Project ECHO programs in Texas: Teleconferencing for specialized care

ECHO model brings specialized medical knowledge to rural and underserved areas through virtual clinics

By Jean Klewitz, image courtesy of ECHO/ECHO Institute

Project ECHO, or Extension for Community Healthcare Outcomes, is a collaborative model of medical education and care management that seeks to empower you to provide better care to more people. It has an exciting and engaging goal of “changing the world fast.” They intend to do this through moving knowledge, not patients. Partnerships formed through Project ECHO bring specialty knowledge to rural and medically underserved areas.

“To change the way the world works for underserved patients, one has to change the way it is distributed,” said Sanjeev Arora, MD, a liver disease specialist doctor in Albuquerque in a 2017 interview on the Healthcare Innovators Podcast. “When you move knowledge instead of patients, knowledge moves so much more smoothly.”

It’s not typical telemedicine where a specialist assumes the care of your patient. Project ECHO is different. Instead, you receive telementoring, where all teach and all learn. You’ll retain the responsibility of managing the care for your patient, and you’ll engage in real-time collaborative sessions with a community of providers to gain expertise. Project ECHO creates self-supporting networks so you can help your patients get the care they need from you, wherever you are. It is a different way to approach health care, providing you with peer-to-peer online learning and no-cost CME.

What is it like to be a part of a teleECHO program?
You’ll join with your webcam and see the faces of the other participants to engage in peer-to-peer learning. A facilitator might put a scenario up on the screen and give you several multiple-choice answers. All on the call will hold up their fingers of the number they believe it is, and then the facilitator and specialist will share the correct answer and the reasoning behind it. Then you’ll engage in case-based learning, where you and other participants present your de-identified real-life cases to the network. After the case is presented, the program team facilitates a discussion around the case, provides evidence-based recommendations, and solicits additional feedback from the network.

What is the impact?
Over 17 years ago, Sanjeev Arora, MD, started the first program out of the University of New Mexico Health Sciences Center. He started it because he was frustrated by the severe lack of access to specialists in New Mexico. Being a very rural state, it had only two clinics that treated more than 30,000 hepatitis C patients. Arora wanted all patients in need of treatment to get it, so he created Project ECHO for primary care clinicians to treat hepatitis C in their communities.

It worked. He saw the benefit to his patients quickly. His wait time went down from eight months to two weeks because through Project ECHO knowledge-sharing, they were able to create 21 primary care centers of excellence for treating hepatitis C. At that time, he must have known he was onto something big. Still, he likely had no idea of the global reach this model would have.

Now more than 800 teleECHO programs share knowledge across the globe. Academic hospitals, medical schools, and other organizations have become training centers, also known as “hubs,” to build these broad physician networks. And in Texas, we have four institutions that serve as hubs and organize regular Project ECHO programs.

Project ECHO programs you can join
CHI St. Luke’s Health
UT Health San Antonio
UT MD Anderson Cancer Center
The University of New Mexico School of Medicine