Sunday, June 5, 2011

Bridging the Distance

Dr. Sanjeev Arora, Director for Project ECHO has been working very hard to combat hepatitis C in New Mexico a state with a very high rate of hepatitis C. As a specialist, Dr. Arora could only treat 70 to 90 patients a year in his clinic, yet more than 30,000 New Mexicans had contracted the disease.

Under the ECHO model based at the University of New Mexico Health Sciences Center, includes primary care clinicians organized into knowledge networks that meet weekly via video-conferencing to present patient cases. These “virtual grand rounds” are led by the University of New Mexico Health Science Center who review and discuss the cases with primary care providers and share best practices with them.

Today, Project ECHO’s video conferencing clinics address asthma, mental illness, chronic pain, diabetes, and cardiovascular risk reduction, hepatitis C, high-risk pregnancy, HIV/AIDS, pediatric obesity, rheumatology, and substance abuse.

Today, web-based disease management tools facilitate consults, and specialists and primary care providers jointly manage complex chronic illness care for patients. Primary care providers than treat the patients in their own communities.

An evaluation of Project ECHO demonstrates that primary care providers anywhere can be trained via video conferencing technology to manage complex conditions formerly outside of their expertise, thus expanding their ability to treat very sick patients. These findings are available online by the New England Journal of Medicine (NEJM) and will appear June 9 in the print edition.

It has been shown that by using real-time video conferencing technology and best practice medicine, Project ECHO teams of primary care clinicians along with specialists at academic medical centers are now being trained in new areas of care delivery and how to effectively co-manage patients.

Risa Lavizzo-Mourey, M.D., President of the Robert Wood Johnson Foundation (RWJF) which provided a three year, $5 million grant to Project ECHO, called the ECHO model “the future of healthcare for those who aspire to excellence.” The ECHO model, she said, “demonstrates how healthcare providers everywhere can and should work collaboratively to provide better care. What began as a truly disruptive innovation in New Mexico for treating hepatitis C has the capacity to re-engineer healthcare delivery and training across the healthcare system.”

RWJFs funding aims to bring the ECHO model to industrial strength within New Mexico and spread the concept to healthcare providers nationwide. Replications are underway in Washington State and Chicago, and other potential sites are exploring the model.

“The key to this study is that technology helped local physicians and other providers deliver safe, high-quality care within their own and in most cases underserved communities”, said Carolyn M. Clancy, M.D., Director of AHRQ which funded the evaluation.

In addition to funding from RWJFs Pioneer Portfolio and AHRQ, Project ECHO also receives strong support from the New Mexico Legislature, the University of New Mexico, and the New Mexico Department of Health.

For more information, email Mary Darby at