Project ECHO
Project ECHO (Extension for Community Healthcare Outcomes) expands access to healthcare by helping primary care clinicians in rural and underserved areas manage complex diseases. They do this by consulting with medical specialists via video conferencing technology.
Credit: John Arnold

The fight against diabetes in New Mexico is getting a big boost from the Helmsley Charitable Trust and the University of New Mexico Health Sciences Center. The trust today announced a $6.4 million grant for UNM’s Project ECHO, a healthcare education and delivery model that links community-based clinicians with UNM specialists to treat patients with complex conditions.

The grant will be used to pilot a program called Endo ECHO, which aims to address the widespread need for greater access to complex diabetes care and specialized endocrinology treatment, especially among publicly-insured and uninsured patients.

While Project ECHO has been adapted for a range of diseases, Endo ECHO marks the first effort to develop an endocrinology-focused program that will manage all endocrinologic disorders, including diabetes.

“No patient should have to suffer or even die because clinicians in local communities don’t have access to the specialized knowledge housed in university medical centers,” said Sanjeev Arora, M.D., the liver disease specialist at the University of New Mexico who founded Project ECHO. “The ECHO model breaks down the walls between primary and specialty care by demonopolizing medical knowledge. In this way, more patients can get better care sooner, in their own communities.”

Under Project ECHO (Extension for Community Healthcare Outcomes), UNM Health Sciences Center specialists use teleconferencing technology to consult with and educate primary care providers across New Mexico on how to treat complex diseases. The model builds primary care capacity, greatly expanding access to specialized care in local communities, Arora said.

Research has demonstrated that Project ECHO results in treatment outcomes equal to those seen in care provided by university specialists, and it increases clinician knowledge, skill and professional satisfaction.

Through a separate award to New York University’s Robert F. Wagner Graduate School of Public Service, the trust will support health policy analysts to conduct an evaluation of Endo ECHO, assessing the pilot clinic’s impact on patient outcomes, utilization of services and health-related expenditures in New Mexico. To lay the groundwork for effective nationwide scaling, the grant for Endo ECHO will also support the Center for Health Care Strategies to develop a multi-state learning collaborative for Medicaid agencies interested in implementing the model in other states.

“In the diabetes community, we know there are challenges facing endocrinology as a medical specialty. Especially in rural, sparsely populated areas, an endocrinologist shortage means patients with type 1 and other complex diabetes conditions rely on under-trained primary care providers, often resulting in poor outcomes,” said Eliot Brenner, program director for the Helmsley Charitable Trust’s Type 1 Diabetes Program. “Endo ECHO is a workforce expansion opportunity that can bolster existing medical support by teaching primary care clinicians and community health workers on the ground to successfully treat the serious conditions they were not formally trained to manage.” 

The grant furthers the Helmsley Charitable Trust’s ongoing commitment to eliminate barriers to high-quality care for patients living in underserved communities, as it aims to replicate Project ECHO’s success in reaching patients in remote and underserved areas who often are unable to get the specialized care they need. 

Since its launch in 2003, the Project ECHO model has spread rapidly, with 32 hubs operating in the U.S. and six hubs operating internationally. Partners include academic medical centers, community clinics, health plans and all levels of government. Project ECHO is engaged in collaborations with the U.S. Department of Veterans Affairs, the U.S. Department of Defense, the Centers for Medicare & Medicaid Services and the Centers for Disease Control and Prevention. Outside the U.S., ECHO programs have launched in Ireland, India, Canada and Uruguay. Programs in other countries are in development.

About the Helmsley Charitable Trust

The Leona M. and Harry B. Helmsley Charitable Trust aspires to improve lives by supporting exceptional nonprofits and other mission-aligned organizations in health, select place-based initiatives, and education and human services. Since 2008, when the Trust began its active grantmaking, it has committed more than $1 billion. The Helmsley Type 1 Diabetes Program is the largest private foundation funder of T1D-related research, treatment and support services in the nation. For more information, visit www.helmsleytrust.org

About Project ECHO

Project ECHO is a disruptive innovation that dramatically improves both capacity and access to specialty care for rural and underserved populations. This low-cost, high-impact intervention is accomplished by linking expert inter-disciplinary specialist teams with primary care clinicians through teleECHO clinics, in which the experts co-manage patient cases and share their expertise via mentoring, guidance, feedback and didactic education. This enables primary care clinicians to develop the skills and knowledge to treat patients with common, complex diseases in their own communities which reduces travel costs, wait times and avoidable complications. Technology is used to leverage scarce healthcare resources, and the specialists at academic medical centers are better able to attend the most complex, high-risk patients. The ECHO model is not “telemedicine” where the specialist assumes the care of the patient, but instead a guided practice model where the primary care clinician retains responsibility for managing the patient, operating with increasing independence as their skills and self-efficacy grow. For more information visit, http://echo.unm.edu/.