Digital Commons Network^™

Healthcare Social Network Research And The Echo Model™: Exploring A Community Of Practice To Support Cultural Brokers And Transfer Cultural Knowledge, Phil Nixon, Chiara Broccatelli, Perrin Moss, Sarah Baggio, Angela Young, Dana Newcomb

Project ECHO Bibliography

BACKGROUND: Project ECHO

METHODS: Social network theories and methods informed the collection of network data and analysis of advice-seeking relationships among ECHO network members and their nominees. Registered members from two ECHO networks were invited to complete the Qualtrics survey. Networks analysed comprised 398 professionals from mainstream health, Aboriginal and Torres Strait Islander Community Controlled Health Organisation, education, disability and child safety service settings.

RESULTS: Brokers were well represented, both those who hold knowledge brokerage positions as well as cultural brokers who incorporate clinical and cultural knowledge enabling holistic care for Aboriginal and Torres Strait Islander patients (38 individuals, 17% …

In-Hospital Postoperative Mortality Rates For Selected Procedures In Tanzania's Lake Zone., Taylor Wurdeman, Christopher Strader, Shehnaz Alidina, David Barash, Isabelle Citron, Ntuli Kapologwe, Erastus Maina, Fabian Massaga, Adelina Mazhiqi, John G. Meara, Gopal Menon, Cheri Reynolds, Meaghan Sydlowski, John Varallo, Sarah Maongezi, Mpoki Ulisubisya

Project ECHO Bibliography

BACKGROUND: Postoperative mortality rate is one of six surgical indicators identified by the Lancet Commission on Global Surgery for monitoring access to high-quality surgical care. The primary aim of this study was to measure the postoperative mortality rate in Tanzania's Lake Zone to provide a baseline for surgical strengthening efforts. The secondary aim was to measure the effect of Safe Surgery 2020, a multi-component intervention to improve surgical quality, on postoperative mortality after 10 months.

METHODS: We prospectively collected data on postoperative mortality from 20 health centers, district hospitals, and regional hospitals in Tanzania's Lake Zone over two time periods: …

Telemedicine In Liver Disease And Beyond: Can The Covid-19 Crisis Lead To Action?, Marina Serper, Allen W. Cubell, Mary Elisabeth Deleener, Tara K. Casher, Dale J. Rosenberg, Dale Whitebloom, Roy M. Rosin

Project ECHO Bibliography

Evidence strongly supports that access to specialty gastroenterology or hepatology care in cirrhosis is associated with higher adherence to guideline-recommended care and improves clinical outcomes. Presently, only about one half of acute care hospitalizations for cirrhosis-related complications result in inpatient specialty care, and the current hepatology workforce cannot meet the demand of patients with liver disease nationwide, particularly in less densely populated areas and in community-based practices not affiliated with academic centers. Telemedicine, defined as the delivery of health care services at a distance using electronic means for diagnosis and treatment, holds tremendous promise to increase access to broadly specialty …

The Influence Of Telehealth For Better Health Across Communities., Jane A. Mcelroy, Tamara M. Day, Mirna Becevic

Project ECHO Bibliography

Rapid spread of coronavirus disease 2019 (COVID-19) forced an abrupt shift in the traditional US health care delivery model to meet the needs of patients, staff, and communities. Through federal policy changes on telehealth, patient care shifted from in-person to telephone or video visits, and health care providers reached out to patients most at risk for exacerbation of chronic disease symptoms. ECHO (Extension for Community Healthcare Outcomes), a videoconferencing peer learning application, engaged health care providers across Missouri in the treatment and management of complex COVID-19-positive patients. Re-envisioning health care in the digital age includes robust utilization of telehealth to …

Accelerating Care Through Echo: Case Examples From The Field., Mirna Becevic, Emmanuelle Wallach, Lincoln R. Sheets, Hope Misterovich, Susan Norris, Evelyn Aboagye, Jonathan A Dyer, Bruce R Bacon, Karen Edison, Kristin Sohl

Project ECHO Bibliography

In this article, we describe three life-changing patient cases demonstrating high-quality and timely care they received in their communities, thanks to the Show-Me ECHO project. Early autism diagnosis, a potentially deadly tumor manifesting as a benign-looking rash, a recalcitrant case of hepatitis C: rural and underserved Missourians now have access to state-of-the-art care through their local providers receiving interdisciplinary telementoring on evidence based practices.

