Project ECHO: digital disruption for better healthcare

The field of medicine evolves constantly, with researchers and practitioners adding to the pool of new and specialized knowledge. Unfortunately, this wealth of information remains largely confined to teaching hospitals and elite institutions. Its dissemination is slow, which impacts the quality of healthcare around the world. Sanjeev Arora, M.D., turned to digital disruption to solve this.

As one of the only two liver disease specialists in New Mexico, Dr. Arora experienced extreme frustration at not being able to treat thousands of patients in the state with Hepatitis C. They did not have access to specialists, and this was fatal to many. He believed everyone who needed treatment, deserved it. Thus, Project ECHO was born.

Simply put, ECHO – Extension for Community Healthcare Outcomes – is a system for transferring specialty care knowledge to primary care providers, through tele-mentoring. Primary care clinicians working in rural and urban underserved areas, are helped to deliver the best care to patients with complex health conditions. Over the last decade, this project has become an exemplary study for best practices in Healthcare IT.

How does it really work?

Two basic factors are applied here – easily available teleconferencing technology, and the hub-spoke model of distribution. Using these, clinicians across geographies virtually present patient cases to the specialist teams and to each other, triggering discussions around latest research and new treatment possibilities. Then, the ECHO specialists who serve as mentors/ trainers, share their medical knowledge and expertise. This model of case-based learning creates online learning communities where primary care clinicians receive support and develop the skills they need, wherever they are.

Wondering if this is effective? A 2011 study published in the New England Journal of Medicine showed that the quality of care provided by Project ECHO-trained clinicians matched that of university-based specialists! It gets better. What started off as an initiative to treat Hepatitis C, today addresses 55 different diseases and conditions.

What’s in it for us?

Digital disruption has been hailed for enabling better healthcare, as well as criticized for not meeting patient/ physician demands. However, Project ECHO is an example of how powerful technological innovation can be, when adopted and assimilated effectively by community leaders. As David Barash, CMO of GE Foundation says, “the strength of a movement is not only about the disruption of the innovation or the brilliance of an idea; it’s also about the tenacity and courage of its followers.”

The lesson for Healthcare IT proponents here – design/ deploy technology that is simple and fits into people’s lives with ease, across different contexts. ECHO is like a foundational tool, which is being adopted not only to address critical diseases, but also to improve the quality of law enforcement education, and build capacity among substance abuse patients to manage their recovery, along with social stigma.

In other words, use technology as a community building tool, and watch its impact amplify.

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