Disseminating Knowledge in Intestinal Failure: Initial Report of the Learn Intestinal Failure Tele‐ECHO (LIFT‐ECHO) Project

Abstract

Background Intestinal failure (IF) is defined as an ultrarare disease, with an estimated prevalence of ∼25,000 cases in the US. There is a suspicion of disparities in outcomes in IF care, likely related to widespread lack of expertise. The Extension for Community Healthcare Outcomes (ECHO) model originally described by Dr Sanjeev Arora has been used to disseminate knowledge and best practices in many chronic diseases to improve outcomes. We examined our initial experience with using the ECHO model to disseminate learning in IF. Method This is a retrospective review of the launch, growth, and geographic reach of the Learn Intestinal Failure TeleECHO (LIFT‐ECHO) program using prospectively collected data. Results The LIFT‐ECHO program has achieved significant geographic reach and clinician engagement. The program has reached close to two‐thirds of the states in the US and several countries outside. Clinician engagement in the learning program appears to be growing exponentially. Conclusion It is feasible to use the ECHO model to disseminate knowledge in managing a rare disease like IF while maintaining fidelity to the proven model. Studies are underway to demonstrate direct benefit to patients.

AGA Clinical Practice Update on Management of Short Bowel Syndrome: Expert Review

“…One such attempt to provide educational support in the form of a virtual multidisciplinary team of experts is the Learn Intestinal Failure Tele-ECHO (Expanding Community Healthcare Outcomes) (LIFT-ECHO) project. 56 The LIFT-ECHO project leverages the highly successful ECHO project launched by Dr Sanjeev Arora, a hepatologist in New Mexico who first showed the success of such an educational platform in improving outcomes in patients with hepatitis C. The LIFT-ECHO project has evolved into an online educational community providing case-based learning in SBS, IF, and PN, directed at nonspecialist clinicians, with all didactic lectures being archived on the project website (liftecho.org/web).…”

Learn Intestinal Failure Tele‐ECHO Project: An innovative online telementoring and case‐based learning clinic

“…The knowledge surveys used in these assessments were not validated and the sample sizes were small (n = 18), hence these data have only limited value. Nevertheless, the preliminary knowledge surveys suggest a significant gap in knowledge and expertise in IF care, with trends toward improvement in participant knowledge 6 . A validated knowledge survey has now been developed to more formally evaluate knowledge improvement post–ECHO clinic participation.…”

“…Nevertheless, the preliminary knowledge surveys suggest a significant gap in knowledge and expertise in IF care, with trends toward improvement in participant knowledge. 6 A validated knowledge survey has now been developed to more formally evaluate knowledge improvement post-ECHO clinic participation.…”

“…Access to highly specialized expertise by patients who have complex or rare disorders and live in underserved regions contributes to healthcare disparities and poor health outcomes 5 . Because novel approaches to provide specialized care for IF are necessary, the innovative Extension for Community Healthcare Outcomes (ECHO) model was adopted to provide such education and virtual multidisciplinary support via the Learn Intestinal Failure Tele‐ECHO project 6 …”

Knowledge of chronic intestinal failure among US gastroenterologists: Cause for concern and learning opportunity

“…Despite these limitations, the results of the test demonstrate lack of knowledge in CIF in a broad cohort of US gastroenterologists and identify opportunities for training and continuing education. Online learning platforms like the Learn Intestinal Failure TeleECHO Clinic (LIFT‐ECHO) Project 7,8 can help to fill this learning gap among community gastroenterologists who find themselves forced to manage complex CIF patients with limited support. We speculate that use of such online learning modules even earlier, perhaps during GI fellowship training, may help to prevent this learning gap and potentially have positive workforce implications.…”