Multi-Model Implementation Of Evidence-Based Care In The Treatment Of Opioid Use Disorder In Pennsylvania, Sarah Kawasaki, Erica Francis, Sara Mills, Glenn Buchberger, Ruth Hogentogler, Jennifer Kraschnewski

Project ECHO Bibliography

Pennsylvania has the third highest rate of death due to drug overdose (44.3 per 100,000) in the country, which is significantly higher than the national rate. This continues to have drastic societal impact. Medication assisted treatment (MAT), which includes opioid agonist medications, is the gold standard in treatment for OUD; however, a significant gap remains between the number of individuals in need of treatment and the number of MAT providers. Penn State Health established a system to address the opioid epidemic through the Pennsylvania Coordinated Medication Assisted Treatment program utilizing lessons learned from existing validated models. Connecting primary care sites …

Expanding Treatment For Opioid Use Disorder In Publicly Funded Primary Care Clinics: Exploratory Evaluation Of The Nyc Health + Hospitals Buprenorphine Echo Program, Babak Tofighi, Noah Isaacs, Hannah Byrnes-Enoch, Rebecca Lakew, Joshua D Lee, Carolyn Berry, Daniel Schatz

Project ECHO Bibliography

Project Extension for Community Healthcare Outcomes (Project ECHO) offers an innovative and low-cost approach to enhancing the management of complex conditions among primary care providers. The NYC Health + Hospitals Buprenorphine ECHO (H + H ECHO) program offers primary care providers (PCPs) training and support in managing opioid use disorder (OUD). This exploratory study assessed the feasibility of a 16-session video conferencing platform led by Addiction Medicine experts in improving addiction knowledge, perceived self-efficacy, and buprenorphine prescribing among PCPs located in 17 publicly-funded ambulatory care clinics. A pre- and post-training survey assessed changes in knowledge and self-efficacy. Buprenorphine prescribing patterns …

Extension For Community Healthcare Outcomes-Palliative Care In Africa Program: Improving Access To Quality Palliative Care, Sriram Yennurajalingam, Charles E Amos, John Weru, Edwina Beryl V N D Addo Opare-Lokko, Joseph Anthony Arthur, Kristy Nguyen, Olaitan Soyannwo, Runcie C W Chidebe, Janet L Williams, Zhanni Lu, Ellen Baker, Sanjeev Arora, Eduardo Bruera, Suresh Reddy

Project ECHO Bibliography

PURPOSE: There is limited access to quality palliative care (PC) for patients with advanced cancer in sub-Saharan Africa. Our aim was to describe the development of the Project Extension for Community Healthcare Outcomes-Palliative Care in Africa (ECHO-PACA) program and describe a preliminary evaluation of attitudes and knowledge of participants regarding the ability of the program to deliver quality PC.

METHODS: An interdisciplinary team at the MD Anderson Cancer Center, guided by experts in PC in sub-Saharan Africa, adapted a standardized curriculum based on PC needs in the region. Participants were then recruited, and monthly telementoring sessions were held for 16 …

Whatsapp: A Real-Time Tool To Reduce The Knowledge Gap And Share The Best Clinical Practices In Psoriasis, Luis D Mazzuoccolo, Maria Noel Esposito, Paula C Luna, Sharon Seiref, Mirtha Dominguez, Cristina M Echeverria

Project ECHO Bibliography

BACKGROUND: Psoriasis is a chronic inflammatory disease that affects around 100 million people worldwide. The burden of disease is high, but more recent therapies show promising results. Clinicians need, however, more training in the use of such therapies.

INTRODUCTION: Project ECHO

MATERIALS AND METHODS: One hundred thirty-two dermatologists in Argentina were invited to participate in the WhatsApp discussion group. After 1 year of participation, a follow-up questionnaire was used to assess the effectiveness of the project.

