Using state-of-the-art telehealth technology, ECHO trains and supports primary care providers from underserved areas to develop knowledge and self-efficacy so they can deliver best practice care for complex health conditions like chronic HCV. At each of these ECHO partner sites, participants include a lead clinician (a physician, nurse practitioner, or physician's assistant) as well as a nurse or medical assistant who will help manage patient care. None of the community practice sites had treated HCV patients before joining the ECHO network.
Community providers take part in weekly HCV clinics, called “Knowledge Networks” by joining a videoconference or calling into a teleconference line. (See online supplement atwww.nejm.org ) The providers present their cases by sharing patient medical histories, lab results, treatment plans, and questions about best practices and individual challenges. UNMHSC specialists from the fields of hepatology, infectious diseases, psychiatry, and pharmacology provide advice and clinical mentoring during these clinics. Working together, the community providers and specialists manage patients following evidence-based protocols. These case-based discussions are supplemented with short didactic presentations by inter-disciplinary experts to improve content knowledge.
This case-based approach creates a “Learning Loop“ which builds deep knowledge, skills and self-efficacy in several ways. Longitudinal co-management of patients with specialists allows community providers to practice their expanded knowledge and skills in a manner that builds self-efficacy in handling real-world situations with their actual patients, while ensuring that they follow best practices as they learn. Learning from other community-based providers with similar challenges and patient profiles is facilitated through shared case management decision making.
There are currently 16 community sites and 5 prisons that deliver HCV treatment using the ECHO model. Since ECHO's inception in 2003 there has been over 5,000 case presentations and 800 patients treated. We conducted a prospective cohort study to assess the safety and efficacy of ECHO model-based treatment in comparison to university clinic-based HCV treatment. Our hypothesis was that when HCV treatment is delivered using the ECHO model it is as effective as that provided on-site at the AMC.
Community providers take part in weekly HCV clinics, called “Knowledge Networks” by joining a videoconference or calling into a teleconference line. (See online supplement at
This case-based approach creates a “Learning Loop“ which builds deep knowledge, skills and self-efficacy in several ways. Longitudinal co-management of patients with specialists allows community providers to practice their expanded knowledge and skills in a manner that builds self-efficacy in handling real-world situations with their actual patients, while ensuring that they follow best practices as they learn. Learning from other community-based providers with similar challenges and patient profiles is facilitated through shared case management decision making.
There are currently 16 community sites and 5 prisons that deliver HCV treatment using the ECHO model. Since ECHO's inception in 2003 there has been over 5,000 case presentations and 800 patients treated. We conducted a prospective cohort study to assess the safety and efficacy of ECHO model-based treatment in comparison to university clinic-based HCV treatment. Our hypothesis was that when HCV treatment is delivered using the ECHO model it is as effective as that provided on-site at the AMC.
