Efficacy of pediatric dermatology Extension for Community Healthcare Outcomes (ECHO) sessions on augmenting primary care providers' confidence and abilities

2021 ◽  
Author(s):  
Haorui Sun ◽  
Brian Green ◽  
Andrea Zaenglein ◽  
Melissa Butt ◽  
Joslyn S. Kirby ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Pediatric Dermatology ◽  
Community Healthcare

Dermatology ECHO: A case presentation demonstrating benefits of specialty telementoring in primary care

2018 ◽  
Vol 25 (8) ◽  
pp. 506-509 ◽  
Author(s):  
Ryan Ladd ◽  
Mirna Becevic ◽  
Hope Misterovich ◽  
Karen Edison
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Community Healthcare ◽  
Rural Primary Care ◽  
Timely Access ◽  
New Treatment ◽  
Allergic Contact ◽  
Improve Patient

Allergic contact dermatitis (ACD) is a common dermatologic disorder that is estimated to affect 15–20% of the general population. Because of its prevalence, it may be expected that ACD should be easily recognized. However, it can present with many clinical variations that may complicate diagnosis. Although ACD is a treatable condition, patients from rural and underserved areas suffer if timely access to specialty care is limited. Dermatology Extension for Community Healthcare Outcomes (Dermatology ECHO) telemedicine sessions were created to mentor rural primary care providers (PCPs). To illustrate their benefit, we present the case of a 19-year-old female patient who suffered from worsening undiagnosed ACD for over nine months following a laparoscopic appendectomy. During that time, the surgeon and multiple PCPs treated her with antibiotics, antivirals, and Scabicide without improvement in her condition. The de-identified patient case was presented by her PCP during the Dermatology ECHO session. The Dermatology ECHO specialty team mentored and educated the PCP in the diagnosis and treatment of ACD. After making the diagnosis, the patient received new treatment and her condition improved significantly. Dermatology ECHO provides a knowledge-sharing network for participating PCPs that may improve patient outcomes and reduce patient suffering.

ECHO Autism

2016 ◽  
Vol 56 (3) ◽  
pp. 247-256 ◽  
Author(s):  
Micah O. Mazurek ◽  
Rachel Brown ◽  
Alicia Curran ◽  
Kristin Sohl
Keyword(s):  
Primary Care ◽  
Self Efficacy ◽  
Pilot Project ◽  
Primary Care Providers ◽  
Autism Spectrum ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Care Needs ◽  
Community Healthcare ◽  
Screening Guidelines

Children with autism spectrum disorder (ASD) have complex medical problems, yet they are at high risk for unmet health care needs. Primary care providers are perfectly positioned to meet these needs; however, they often lack training in ASD. This pilot project developed and tested a new model for training primary care providers in best-practice care for ASD using the Extension for Community Healthcare Outcomes (ECHO) framework. The 6-month ECHO Autism pilot project consisted of 12 biweekly clinics focused on screening and identification of ASD symptoms and management of medical and psychiatric comorbidities. Participants completed measures of practice behavior and self-efficacy in screening and management of children with ASD at baseline (pretest) and after 6 months of ECHO Autism (posttest). Statistically significant improvements were observed in self-efficacy, in adherence to ASD screening guidelines, and in use of ASD-specific resources. Participants also reported high satisfaction with the program.

Improving Pediatrician’s Behavioral Health Competencies Through the Project ECHO Teleconsultation Model

2020 ◽  
Vol 59 (12) ◽  
pp. 1049-1057
Author(s):  
Cody A. Hostutler ◽  
Jahnavi Valleru ◽  
Heather M. Maciejewski ◽  
Amy Hess ◽  
Sean P. Gleeson ◽  
...  
Keyword(s):  
Primary Care ◽  
Behavioral Health ◽  
Workforce Development ◽  
Primary Care Providers ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Community Healthcare ◽  
Project Echo ◽  
Underserved Patients ◽  
Development Approach

