Project ECHO: A Model for Complex, Chronic Care in the Pacific Northwest Region of the United States

Project ECHO creates communities of practice where primary care providers and specialists work together with the goals of gaining and spreading new medical knowledge and applying it to patient care.

This model organizes medical education, practice, and research around weekly virtual clinics focused on case-based learning.

These sessions share specialized knowledge and best practices that exist primarily in academic medical centers with community-based primary care clinicians, who develop new expertise for providing care in their own communities.

This article discusses Project ECHO’s expansion in the U.S. Pacific Northwest in 2009 through the University of Washington. Weekly videoconferences focused on hepatitis C, chronic pain, integrated addictions and psychiatry, and HIV/AIDS.

  • Overall, 900 clinicians participated with more than 700 patient cases presented.
  • The number of clinics for Hepatitis C was 23; 16 for addiction and psychiatry; 97 for chronic pain; and 13 for HIV/AIDS.
  • The project provided 23 different videoconference clinics for hepatitis C, specifically, with 263 participating clinicians representing a total of 399 patients between 2009 and the end of June 2012.
  • Finding an appropriate location for videoconferencing equipment in rural clinics was an initial challenge. Utilizing desktop computers with webcams and microphones provided the needed confidentiality, and saved on equipment costs.

Looking forward, Project ECHO must address financial sustainability and issues of expansion. Overall, however, this model proves promising for bringing specialist care to rural areas.