Leveraging Local Expertise to Improve Rural Cancer Care Outcomes Using Project ECHO: A Response to Levit et al

Arora, Sanjeev; Byers, Emily

doi:10.1200/op.20.00260

Cited by 6 publications

(4 citation statements)

References 17 publications

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“…Almost all ECHO participants reported enhanced knowledge, and most reported intent to apply what they learned to their practices. Our results support the ECHO model as an effective tool for strengthening the capacity of rural HCPs to deliver up‐to‐date, high‐quality cancer care to their patients 19 . Similar to an assessment of the Cancer Screening, Prevention, and Survivorship ECHO, 20 we found that the educational material delivered in ECHO sessions was relevant to HCP from diverse disciplines and that the online learning platform was advantageous during the COVID‐19 pandemic.…”

Section: Discussionsupporting

confidence: 72%

Pairing Project ECHO and patient navigation as an innovative approach to improving the health and wellness of cancer survivors in rural settings

Rohan

Kuiper

Bowen

et al. 2022

The Journal of Rural Health

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Purpose: We conducted a 12-month pilot study of 2 complementary strategies for improving rural cancer survivorship outcomes: (1) Project ECHO, a telementoring model to increase knowledge and skills about cancer survivorship among multidisciplinary health care provider teams in rural areas and (2) patient navigation (PN) services to connect rural cancer survivors with resources for enhancing health and wellness. Methods: We recruited 4 CDC-funded National Comprehensive Cancer Control Program sites to implement Project ECHO and PN interventions for a defined rural population in each of their jurisdictions. Sites received ongoing technical assistance and a stipend to support implementation. We conducted a mixed-methods evaluation consisting of quantitative performance monitoring data and qualitative interviews with site staff to assess implementation.Findings: Site teams delivered 21 cancer survivorship ECHO sessions to rural providers resulting in 329 participant encounters. Almost all (93%) ECHO participants reported enhanced knowledge of cancer survivorship issues, and 80% reported intent to apply learnings to their practices. Site teams engaged 16 patient navigators who navigated 164 cancer survivors during the study period. Successful implementation required strong partnerships, clear avenues for recruitment of rural providers and cancer survivors, and activities tailored to local needs. Fostering ongoing relationships among sites through community of practice calls also enhanced implementation.

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Section: Discussionsupporting

confidence: 72%

Pairing Project ECHO and patient navigation as an innovative approach to improving the health and wellness of cancer survivors in rural settings

Rohan

Kuiper

Bowen

et al. 2022

The Journal of Rural Health

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“…Project Echo is a tele-mentoring program that links health care experts with local clinicians in a "hub" (expert) and "spokes" (community facilities in need) model. 35,36 A case, evidence, and program description illustrate the use of telehealth to carry out a comprehensive cancer plan for a patient with advanced disease.…”

Section: Telehealth For Providing Palliative Carementioning

confidence: 99%

Telehealth Strategies to Support Patients and Families Across the Cancer Trajectory

Bakitas

Cheville

Mulvey

et al. 2021

American Society of Clinical Oncology Educational Book

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Effective delivery of cancer care via telehealth requires a planned care system that accounts for myriad patient, provider, and practice/cancer center resources before, during, and after the care episode. Telehealth is broadly defined as a method to have virtual, bidirectional communication between patients and providers. Telehealth can include methods such as audio-only, video-consultation, and tele-monitoring, which can occur in a synchronous, asynchronous, or blended format. The purpose of this review is to present common foundational principles for providing clinical cancer care via telehealth, followed by an overview of three distinct examples of comprehensive telehealth programs that have been developed to meet the needs of patients and families across the cancer trajectory, including survivorship, rehabilitation, and palliative care phases. The programs described are exemplars that were developed and implemented prior to the coronavirus pandemic, so they reflect many years of planning and evidence. Lessons learned include the need for ongoing patient support, clinician training, and cancer health system/practice programmatic considerations such as billing, scheduling, reimbursement, software, and hardware/platform security. Although the COVID-19 pandemic produced an explosive shift in regulations and implementation, sustainability of these changes may not be long-term. Nevertheless, a permanent shift in cancer care to include telehealth is likely here to stay.

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“…This includes involving not just physician providers, but also nurses and other community health workers. 69 70 support the idea that community providers, in conjunction with principal investigators at academic centers, actively participate in adverse-event assessment and medical care management of clinical trial patients in their communities. The infrastructure to implement this collaboration must be addressed by clinical trial stakeholders.…”

Section: Access To Oncology Providers Who Can Offer Trialsmentioning

confidence: 96%

“…70 Project Echo (University of New Mexico Health Sciences Center, Albuquerque, NM) is an example of leveraging technology to create training, mentoring, and principal investigator oversight partnerships. 69 Travel Requirements…”

Section: Access To Oncology Providers Who Can Offer Trialsmentioning

confidence: 99%

Strategies to Advance Equity in Cancer Clinical Trials

Guerra

Fleury

Byatt

et al. 2022

American Society of Clinical Oncology Educational Book

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Cancer clinical trials are critical for testing new treatments, yet less than 5% of patients with cancer enroll in these trials. Minority groups, elderly individuals, and rural populations are particularly underrepresented in cancer treatment trials. Strategies for advancing equity in cancer clinical trials for these populations include (1) optimizing clinical trial matching by broadening eligibility criteria, screening all patients for trial eligibility, expanding the number of trials against which patients are screened, and following up on all patient matches with an enrollment invitation; (2) conducting site self-assessments to identify clinical-, patient-, provider-, and system-level barriers that contribute to low rates of clinical trial screening and enrollment; (3) creating a quality improvement plan that addresses the barriers to enrollment and incorporates the use of tools and strategies such as clinical trial checklists; workforce development and trainings to improve cultural competence and reduce unconscious bias; guides to promote community education, outreach and engagement with cancer clinical trials; screening and accrual logs designed to measure participation by demographics; models of informed consent that improve understanding; clinical trial designs that reduce accessibility barriers; use of cancer clinical trial patient navigators; and programs to eliminate barriers to participation and out-of-pocket expenses; and (4) working with stakeholders to develop both protocols that are inclusive of diverse populations’ geographic locations, and strategies to access those trials. These actions will support greater access for populations that have remained underrepresented in cancer clinical trials and thereby increase the generalizability and efficiency of cancer research.

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Leveraging Local Expertise to Improve Rural Cancer Care Outcomes Using Project ECHO: A Response to Levit et al

Cited by 6 publications

References 17 publications

Pairing Project ECHO and patient navigation as an innovative approach to improving the health and wellness of cancer survivors in rural settings

Pairing Project ECHO and patient navigation as an innovative approach to improving the health and wellness of cancer survivors in rural settings

Telehealth Strategies to Support Patients and Families Across the Cancer Trajectory

Strategies to Advance Equity in Cancer Clinical Trials

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