Project ECHO (Extension for Community Healthcare Outcomes) is a teleconsultation model for enhancing the treatment of underserved patients in primary care. Previous behavioral health (BH) adaptations of Project ECHO have primarily focused on adults or specific diagnoses and have relied on self-reported outcomes. The purpose of this pilot was to adapt Project ECHO to support pediatric primary care providers in addressing common BH needs and to conduct an initial evaluation of its effectiveness. Overall, participants reported high levels of satisfaction and a statistically significant improvement in their overall knowledge and skills ( P = 0.001). Participation was also associated with a reduction in the use of psychotropic polypharmacy. This pilot adds to a growing body of literature suggesting that Project ECHO is a promising workforce development approach to build competencies for the management of BH issues in primary care.

scholarly journals Project ECHO-Geriatrics: Training Future Primary Care Providers to Meet the Needs of Older Adults

2018 ◽  
Vol 10 (3) ◽  
pp. 311-315 ◽  
Author(s):  
Katherine A. Bennett ◽  
Thuan Ong ◽  
Aimee M. Verrall ◽  
Michael V. Vitiello ◽  
Zachary A. Marcum ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Family Medicine ◽  
Primary Care Providers ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Specific Knowledge ◽  
Community Healthcare ◽  
Family Medicine Residency ◽  
Project Echo

ABSTRACT Background  Geriatrics training is essential for future primary care providers. The Extension for Community Healthcare Outcomes (ECHO) model improves access to specialty care via case-based videoconferencing, but Project ECHO has not previously been designed to target residents. Objective  We designed Project ECHO-Geriatrics to deliver geriatrics education to primary care trainees using the ECHO model and evaluated self-rated geriatrics competency of trainees from the University of Washington Family Medicine Residency Network programs who participated between January 2016 and March 2017. Methods  We assessed outcomes of Project ECHO-Geriatrics through anonymous surveys. Participants rated didactics, case discussions, and geriatrics-specific knowledge before and after sessions on a 5-point scale (1, low, to 5, high). Participants were asked whether they planned to do anything differently in their practice and, if yes, to describe this change. Results  Fifteen sessions were held with 204 unique participants from 12 sites, with an average of 28 (range, 13–41) participants per session. From the 9 of 29 (31%) Family Medicine Residency Network programs that enrolled, 63% percent (116 of 184) of eligible residents attended. Sessions were highly rated (89% of responses were 4 or 5). Self-reported geriatrics-specific knowledge increased significantly (before 3.3 [SD = 0.89] versus after 4.0 [SD = 0.60], P < .001). Sixty-five percent (118 of 181) of participants reported plans to change their practice. Conclusions  Project ECHO-Geriatrics is an innovative, feasible way to train the future primary care workforce in geriatrics and grow the capacity to provide high-quality care to older adults.

scholarly journals Using Project Echo Telementoring to Improve Sickle Cell Disease Care in the Midwest

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5923-5923
Author(s):  
Lisa Marie Shook ◽  
Christina Bennett Farrell ◽  
Karen A. Kalinyak ◽  
Stephen C Nelson ◽  
Brandon M. Hardesty ◽  
...  
Keyword(s):  
Primary Care ◽  
Sickle Cell Disease ◽  
Medical Care ◽  
Sickle Cell ◽  
Research Funding ◽  
Primary Care Providers ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Cell Disease ◽  
Project Echo

