Telementoring with project ECHO: a pilot study in Europe

Abstract

The Extension of Community Healthcare Outcomes (ECHO) project is a novel educational intervention designed in New Mexico to transfer subspecialty knowledge about hepatitis C virus (HCV) to primary care providers, thereby increasing patient access to HCV care. The ECHO model has been shown to deliver educational benefits and to result in good treatment outcomes for HCV-infected individuals in the USA; however, this approach has not been assessed in a European setting.We sought to evaluate the feasibility, acceptability and implementation of the ECHO model in Ireland using a pilot study. We present a descriptive review of recruitment, participation, retention and cost of the intervention as well as a qualitative review of the views of participants on the barriers, benefits and acceptability of the ECHO model. In the original Project ECHO in New Mexico, geographical distance posed the greatest barrier to accessing HCV care. In Ireland, people who inject drugs (PWID) were identified by interviewees as the main group facing barriers to accessing specialist HCV care. State-employed doctors and nurses caring for large numbers of HCV-infected PWID in opiate substitution treatment centres and homeless hostels were successfully recruited to participate in the project. Self-employed general practitioners did not participate, due mainly to a lack of time and the absence of reimbursement for participation. Practitioners who participated in the pilot reported benefits to themselves and their patients and would like to continue to participate in similar multidisciplinary, multisite educational interventions in the future.

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

“…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. In this scheme, specialist care providers/clinicians with the appropriate expertise in home dialysis would cover a predetermined curriculum in home dialysis (home hemodialysis and peritoneal dialysis) serially followed by addressing a number of clinical scenarios, predetermined and requested by the audience, to help manage patients and teach management skills to other Project ECHO participants.…”

We know DAAs work, so now what? Simplifying models of care to enhance the hepatitis C cascade

“…One model that has proven useful in helping such providers serve vulnerable and dispersed populations is the model promoted by Project ECHO (Extension for Community Healthcare Outcomes) . By engaging frontline service providers with a continuous learning system and specialist mentors, it can dramatically increase the access of PWID to HCV care and treatment .…”

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“…An important aspect is that not only the hub experts offer management advice; participants at every site are encouraged to ask questions and offer suggestions on management. In many cases, community sites have highly relevant expertise in areas related to HCV care, such as management of substance use disorders and mental health (8).…”