WASHINGTON – Project ECHO, a care model that brings specialists’ knowledge and skills to underserved communities through training, distance learning, and video conferencing, is getting its own institute with an eye on replicating the care model across the country and across specialties.
The Robert Wood Johnson Foundation is helping fund the new ECHO Institute, which will be located at the University of New Mexico Health Sciences Center in Albuquerque.
Dr. Sanjeev Arora
Project ECHO (Extension for Community Healthcare Outcomes) began at the university in 2003 as a way to extend more and better health care services to New Mexico residents. The state is largely rural, and it is not unusual for some patients to drive 6 hours to and from a medical appointment, said Dr. Richard Larson, executive vice chancellor and vice chancellor for research at the university.
The ECHO Institute will be led by the project’s creator, Dr. Sanjeev Arora. The institute’s first project will be to bring mental health and substance abuse treatment to more of the state’s rural populace, using a $4.5 million, 3-year grant from the GE Foundation.
"This approach with Project ECHO will bring mental health care to patients in their home communities with local clinicians," Bob Corcoran, president and CEO of the GE Foundation, said in a statement. "We think this will not only improve access to mental health care, but ultimately improve overall well-being and quality of life for these patients and their families."
The grant program will train 16 nurse practitioners and community health workers to work at eight federally qualified health centers in rural New Mexico. These pairs will focus on mental health care and addiction services for the 3 years of the project. They’ll be trained initially at the university by specialists who already are part of Project ECHO.
The local teams will be trained to screen, diagnose, and develop treatment plans, then return to their community to put the skills to work. Once a week, they will meet by video conference with the university’s specialized team to go over difficult cases and get recommendations on treatment.
Project ECHO takes expertise from the academic medical center and puts it in the hands of the primary care providers in the field, said Dr. Arora at a press briefing. He noted that, over the years, ECHO has been well received by specialists at the university because it allows them to "have 10 times the impact" they would if they merely practiced in their clinic.
But, he added, for ECHO to be successfully replicated, specialists have to be willing to "de-monopolize their knowledge base" and share it with primary care practitioners.
However, payment issues may slow adoption of the ECHO model. Medicare, for one, does not reimburse for video consultations, said Dr. Coleen Kivlahan, senior director of health systems innovation at the Association of American Medical Colleges, at the briefing.
Project ECHO supporters include the Robert Wood Johnson Foundation, the GE Foundation, New Mexico Medicaid, the University of New Mexico, and the New Mexico Department of Health. The project also has a 3-year, $8.5 million grant from the Center for Medicare and Medicaid Innovation.
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