Project ECHO: Bridging the Gap in Health Care for Rural and Underserved Communities

Specialists and primary care providers jointly manage complex illness through videoconferencing

Dates of Project: February 2009 through May 2015

A new model of continuing medical education, Project ECHO links a specialty care team at a “hub” site to primary care clinicians in isolated communities so that they can co-manage patients. Regularly scheduled teleECHO clinics use a “bridging the gap in health care” approach which allows physicians, nurse practitioners, and other clinicians to jointly manage complex illness—and promotes the use of best practices in care—while enabling patients to receive treatment in their home communities.

Description: RWJF has given two grants totaling $10 million to the University of New Mexico School of Medicine, where the initiative is housed, to build capacity to scale the model nationally. The project’s teleECHO clinics are used to treat complex, chronic diseases, including hepatitis C infection, HIV, chronic pain, mental illness, complex care, endocrinology, and other costly health issues.

ECHO bridges the disconnect between specialists and front line clinicians by using technology to create a platform for collaboration among all clinicians.—Sanjeev Arora, MD, Director, Project ECHO

Key Results

  • Project ECHO has expanded throughout New Mexico, across the country, and around the world. As of January 2014:

    • Project ECHO has provided more than 57,000 hours of continuing medical education to more than 300 clinical teams in 74 communities across New Mexico.
    • Partner organizations have created Project ECHO hubs at a total of 32 U.S. sites and 38 locations around the world. Hub sites include academic medical centers, a community health center, the Veterans Health Administration, and the U.S. Department of Defense.
  • Other key results:

    • A study by the founder, Sanjeev Arora, MD, published in the New England Journal of Medicine in June 2011 demonstrated that hepatitis C patients treated by ECHO-trained primary care clinicians did as well as patients treated in person at a specialty clinic.
    • Project ECHO was awarded an $8.5 million grant from the Center for Medicare & Medicaid Innovation in 2012 to test a “primary care intensivist” model, which uses ECHO clinics and team-based care to treat high-cost Medicaid beneficiaries.
    • The GE Foundation allocated $4.6 million for a three-year pilot program beginning in 2013 to develop ECHO clinics to guide the integration of mental health and substance abuse treatment into primary care. Eight community health centers in New Mexico will test the model.

Project ECHO “has the opportunity to transform American medicine.”—John W. Ward, MD, director of the Division of Viral Hepatitis at the Centers for Disease Control and Prevention (CDC)