The ECHO model is not “traditional telemedicine,” where the specialist assumes care of the patient, but instead a collaborative care model where a primary care provider retains responsibility for managing the patient.
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An ECHO session is, essentially, virtual telementoring. Primary care providers from multiple locations connect at regularly scheduled times with a team of specialists using low-cost, multi-point videoconferencing.
During ECHO sessions, providers present patient cases to specialist expert teams who mentor the providers to manage patients with common, complex conditions. These case-based discussions are supplemented with brief presentations to improve content knowledge and share evidence-based best practices.
Providers can connect to an ECHO session that is focused on a complex condition of interest to them. Providers also receive no-cost CME credits for each ECHO session attended.
Project ECHO enables providers to improve their expertise while treating patients with common complex conditions rather than referring them on. Increased patient retention and satisfaction keeps patients at their local health center, and treated within their local community.
Physician/physician assistant/nurse practitioner Development and retention
Through Project ECHO, primary care providers acquire new skills and competencies, expanding access to care. They become part of a community of learners, increasing professional satisfaction and decreasing feelings of professional isolation. For a health center, this means that providers are more productive and stay in their positions longer.
Health centers and their providers also enjoy no-cost access to continued learning and specialist consultations during the ECHO sessions. This enables health centers to be part of a knowledge network.
ECHO has allowed health centers to see more patients and to better utilize their staff to serve more patients overall. The model allows health centers to be part of a professional network and referral network, making it easier to get patients in to be seen, a process that previously could take weeks. This standardization of best practices also strengthens the health system as a whole.
The ECHO model dramatically improves health outcomes for patients while bolstering patient retention and satisfaction.
When a local health center adopts ECHO, many patients no longer have to travel long distances to see a specialist, a journey which is often very difficult for those with chronic conditions, and which can be prohibitively expensive.
With ECHO, patients with a wide range of chronic, complex conditions can be treated close to home, without waiting months for an appointment.
The ECHO model has also demonstrated that when patients are treated in their local communities, by providers they know and trust, it enhances their adherence to treatment and follow-up care. Expert consultations between providers and academic specialists also directly impact the health of patients, who benefit from the provider’s increased knowledge of best practices.
Time constraints have been identified as one of the most significant challenges for health centers. The specialist teams often work to schedule the ECHO sessions either before office hours or during lunch so as not to take away from provider-patient time.
Participating in Project ECHO via video conferencing requires broadband Internet access at every site, which has not been an issue for the health centers currently participating in the model.
Project ECHO is a powerful tool in recruiting and retaining providers. Both in rural and urban areas, health center providers often feel professionally isolated. ECHO is a major selling point for providers, as it allows for professional development, CME credits and access to a knowledge network of peers and experts.
Providers participate in the ECHO model first and foremost to help their patients, and the model increases their capacity to do so. Increased provider satisfaction often results in greater provider retention.
All levels of providers are welcome and highly encouraged to participate in ECHO sessions.
- Physician assistants
- Nurse practitioners
- Registered nurses
- Social workers
- Community health workers
Participation in ECHO sessions is free. The only associated costs are those for IT equipment (if needed) and time away from clinic. Many ECHO sessions are offered early in the morning or during lunch hours to minimize the time away from direct patient care.
Most clinics already possess the required IT equipment to connect via video (Internet and webcam), so no additional costs are incurred.
Additionally, ECHO sessions can be accessed via a smartphone application.
The technology can be as simple as an individual using a laptop, tablet or phone; a small room set up for one to two people; or a videoconferencing room to allow the participation of groups.
ECHO sessions use a cloud-based system called Zoom. This system has a number of benefits, including the ability to run on lower-speed Internet connections. Zoom works well on mobile devices such as iPhones, iPads and Androids, and has web-conferencing features like chat and sharing.
Participants who join ECHO sessions receive CMEs for the total time spent participating, including brief and patient-case presentations.
CME credit is offered by the University of New Mexico School of Medicine, Office of Continuing Medical Education.
To claim this credit, a short evaluation must be completed within 48 hours after each ECHO session. All CMEs from participation in ECHO sessions are given at no charge.