Expanding Access to Hepatitis C Virus Treatment

Extension for Community Healthcare Outcomes (ECHO) Project: Disruptive Innovation in Specialty Care

Local primary care physicians (PCPs) who had little skill in Hepatitis C (HCV) treatment before the Extension for Community Healthcare Outcomes (ECHO) reported being competent after 12 months. In 2008, the Robert Wood Johnson Foundation awarded Project ECHO $5 million.

HCV is a complex disease that requires specialized treatment in several areas. Project ECHO has trained local PCPs in all facets of HCV treatment. Project ECHO conducts regular telehealth clinics that convene PCPs in underserved, rural areas and specialists from the University of New Mexico Health Sciences Center (UNMHSC). The specialists instruct PCPs in best practices; specialists and PCPs co-manage patients as PCPs hone their skills and operate with increasing independence.

This article describes the Project ECHO model and its application to HCV treatment in New Mexico. The authors review the theoretical foundation of the ECHO model; report the expansion of ECHO to the treatment of additional diseases; and present data from two surveys. The first survey is from the ECHO annual meeting, and the second is a survey of HCV treatment providers after they had participated in ECHO telehealth clinics for six months.

Key Findings:

  • After six months of participation in Project ECHO, providers reported a moderate to high degree of learning in screening patients for HCV, treating behavioral and substance abuse issues related to HCV, and managing side effects.
  • Project ECHO now covers 12 additional disease areas, including HIV/AIDS and family psychiatry.

Chronically-ill patients who are uninsured or living in poor communities often must travel to academic medical centers in larger cities to receive state-of-the-art specialty care. Project ECHO has trained local PCPs in New Mexico to deliver best practice treatment for HCV.