Leveraging Scarce Resources With Bone Health TeleECHO to Improve the Care of Osteoporosis

Abstract

Osteoporosis is a common condition with serious consequences because of fractures. Despite availability of treatments to reduce fracture risk, there is a large osteoporosis treatment gap that has reached crisis proportions. There are too few specialists to provide services for patients who need them. Bone Health Extension for Community Health Care Outcomes (TeleECHO) is a strategy using real-time ongoing videoconferencing technology to mentor health care professionals in rural and underserved communities to achieve an advanced level of knowledge for the care of patients with skeletal diseases. Over the first 21 months of weekly Bone Health TeleECHO programs, there were 263 registered health care professionals in the United States and several other countries, with 221 attending at least 1 online clinic and typically 35 to 40 attendees at each session at the end of the reported period. Assessment of self-confidence in 20 domains of osteoporosis care showed substantial improvement with the ECHO intervention (P = 0.005). Bone Health TeleECHO can contribute to mitigating the crisis in osteoporosis care by leveraging scarce resources, providing motivated practitioners with skills to provide better skeletal health care, closer to home, with greater convenience, and lower cost than referral to a specialty center. Bone Health TeleECHO can be replicated in any location worldwide to reach anyone with Internet access, allowing access in local time zones and languages. The ECHO model of learning can be applied to other aspects of bone care, including the education of fracture liaison service coordinators, residents and fellows, and physicians with an interest in rare bone diseases.

Telehealth Interventions and Outcomes Across Rural Communities in the United States: Narrative Review

“…A total of three studies analyzed telehealth interventions in health care professionals and reported outcomes. Lewiecki et al [ 16 ] examined the acceptability of TeleECHO and found that self-confidence in 20 domains of osteoporosis care showed substantial improvement. In addition, they determined that TeleECHO can contribute to alleviating the osteoporosis care crisis by leveraging scarce resources; providing motivated practitioners with the skills to provide better skeletal health care, closer to home, with greater convenience; and being lower cost than referral to a specialty center.…”

“…In addition, they determined that TeleECHO can contribute to alleviating the osteoporosis care crisis by leveraging scarce resources; providing motivated practitioners with the skills to provide better skeletal health care, closer to home, with greater convenience; and being lower cost than referral to a specialty center. Additionally, TeleECHO can be applied to any location worldwide with internet access, allowing access in local time zones and a variety of languages [ 16 ].…”

Impact of Project ECHO Models of Medical Tele-Education: a Systematic Review

“…The response rate was also as low as 7% of participants, suggesting self-selection bias. 37 The one recorded cluster RCT, by Eaton and colleagues, 26 did not find a benefit of EELM in terms of provider knowledge or perceived competence.…”

Overcoming Barriers for Uptake and Continued Use of Home Dialysis: An NKF-KDOQI Conference Report

“…Project ECHO (Extension for Community Healthcare Outcome) is a distance health educational model that uses videoconferencing technology to connect care providers across multiple geographical settings and areas of expertise. 9,10 After conducting a needs assessment to identify knowledge gaps of dialysis providers, we envision creating a forum in which a high-performing home dialysis center will act as "host" institution and provide clinical expertise in home dialysis through a multidisciplinary team. 11 Most home dialysis teams consist of nephrologists, home dialysis nurses and technicians, social workers, dietitians, and dialysis technicians.…”