Project ECHO Wins International Competition

The UNM Health Sciences Center Project ECHO recently came in first in an international competition to identify programs that are changing the paradigm of how medicine is practiced.

Project ECHO (Extension for Community Healthcare Outcomes) is a collaborative partnership of UNM School of Medicine faculty, the New Mexico Department of Health and the State Department of Corrections that treats complex diseases in remote, rural and underserved communities. It has been a pioneer in teleheath consulting between university specialists and community physicians throughout New Mexico treating Hepatitis C patients and is being used as a model for treating a number of complex, chronic illnesses in rural and remote areas.

“It is gratifying that our project’s description was distributed around the globe,” said Sanjeev Arora, M.D., executive vice chair for the Department of Internal Medicine and director of Project ECHO. “We competed with programs from some of the best medical schools in the US and the world including such names as Johns Hopkins, Stanford and Columbia university. At each point in the process we had the opportunity to discuss our program with health professionals and receive their comments.”

New Mexico leads the nation in deaths from chronic liver disease and cirrhosis and some 34,000 New Mexicans, including 2500 prisoners, are infected with Hepatitis C. Prior to the launch of project ECHO, less than 1600 rural residents and no prisoners had received treatment for chronic liver disease.

“This project overcomes the barriers of distance and income to increase access to specialty medicine for our border and rural residents,” said Health Secretary Dr. Alfredo Vigil. “Patients across New Mexico benefit from the incredible collaboration we have with UNM and the Department of Corrections.”

In the competition, the Robert Wood Johnson (RWJ) and Askoha Changemakers looked for projects that fit the criteria of “disruptive practices.” Clayton Christenson, Harvard Business Professor and author of The Innovator’s Dilemma and The Innovator’s Solution, defines a disruptive innovation as one that is so big that it eventually replaces, or disrupts, the established approach to providing that product or service.

The two foundations sought an innovative approach in uncovering these disruptive medical programs. Instead of following a traditional grant application and review process, they went on-line to sponsor the competition entitled “Disruptive Innovations in Health and Health Care: Solutions People Want.”

The project attracted more than 300 entries from 27 countries. At each point in the process the proposals were open to public comment and discussion over the internet with UNM faculty responding to comments and answering questions regarding the project. In the final round, health professionals all over the globe voted for their top three programs. The programs are now eligible for some $5-million foundation funding from RWJ.

Since its inception in June 2004, Project ECHO has established 21 HCV treatment centers in rural New Mexico and at prisons around the state, resulting in an additional 3500 patients receiving disease management who otherwise would likely have received no treatment at all.

The key component of the ECHO model is a disruptive innovation called the Knowledge Network. In this “one-to-many” knowledge network, the expertise of a single specialist is “cloned” and shared with multiple primary healthcare providers, each of whom, in turn, sees numerous patients through telemedicine and internet connections. This virtual team of UNM specialists has the potential ability over time to help treat thousands more patients than any one person could ever personally schedule and see.

Knowledge under the model is a two-way street with community providers both learning - through individual case reviews and short presentations - and teaching through the shared case management of their patients. Since its inception in June 2004, Project ECHO has established 21 HCV treatment centers in rural New Mexico and at prisons around the state, resulting in an additional 3500 patients receiving disease management during this time who would otherwise have been unlikely to have received any medical treatment at all.

Given the success of the program, additional ECHO clinics have been launched, in rheumatology, substance abuse, mental health disorders, HIV, high risk pregnancy as well as cardiac disease risk reduction including diabetes, weight reduction and smoking cessation.

About the Robert Wood Johnson Foundation

The Robert Wood Johnson Foundation is the nation’s largest philanthropy and focuses on the most pressing health and health care issues facing our country. The Foundation's Pioneer Portfolio supports innovative ideas and projects that may trigger important breakthroughs in health and health care. Projects in the Pioneer Portfolio are typically future-oriented and look beyond conventional thinking to explore solutions at the cutting edge of health and health care.

About Changemakers

Changemakers is an initiative that focuses on the rapidly growing world of social innovation. It provides solutions and resources needed to help everyone become a changemaker and presents compelling stories that explore the fundamental principles of successful social innovation around the world. Changemakers is building the world's first global online "open source" community that competes to surface the best social solutions, and then collaborates to refine, enrich, and implement those solutions. Changemakers begins by providing an overarching intellectual framework for collaborative competitions that bring together individual social change initiatives into a more powerful whole. For details on the competition, go to

Contact: Cindy Foster, 272-3322

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