage heart disease among African American men, wrote Arora and colleagues.
Financial support for Project ECHO was provided by the Robert Wood Johnson Foundation, the Agency for Healthcare Research and Quality and the New Mexico State Legislature.