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Project ECHO expands, spreads telehealth model


By Jessica Zigmond
Posted: June 26, 2013 - 2:30 pm ET
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Building on its success from the past 10 years, Project ECHO has established a new national institute to replicate its model of using “telementoring” to improve the expertise of primary-care clinicians so they can better serve 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.

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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. It uses videoconference weekly to host tele-ECHO clinics where 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 primary-care physicians. Then every week, he hosted meetings through a video network to train the specialists, build on best practices and use technology to leverage their expertise.

“What we found is, over a course of year, they became great experts,” Arora said in an interview. “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 through the Beth Israel Deaconess Medical Center, and they've addressed a host of other specialties, such as diabetes and cardiovascular care, women's health, psychiatry and HIV/AIDS.

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.

“This approach with Project ECHO will bring mental healthcare to patients in their home communities with local clinicians,” Bob Corcoran, president and chairman of the GE Foundation, said in a news release about the new initiatives. “We think this will not only improve access to mental healthcare, but ultimately will improve overall well-being and quality of life for these patients and their families.”

GE will fund Project ECHO to train and mentor a team of primary-care physicians to provide mental healthcare at community health centers in rural and underserved areas of New Mexico. If it's successful, it will be copied at other Project ECHO sites.

Follow Jessica Zigmond on Twitter: @MHjzigmond


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