In November 2013, the AAP forged a partnership with the University of New Mexico (UNM) Project ECHO® to address the health and social needs of children and youth with epilepsy in rural and underserved areas of New Mexico. Project ECHO is an innovative hub and spoke program, designed to create knowledge networks bringing together Primary Care Providers (PCPs) in rural and underserved areas and specialty care providers at academic medical centers through a telementoring program using didactic and case‐based presentations. These formalized partnerships increase capacity for PCPs to identify, treat, and manage the care of their patients within the medical home. Using state‐of‐the‐art technology, clinical management tools, and case‐based learning, PCPs develop knowledge and self‐efficacy on diseases/conditions in which they don’t usually assume responsibility for the care and treatment.
Project ECHO has been recognized nationally and globally. Unlike telemedicine, this tele-mentoring model does not foster a physician and patient relationship. Instead, the purpose of the ECHO sessions is to build capacity and to dramatically increase the effectiveness of the group; the goal of this program is to create self‐sustaining organizations and freely share access to quality and cost effective care using the following 4 key attributes:
- Disease management model of care that aims to improve quality, reduce variety, and standardize best practices.
- Superspecialist teams foster multidisciplinary partnerships that increase access to care and reduce health care costs.
- Primary Care Providers (nurse practitioners, nurses, physician assistants, pediatricians, internists, etc) participate in case‐based learning under guided practice to co‐manage their own patients.
- Technology promotes face-to-face mentorship and sharing of knowledge and experience by experts and peers.
Published data demonstrates that patients who were treated via the Project ECHO methodology had outcomes as good or better than those treated at an academic medical center.2 This success has largely been credited to patients receiving patient‐centered, culturally competent care by local providers, who are often a trusted resource to the patient, and more likely to engage in regular communication, thereby enhancing a patient’s compliance with treatment.2
ECHO has been successfully utilized in the adult system and has been adapted by institutions globally. Project ECHO has supported the development of more than 110 hubs worldwide in more than 20 countries on six continents for nearly 67 diseases and conditions, including sites within the Department of Defense healthcare systems.3
The AAP continues to expand and partner on a variety of pediatric-specific ECHOs. To learn about which topics, click here.
The AAP also serves as a Superhub and can provide training and technical support. Click here to learn more.
References:
- Basco, WT, Rimsza, M. Pediatrician Workforce Policy Statement. Pediatrics. 2013; 132(2): 390-7.
- Arora S, Thornton K, Murata G, et al. Outcomes of Treatment for Hepatitis C Virus Infection by Primary care Providers. N Engl J Med 2011; 364: 2199-2207.
- From https://app.box.com/files/0/f/2620531929/1/f_100221395943. Accessed November 9, 2016
Additional Information:
- New model of care improves access for children with epilepsy.
- Telementoring improves children’s access to specialty care.
Project ECHO at the AAP
AAP received funding from the Maternal Child Health Bureau to increase access to care and awareness to Children and Youth with Epilepsy (CYE). In November 2013, the AAP partnered with the University of New Mexico (UNM) Project ECHO to expand the existing capacity of providing best practice care to CYE in rural and underserved areas of New Mexico. The CYE ECHO clinic launched on June 3rd, 2014. Due to a successful launch and the ability to leverage and enhance limited resources for specialty care required by children with complex medical conditions and the potential to replicate the ECHO model in other programs, domestically and internationally, AAP decided to expand the CYE ECHO program across the country.
The Coordinating Center for Access to Services for Children and Youth with Epilepsy (Center) identified five Universities/Academic Medical Centers in five different states with an interest in increasing access to care for CYE. Since then, AAP also received funding from Novo Nordisk to implement an ECHO clinic specifically to address endocrinology- short stature in the Southeast region, Georgia.
AAP Superhub offers on-site and off-site trainings for the ECHO program. Trainings for representatives of health care organizations are 2 days. All ECHO clinic sessions are designed to be facilitated by a multidisciplinary team, so it is important that any new organization send the team members who will be involved in implementing the ECHO model.