Abstract Sickle Treatment and Outcomes Research in the Midwest (STORM) is a regional sickle cell network, funded by the Health Resources and Services Administration Treatment Demonstration Project (HRSA U1EMC27863), established to improve outcomes for individuals with sickle cell disease (SCD) living in Indiana, Illinois, Michigan, Minnesota, Ohio and Wisconsin. The STORM network is led by pediatric and adult hematologists who coordinate network activities in each state, along with a Regional Coordinating Center that organizes efforts throughout the Midwest. The goal of the STORM network is to increase the number of pediatric and adult primary care providers (PCP) who are knowledgeable about the management and treatment of SCD, and who are willing to prescribe and manage hydroxyurea therapy as a means to improve medical care for the approximately 15,000 individuals living with SCD in the Midwest. One PCP engagement strategy that has been implemented to increase provider knowledge in the region is replication of the Project ECHOTM (Extension for Community Healthcare Outcomes) telementoring model. Project ECHO was developed by the University of New Mexico to utilize low-cost, high-impact video technology to link expert inter-disciplinary specialist teams with primary care providers to improve management of chronic diseases. This guided practice telementoring model delivers complex specialty medical care to underserved areas, reduces health disparities, and increases workforce capacity. Project ECHO's methodology is based on 1) using telehealth technology to build healthcare resources where they are scarce; 2) sharing best practices to reduce variation in clinical care; 3) utilizing practice-based learning to develop specialty expertise among providers; and 4) monitoring and evaluating provider outcomes. Project ECHO has demonstrated improved healthcare outcomes in Hepatitis C and several other chronic diseases, and is now being piloted by STORM to test its feasibility and applicability for SCD by using a regional approach with CME accreditation. STORM network site physician leads in each state are recruiting multi-disciplinary primary care teams to participate as "spokes" in monthly SCD TeleECHO clinics. The "hub" led by the STORM Regional Coordinating Center, located at Cincinnati Children's Hospital Medical Center, coordinates implementation and evaluation of the telementoring clinics, delivered through monthly teaching sessions. STORM TeleECHO participants log onto an internet-based virtual meeting site, using a webcam to interact during the session. STORM TeleECHO clinics include brief didactic presentations from nationally-recognized SCD content experts with topics and curriculum based on the National Heart Lung and Blood Institute Evidence-Based Management of Sickle Cell Disease guidelines released in 2014. TeleECHO teaching clinics also include 1-2 de-identified, HIPAA protected case discussions (pediatric and adult) presented by providers who would like medical and psychosocial feedback on management of challenging clinical scenarios. Providers participating in the STORM TeleECHO complete an initial survey assessing knowledge and comfort levels, practice behaviors (including hydroxyurea prescribing practices) and clinic demographics. Satisfaction surveys are sent to participants after each session as part of the CME-credit evaluation. Follow-up surveys at 6 months and 1 year will assess satisfaction, knowledge, comfort level and changes in practice. STORM's TeleECHO was launched in March 2016. Preliminary data indicate an interest in STORM TeleECHO teaching sessions by both pediatric and adult providers across the Midwest region. Future efforts will expand the network to more PCPs in the region, while improving the applicability and utility of STORM TeleECHO in SCD through provider assessment. Disclosures Ware: Global Blood Therapeutics: Consultancy; Biomedomics: Research Funding; Bristol Myers Squibb: Research Funding; Addmedica: Research Funding; Nova Laboratories: Consultancy; Bayer Pharmaceuticals: Consultancy.

scholarly journals Democratizing type 1 diabetes specialty care in the primary care setting to reduce health disparities: project extension for community healthcare outcomes (ECHO) T1D

2021 ◽  
Vol 9 (1) ◽  
pp. e002262
Author(s):  
Ashby F Walker ◽  
Nicolas Cuttriss ◽  
Michael J Haller ◽  
Korey K Hood ◽  
Matthew J Gurka ◽  
...  
Keyword(s):  
Primary Care ◽  
Type 1 Diabetes ◽  
Diabetes Care ◽  
Primary Care Providers ◽  
Health Centers ◽  
Medical Decision ◽  
Diabetes Knowledge ◽  
Healthcare Outcomes ◽  
Community Healthcare

