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. 2007 Feb;82(2):154-60.
doi: 10.1097/ACM.0b013e31802d8f68.

Academic health center management of chronic diseases through knowledge networks: Project ECHO

Sanjeev Arora  1 , Cynthia M A Geppert, Summers Kalishman, Denise Dion, Frank Pullara, Barbara Bjeletich, Gary Simpson, Dale C Alverson, Lori B Moore, Dave Kuhl, Joseph V Scaletti
Affiliations

Academic health center management of chronic diseases through knowledge networks: Project ECHO

Sanjeev Arora et al. Acad Med. 2007 Feb.

Abstract

The authors describe an innovative academic health center (AHC)-led program of health care delivery and clinical education for the management of complex, common, and chronic diseases in underserved areas, using hepatitis C virus (HCV) as a model. The program, based at the University of New Mexico School of Medicine, represents a paradigm shift in thinking and funding for the threefold mission of AHCs, moving from traditional fee-for-service models to public health funding of knowledge networks. This program, Project Extension for Community Health care Outcomes (ECHO), involves a partnership of academic medicine, public health offices, corrections departments, and rural community clinics dedicated to providing best practices and protocol-driven health care in rural areas. Telemedicine and Internet connections enable specialists in the program to comanage patients with complex diseases, using case-based knowledge networks and learning loops. Project ECHO partners (nurse practitioners, primary care physicians, physician assistants, and pharmacists) present HCV-positive patients during weekly two-hour telemedicine clinics using a standardized, case-based format that includes discussion of history, physical examination, test results, treatment complications, and psychiatric, medical, and substance abuse issues. In these case-based learning clinics, partners rapidly gain deep domain expertise in HCV as they collaborate with university specialists in hepatology, infectious disease, psychiatry, and substance abuse in comanaging their patients. Systematic monitoring of treatment outcomes is an integral aspect of the project. The authors believe this methodology will be generalizable to other complex and chronic conditions in a wide variety of underserved areas to improve disease outcomes, and it offers an opportunity for AHCs to enhance and expand their traditional mission of teaching, patient care, and research.

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Figures

Figure 1
Figure 1
Project ECHO video teleconferencing implementation. Project ECHO is based at the University of New Mexico, Albuquerque, NM, and was implemented in June 2003.
Figure 2
Figure 2
Project ECHO care manager implementation. Project ECHO is based at the University of New Mexico, Albuquerque, NM, and was implemented in June 2003.
Figure 3
Figure 3
The role of expanding knowledge in caring for underserved populations.
See this image and copyright information in PMC

References

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