ECHO Institute to expand doc 'telementoring'

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 primary-care 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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