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Project ECHO® (Extension for Community Health Outcomes)
Brant Hager, MDAssistant Professor of Psychiatry
University of New Mexico
Disclosure
No conflicts to disclose
Learning Objectives
Review history, anatomy, and reach of of ECHOHighlight key outcomes associated with ECHO participationShare current open ECHO clinics in NM
Ca. 2003
with permission
~30,000 Persons with HCV in NM2 Specialty Clinics
Sanjeev Arora, MD, FACP, FACG
ECHO® Model
Direct Consultation or TelemedicineCurbside Consult, TelephoneConsult, eConsult, Traditional CME
Comparison with Telemedicine
Project ECHO 2019
Hub
Tedeschi and Fritz 2016
Spokes
Tedeschi and Fritz 2016
Patients
Tedeschi and Fritz 2016
Outcome: Sustained Virologic Response
UNM HCV Clinic57.5%
Primary Care ECHO® Sites58.2%
Arora et al. 2011
ECHO Goals
Project ECHO 2019
ECHO Goals
Project ECHO 2019
Expansion to Other ConditionsGeographic Expansion
https://echo.unm.edu
Project ECHO 2019
Mental Health ECHO Programs Reach
Project ECHO 2019
SUD, Pain Management ECHO Reach
Project ECHO 2019
Outcomes - Provider
High levels of health care provider self-reported satisfactionImproved PCP self-reported and multiple choice knowledge about conditions of interestIncreased PCP self-reported confidence in managing conditions of interestIncreased utilization of physical medicine and initiation of non-opioid pharmacotherapy in chronic non-cancer painGreater increase in buprenorphine-waivered physicians inNM relative to other states75% change in primary care behavioral health treatment plan after ECHO participation
Zhou et al. 2016, Hager et al. 2018
UNM Behavioral Health and Addiction ECHO Bup Certification
Komaromy et al. 2016
Outcomes - Patient
VA SCAN-ECHO: DiabetesReduction in HgA1C from 10.2% to 8.4% in patients with difficult to control diabetes
ECHO-AGE: Nursing Home Care75% less use of restraints, 17% less use of antipsychotics, 23% fewer UTI, in ECHO provider-supported nursing home residents compared to control provider-supported nursing home residents
ECHO GEMH: Geriatric Behavioral Health24% reduction in emergency medicine cost in ECHO provider-associated patients
Zhou et al. 2016, Hager et al. 2018
Behavioral Health and Addiction ECHO
2019 Calendar Year: Depression-focusedSupported by NM MCOs BCBS, Presbyterian, and Western Sky
Project ECHO 2019
Behavioral Health and Addiction ECHO
2020 Calendar Year: Return to broad BH topics
Project ECHO 2019
Behavioral Health and Addiction ECHOHubTeam
Brant Hager, MDPsychiatry, Consultation-Liaison Psychiatry
Christopher Morris, PhDClinical Psychology
Vanessa Jacobsohn, MDFamily Medicine, Addiction Medicine
Shanna Diaz, DOPsychiatry, Geriatric Psychiatry, Sleep Medicine
Open ECHO Clinics in NM
Project ECHO 2019
Questions?