Project ECHO: Linking University Specialists with Rural and Prison-Based Clinicians to Improve Care for People with Chronic Hepatitis C in New Mexico

Abstract

Project Extension for Community Healthcare Outcomes (Project ECHO) is a telemedicine and distance-learning program designed to improve access to quality health care for New Mexicans with hepatitis C. Project ECHO links health-care providers from rural clinics, the Indian Health Service, and prisons with specialists at the University of New Mexico. At weekly clinics, partners present and discuss patients with hepatitis C with specialists. Partners can receive continuing education credits for participating. Since June 2003, 173 hepatitis C clinics have been conducted with 1,843 case presentations. Partners have received 390 hours of training and 2,997 hours of continuing education credits. And in 2006, the State Legislature approved $1.5 million in annual funding for the project. Project ECHO has increased access to state-of-the art hepatitis C virus care for patients living in rural areas or prisons. Because of its success with hepatitis C, this project is being expanded to other chronic medical conditions.

Access to care for vulnerable veterans with hepatitis C: a hybrid conceptual framework and a case study to guide translation

“…The VHA is implementing a new model of telemedicine care, based on New Mexico's Project ECHO (Extension for Community Healthcare Outcomes) telemedicine program that would consolidate liver telemedicine care into one provider to provider visit [42][43][44]. The model is based on case-based learning like a tumor board conference whereby primary care providers dialing in from multiple outpatient clinics present a patient's case to the specialists and discuss options for management.…”

“…As the Project SCAN-ECHO requires collaboration between primary and specialty care, in which the specialist is "mentoring" primary care physicians on HCV management, context exploration could determine important characteristics of the mentoring specialist which facilitated a collaborative and team-based approach. Borrowing lessons learned from the contextual elements of the New Mexico-based Project SCAN-ECHO could include terming specialty and primary care coordinated care as "learning loops" or "collaborative groups" to reinforce the team-based, dialectical approach to care [43,44]. Contextual assessment would strongly influence the early processes of implementation by simultaneously developing the optimal organizational and clinical environment for the intervention and tailoring the intervention with the contextual environment.…”

The Patient-Centered Medical Neighborhood and Diabetes Care

“…Project ECHO was launched in 2004 in 32 rural, underserved New Mexico counties. 16 Its aim is to educate PCPs using specialist-led, case-based learning to increase PCPs' knowledge about cases that were traditionally handled by specialists. Group sessions with providers are held via Internet teleconference twice monthly to discuss patient cases and ultimately guide clinical decision-making.…”

Integrating Viral Hepatitis Prevention into Public Health Programs Serving People at High Risk for Infection: Good Public Health

“…30,32,35 This supplement includes viewpoints and commentaries that address many of these barriers and challenges, including (1) access to and models for care of people identified with positive anti-HCV test results in the public sector; 42,43 (2) vaccination of high-risk adults; 29 and (3) data systems and other infrastructure barriers, such as categorical funding. 24,41 In addition, CDC describes progress in bringing together related prevention programs on a national level and promoting a comprehensive approach to prevention of HIV, STD, and viral hepatitis; 24 and the Substance Abuse and Mental Health Services Administration (SAMHSA) describes several new federal programs to advance integration of viral hepatitis prevention into drug treatment programs.…”