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Project ECHO Poised to Become a National Telehealth Model

A new bill shines the spotlight on an innovative mHealth platform launched in New Mexico in 2011, and could make it a nation-wide rural health program.

By Eric Wicklund

- A ground-breaking telehealth project launched in 2011 to push hub-and-spoke videoconferencing platforms out to rural providers may become a national initiative.

Sens. Brian Schatz (D-Hawaii) and Orrin Hatch (R-Utah) have introduced the Expanding Capacity for Health Outcomes (ECHO) Act, which seeks to expand the University of New Mexico’s Project ECHO model to rural health networks around the country.

“Technology has the potential to transform how we train doctors and deliver healthcare,” Schatz, a noted telehealth proponent who earlier this year introduced the CONNECT for Health Act, said in a release on his website. “Our bill would help connect primary care providers in underserved areas with specialists at academic hubs, making it easier for medical professionals to access the continuing education they need and provide healthcare to more people.”

“In states with large rural populations like Utah, it’s vital that we do everything we can to ensure that patients have access to quality healthcare, no matter where they live,” Hatch added in the release. “By using technology to connect patients and providers, this bill will benefit Utahns living in rural areas by helping them receive the care they need.”

Specifically, the bill:

  • Requires the U.S. Health and Services Secretary, working with the Health Resources & Services Administration (HRSA), “to prioritize analysis of the model, its impacts on provider capacity and workforce issues, and evidence of its effects on quality of patient care;”
  • Requests that the Government Accountability Office (GAO) study “opportunities for increased adoption of such models, efficiencies and potential cost savings from such models, ways to improve healthcare through such models, and field recommendations to advance the use of such models;” and
  • Requires the HHS Secretary to report to Congress on the result of the both the HHS and GAO studies, “including ways such models have been funded by HHS and how to integrate these models into current funding streams and innovative grant proposals.”

READ MORE: PA Legislature Introduces Telemedicine Reimbursement Bill

Project ECHO (Extension for Community Health Outcomes) was launched by the University of New Mexico Health Sciences Center in 2011 to connect healthcare specialists with rural providers and their patient populations through a telehealth platform. The program created a hub-and-spoke model, in which specialists at a hub hospital would conduct virtual teleECHO clinics for providers in rural health systems, or spoke sites.

The original program focused on providers treating patients with Hepatitis C and was favorably reviewed in a study that year by the Health and Human Services Department’s Agency for Healthcare Research and Quality (AHRQ).

"The key to this study is that technology helped local physicians and other providers deliver safe, high-quality care within their own – in most cases, underserved – communities," AHRQ Director Carolyn M. Clancy, MD, said in a June 2011 report in the New England Journal of Medicine. "We've known that geography can play a role in timely and appropriate treatment, especially in managing complex conditions such as Hepatitis C; however, it doesn't have to mean destiny."

In 2012, the Department of Veterans’ Affairs used the model in a nationwide rollout of the Specialty Care Access Network (SCAN) ECHO program. Since then, several health systems, particularly in the south and west, have adopted the model to develop telehealth programs for population health initiatives.

Schatz and Hatch now want to make that model a national program. And they’ve received support from several organizations.

READ MORE: AMGA Lobbies CMS to Give Telehealth More Medicare Opportunities

“Project ECHO is bridging geographic divides to connect physicians and experts with patients in underserved, rural areas,” Barbara McAneny, immediate past chair of the American Medical Association, said of the new bill. “An exemplary model of using new technologies to improve patient care, Project ECHO has potential to bolster access to specialists, reduce incidence of chronic disease and rein in costs through reduced travel and fewer ER visits. The AMA believes the ECHO Act would provide policymakers with critical information to expand such models to improve clinical practice.”

“Hawaii launched two ECHO clinics only three months ago and we've already provided over 100 hours of continuing medical education and we have had inquiries to start four more ECHO clinics on important local topics,” added Kelly Withy, MD, PhD, director of the Hawaii-Pacific Basin Area Health Education Center at the University of Hawaii’s John A. Burns School of Medicine. “Healthcare providers love it because they are learning by discussing interventions to help their own patients. It's very gratifying and a win-win all around.” 

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