Outcomes of Treatment for Hepatitis C Virus Infection by Primary Care Providers

Some 3.2 million people in the United States are chronically infected with hepatitis C virus (HCV); 10,000 die each year. Effective treatment for the disease is available and can halt the progression of liver damage and reverse fibrosis but treatment is complex and requires medical management. Members of racial or ethnic minorities and people living in rural areas are less likely to receive needed care.

Project ECHO (Extension for Community Healthcare Outcomes), a disruptive model of health education and delivery developed by the University of New Mexico Health Sciences Center (UNMHSC), sought to improve access to care for patients with HCV. At 16 community sites and five prisons, participating clinicians (physicians, nurse practitioners and physician’s assistants) took part in weekly videoconferences where UNMHSC specialists provided clinical mentoring and case-based learning.

Patients who received HCV treatment, per the ECHO clinical protocol, had similar cure rates (measured by sustained virologic response) of approximately 58 percent–which is considered very high—as those treated at UNMHSC’s HCV clinic. Findings demonstrate that primary care providers anywhere can be trained via videoconferencing technology to manage complex chronic conditions, formerly outside their expertise, thus expanding their ability to treat very sick patients.