RESULTS: Eighty dermatologists participated. All questions placed in the discussion were answered by a psoriasis specialist, 79% of which were answered within the first …

Army And Navy Echo Pain Telementoring Improves Clinician Opioid Prescribing For Military Patients: An Observational Cohort Study., Joanna G. Katzman, Clifford R. Qualls, William A. Satterfield, Martin Kistin, Keith Hofmann, Nina Greenberg, Robin Swift, George D. Comerci, Rebecca Fowler, Sanjeev Arora

Project ECHO Bibliography

BACKGROUND: Opioid overdose deaths occur in civilian and military populations and are the leading cause of accidental death in the USA.

OBJECTIVE: To determine whether ECHO Pain telementoring regarding best practices in pain management and safe opioid prescribing yielded significant declines in opioid prescribing.

DESIGN: A 4-year observational cohort study at military medical treatment facilities worldwide.

PARTICIPANTS: Patients included 54.6% females and 46.4% males whose primary care clinicians (PCCs) opted to participate in ECHO Pain; the comparison group included 39.9% females and 60.1% males whose PCCs opted not to participate in ECHO Pain.

INTERVENTION: PCCs attended 2-h weekly Chronic Pain …

Retention Of Knowledge Levels Of Health Care Providers In Cancer Screening Through Telementoring, Roopa Hariprasad, Sanjeev Arora, Roshani Babu, Latha Sriram, Sarita Sardana, Sudarshan Hanumappa, Ravi Mehrotra

Project ECHO Bibliography

Purpose Every year > 450,000 individuals are diagnosed with cancer and approximately 350,000 die of it in India. The Ministry of Health and Family Welfare has released an Operational Framework for the Management of Common Cancers that highlights population-based cancer screening programs in primary health care facilities by health care providers (HCPs) and capacity building of HCPs. The purpose of this study is to present a low-cost training model that is highly suitable for resource-deficient settings, such as those found in India, through Extension for Community Health Outcome (ECHO), a knowledge-sharing tool, to enable high-quality training of HCPs. Materials and Methods …

Project Echo Telementoring Intervention For Managing Chronic Pain In Primary Care: Insights From A Qualitative Study, Leslie Carlin, Jane Zhao, Ruth Dubin, Paul Taenzer, Hannah Sidrak, Andrea Furlan

Project ECHO Bibliography

Objective: Family physicians in Canada receive little training in chronic pain management; concomitantly, they face increasing pressure to reduce their prescribing of opioids. Project ECHO Ontario Chronic Pain/Opioid Stewardship (ECHO) is a telementoring intervention for primary care practitioners that enhances their pain management skills. This qualitative study reports participants' experiences and assessment of ECHO.

Design: An opportunistic sample of multidisciplinary primary care providers attending one of three residential weekend workshops participated in focus group discussions.

Setting: University or hospital facilities in Toronto, Thunder Bay, and Kingston, Ontario, Canada.

Subjects: Seventeen physicians and 20 allied health professionals.

Methods: Six focus group …

Project Echo-Geriatrics: Training Future Primary Care Providers To Meet The Needs Of Older Adults, Katherine A Bennett, Thuan Ong, Aimee M Verrall, Michael V Vitiello, Zachary A Marcum, Elizabeth A Phelan

Project ECHO Bibliography

BACKGROUND: Geriatrics training is essential for future primary care providers. The Extension for Community Healthcare Outcomes (ECHO) model improves access to specialty care via case-based videoconferencing, but Project ECHO has not previously been designed to target residents.

OBJECTIVE: We designed Project ECHO-Geriatrics to deliver geriatrics education to primary care trainees using the ECHO model and evaluated self-rated geriatrics competency of trainees from the University of Washington Family Medicine Residency Network programs who participated between January 2016 and March 2017.

METHODS: We assessed outcomes of Project ECHO-Geriatrics through anonymous surveys. Participants rated didactics, case discussions, and geriatrics-specific knowledge before and after …

Evaluation Of The Impact Of Telementoring Using Echo© Technology On Healthcare Professionals' Knowledge And Self-Efficacy In Assessing And Managing Pain For People With Advanced Dementia Nearing The End Of Life, Bannin De Witt Jansen, Kevin Brazil, Peter Passmore, Hilary Buchanan, Doreen Maxwell, Sonja J Mcilfatrick, Sharon M Morgan, Max Watson, Carole Parsons