IntroductionProject ECHO (Extension for Community Healthcare Outcomes) is a tele-education outreach model that seeks to democratize specialty knowledge to reduce disparities and improve health outcomes. Limited utilization of endocrinologists forces many primary care providers (PCPs) to care for patients with type 1 diabetes (T1D) without specialty support. Accordingly, an ECHO T1D program was developed and piloted in Florida and California. Our goal was to demonstrate the feasibility of an ECHO program focused on T1D and improve PCPs’ abilities to manage patients with T1D.Research design and methodsHealth centers (ie, spokes) were recruited into the ECHO T1D pilot through an innovative approach, focusing on Federally Qualified Health Centers and through identification of high-need catchment areas using the Neighborhood Deprivation Index and provider geocoding. Participating spokes received weekly tele-education provided by the University of Florida and Stanford University hub specialty team through virtual ECHO clinics, real-time support with complex T1D medical decision-making, access to a diabetes support coach, and access to an online repository of diabetes care resources. Participating PCPs completed pre/post-tests assessing diabetes knowledge and confidence and an exit survey gleaning feedback about overall ECHO T1D program experiences.ResultsIn Florida, 12 spoke sites enrolled with 67 clinics serving >1000 patients with T1D. In California, 11 spoke sites enrolled with 37 clinics serving >900 patients with T1D. During the 6-month intervention, 27 tele-education clinics were offered and n=70 PCPs (22 from Florida, 48 from California) from participating spoke sites completed pre/post-test surveys assessing diabetes care knowledge and confidence in diabetes care. There was statistically significant improvement in diabetes knowledge (p≤0.01) as well as in diabetes confidence (p≤0.01).ConclusionsThe ECHO T1D pilot demonstrated proof of concept for a T1D-specific ECHO program and represents a viable model to reach medically underserved communities which do not use specialists.

scholarly journals An Evaluation of An Extension for Community Healthcare Outcomes (ECHO) Intervention in Cancer Prevention and Survivorship Care

2021 ◽  
Author(s):  
Zheng Milgrom ◽  
Tyler Severance ◽  
Caitlin Scanlon ◽  
Any'e Carson ◽  
Andrea Janota ◽  
...  
Keyword(s):  
Cancer Prevention ◽  
Real Life ◽  
Cancer Control ◽  
Primary Care Providers ◽  
Target Audience ◽  
Evaluation Framework ◽  
Survivorship Care ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Community Healthcare

Abstract To address the increasing cancer burden in Indiana, a telementoring program using the Extension for Community Healthcare Outcomes (ECHO) model focusing on cancer prevention, screening, and survivorship care, was deployed in September 2019 to guide best-practice care to primary care providers (PCPs). We utilized Moore’s Evaluation Framework for Continuing Medical Education to evaluate the program's educational outcomes. We collected 22 semi-structured interviews and 30 anonymous one-time surveys from the program participants (hub and spoke members) and the target audience. During the first year, there was an average of 12 non-PCP professionals and 2.5 PCPs come to each session. In spite of a relatively low PCP participation, the program overall received very positive satisfaction and feedback of their improvement in knowledge, confidence and practice. There are three features that both program participants and target audience valued in the Cancer ECHO: a conversational format, gaining real-life experiences, and support from a professional interdisciplinary community. Our study also discovered the PCP’s resistance to didactics focused on prevention and screening, their preference on case discussion part about survivorship care but they do not have enough cases to present. Our study showed that the Cancer ECHO program could be an effective educational means in improving the cancer control capacity, especially to the PCPs. The program strengths suggested a unique role of the ECHO model among the existing physician-targeting cancer control interventions. A further study is warranted to explain the discrepancy between the program’s strengths and a relatively low PCP adoption.

scholarly journals Telementoring with project ECHO: a pilot study in Europe

2017 ◽  
Vol 3 (3) ◽  
pp. 144-151 ◽  
Author(s):  
Clíona Ní Cheallaigh ◽  
Aisling O’Leary ◽  
Shay Keating ◽  
Aileen Singleton ◽  
Sheila Heffernan ◽  
...  
Keyword(s):  
New Mexico ◽  
Pilot Study ◽  
Primary Care Providers ◽  
Educational Interventions ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Community Healthcare ◽  
Educational Benefits ◽  
Project Echo ◽  
The Usa

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.

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