ECHO In­sti­tute to ex­pand doc ‘tele­men­tor­ing’

Modern Healthcare - - THE WEEK IN HEALTHCARE - Jessica Zig­mond

Build­ing on its suc­cess from the past 10 years, Pro­ject ECHO has es­tab­lished a national in­sti­tute to repli­cate its model of us­ing “tele­men­tor­ing” to im­prove the ex­per­tise of pri­mary-care clin­i­cians so they can bet­ter treat pa­tients with chronic con­di­tions in un­der­served ar­eas.

Dr. San­jeev Arora, a liver dis­ease spe­cial­ist who cre­ated the model in 2003, will lead the new ECHO In­sti­tute—ECHO stands for Ex­ten­sion for Com­mu­nity Health­care Out­comes—at the Univer­sity of New Mex­ico Health Sciences Cen­ter in Al­bu­querque. The Robert Wood John­son Foun­da­tion has in­vested $5 mil­lion through 2016 to fund the new in­sti­tute.

The Pro­ject ECHO model re­lies on pair­ing spe­cial­ists at aca­demic med­i­cal cen­ters with pri­mary-care physi­cians in lo­cal com­mu­ni­ties to treat com­plex and com­mon con­di­tions such as hep­ati­tis C and ad­dic­tions. In weekly tele-ECHO clin­ics, physi­cians, nurses and other clin­i­cians from dif­fer­ent ar­eas present pa­tient cases.

When Arora founded the ECHO model a decade ago, he had been treat­ing pa­tients with hep­ati­tis C in un­der­served ar­eas, and found that some had waited eight months to see him. He then set up 21 treat­ment cen­ters in New Mex­ico—in­clud­ing 16 in the com­mu­nity and five in the prison sys­tem—which were run by pri­ma­rycare physi­cians. Ev­ery week, he hosted meet­ings through a video net­work to train the spe­cial­ists and help them build on best prac­tices and use tech­nol­ogy to lever­age their ex­per­tise.

“What we found is, over the course of a year, they be­came great ex­perts,” Arora said. “Now ev­ery­body in the com­mu­nity could go to them,” which meant the high rate of vis­its to Arora’s clinic went down.

Other uni­ver­si­ties have since repli­cated the Pro­ject ECHO model, in­clud­ing the Univer­sity of Chicago; the Univer­sity of Wash­ing­ton; and Har­vard Univer­sity through the Beth Is­rael Dea­coness Med­i­cal Cen­ter in Bos­ton. They’ve ad­dressed a host of other spe­cial­ties, in­clud­ing di­a­betes and car­dio­vas­cu­lar care.

Mean­while, the GE Foun­da­tion has in­vested $4.7 mil­lion over three years to eval­u­ate a new model that will im­prove ac­cess to men­tal health and sub­stance-abuse treat­ment by bring­ing those ser­vices to pri­mary-care set­tings.

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