Project ECHO Bibliography

BACKGROUND: Pain assessment and management in advanced and end-stage dementia are challenging; patients are at risk of under-diagnosis, under-assessment and under-treatment. Previous research has highlighted the importance of needs-driven training and development in this area for physicians, nurses and healthcare assistants (HCAs) across specialties, disciplines and care settings. This study used teleconferencing technology to connect healthcare professionals across multiple settings and disciplines in real-time clinics, based on the Project ECHO© model. This paper reports the evaluation of the clinics by physicians, nurses and HCAs, including their knowledge and self-efficacy in pain assessment and management for patients with advanced and end-stage …

Current And Future Applications Of Telemedicine To Optimize The Delivery Of Care In Chronic Liver Disease, Marina Serper, Michael L Volk

Project ECHO Bibliography

No abstract provided.

Use Of Self-Management Interventions For Chronic Pain Management: A Comparison Between Rural And Nonrural Residents, Linda H Eaton, Dale J Langford, Alexa R Meins, Tessa Rue, David J Tauben, Ardith Z Doorenbos

Project ECHO Bibliography

Individuals with chronic pain who live in rural communities often lack access to pain specialists and rely on primary care providers who may be less prepared. Research has indicated that rural residents with chronic pain are more likely to receive an opioid prescription than nonrural residents. Although self-management approaches are available for chronic pain management, it is unclear to what extent rural residents use these interventions. This study compares usage of self-management interventions and opioid-based analgesics for chronic pain management between rural and nonrural residents. This study is a secondary analysis of baseline data from a randomized controlled trial evaluating …

Transaction Cost Analysis Of In-Clinic Versus Telehealth Consultations For Chronic Pain: Preliminary Evidence For Rapid And Affordable Access To Interdisciplinary Collaborative Consultation, Brian R. Theodore, Jan Whittington, Cara Towle, David J. Tauben, Barbara Endicott-Popovsky, Alex Cahana, Ardith Z. Doorenbos

Project ECHO Bibliography

OBJECTIVES: With ever increasing mandates to reduce costs and increase the quality of pain management, health care institutions are faced with the challenge of adopting innovative technologies and shifting workflows to provide value-based care. Transaction cost economic analysis can provide comparative evaluation of the consequences of these changes in the delivery of care. The aim of this study was to establish proof-of-concept using transaction cost analysis to examine chronic pain management in-clinic and through telehealth.

METHODS: Participating health care providers were asked to identify and describe two comparable completed transactions for patients with chronic pain: one consultation between patient and …

Using An Established Telehealth Model To Train Urban Primary Care Providers On Hypertension Management, Christopher Masi, Tamara Hamlish, Andrew Davis, Kristine Bordenave, Stephen Brown, Brenda Perea, Glen Aduana, Marcus Wolfe, George Bakris, Daniel Johnson

Project ECHO Bibliography

The objective of this study was to determine whether a videoconference-based telehealth network can increase hypertension management knowledge and self-assessed competency among primary care providers (PCPs) working in urban Federally Qualified Health Centers (FQHCs). We created a telehealth network among 6 urban FQHCs and our institution to support a 12-session educational program designed to teach state-of-the-art hypertension management. Each 1-hour session included a brief lecture by a university-based hypertension specialist, case presentations by PCPs, and interactive discussions among the specialist and PCPs. Twelve PCPs (9 intervention and 3 controls) were surveyed at baseline and immediately following the curriculum. The mean …

Outcomes Of Treatment For Hepatitis C Virus Infection By Primary Care Providers, Sanjeev Arora, Karla Thornton, Glen Murata, Paulina Deming, Summers Kalishman, Denise Dion, Brooke Parish, Thomas Burke, Wesley Pak, Jeffrey Dunkelberg, Martin Kistin, John Brown, Steven Jenkusky, Miriam Komaromy, Clifford Qualls

Project ECHO Bibliography

BACKGROUND: The Extension for Community Healthcare Outcomes (ECHO) model was developed to improve access to care for underserved populations with complex health problems such as hepatitis C virus (HCV) infection. With the use of video-conferencing technology, the ECHO program trains primary care providers to treat complex diseases.

METHODS: We conducted a prospective cohort study comparing treatment for HCV infection at the University of New Mexico (UNM) HCV clinic with treatment by primary care clinicians at 21 ECHO sites in rural areas and prisons in New Mexico. A total of 407 patients with chronic HCV infection who had received no previous …