Cancer prevention, screening, and survivorship ECHO: A pilot experience with an educational telehealth program

Abstract

Introduction: The American Cancer Society, Inc. (ACS) estimates that 37,940 Indiana residents were diagnosed with cancer in 2020, which remains the leading cause of death in the state. Across the cancer continuum, national goals have been established targeting recommended benchmarks for states in prevention, screening, treatment, and survivorship. Indiana consistently falls below most goals for each of these targeted categories.

Methods: To address these disparities, we implemented Project ECHO (Extension for Community Healthcare Outcomes) as a virtual telehealth educational platform targeted at local healthcare providers. ECHO programs utilize a novel tele-mentoring approach to the education of clinicians in a hub/spoke design. Sessions occurred twice monthly from September 2019 to September 2020 and consisted of a traditional didactic lecture and a case-based discussion led by participating providers.

Results: During the pilot year there were a total of 22 ECHO sessions with 140 different participants. On average, 15.5 spokes attended each session with increasing participation at the end of the year. Post-session surveys suggested generally favorable perception with 72% of respondents finding the quality "excellent."

Discussion: Given the increasing rate of recurrent participation toward the end of the pilot year in conjunction with the favorable survey responses following each session, it was felt that the program was overall successful and warranted continued implementation.

Conclusion: The Project ECHO platform is a validated telehealth education platform that has the potential to impact cancer care at multiple points along the cancer continuum at the regional level.

Keywords: cancer; disparities; education; public health; telehealth.

FIGURE 1

A representation of the educational learning loop where a bidirectional flow of knowledge can impact an exponentially greater number of patients. Reproduced with permission from the ECHO Institute,

FIGURE 2

Graphic represenation of the total distribution of provider roles for participants at all ECHO sessions

FIGURE 3

State map of Indiana where highlighted counties represent those with participation in Cancer ECHO sessions. Map generated using Microsoft Excel

FIGURE 4

A graphic representation of spoke site attendance at each of the 22 sessions during the year with segments representing recurrent participation