Patients who receive care at community health centers often have limited access to subspecialists, research shows, and Institute for Translational Medicine Pilot awardee ECHO-Chicago is changing that by expanding what started as medical training for six federally qualified health centers on Chicago’s South Side to working with 22 different organizations across Chicagoland.
“We’re translating the changes in medicine more rapidly out to community providers,” said Daniel Johnson, MD, the principal investigator for ECHO-Chicago, associate professor of pediatrics and chief of the Section of Academic Pediatrics at the University of Chicago Medicine. “It normally takes years for new knowledge to trickle out. We’re able to reduce that time by bringing state-of-the-art care to community providers at the speed of light.”
ECHO stands for Extension of Community Healthcare Outcomes, and its goal is to provide innovative medical training using videoconferencing technology to break down the divisions between primary and specialty care.
The first ECHO project was born at the University of New Mexico School of Medicine, and ECHO-Chicago is one of 39 tele-ECHO hubs that run in 22 states and six countries.
But Chicago’s project is the first one to apply the model to an urban setting and continues to be the most successful urban ECHO.
Over the past five years ECHO-Chicago has trained more than 250 providers, which includes physicians, advanced practice nurses, and social workers. And its educational offerings have expanded from three to five subjects taught over 12 sessions.
Those subjects now cover resistant hypertension, pediatric ADHD, risk-based approach to women’s health, hepatitis C, and pediatric obesity and comorbidities.
ECHO Chicago also recently received a $1.55 million grant from the Centers for Disease Control and Prevention to lead an unprecedented public health collaboration to reduce hepatitis C (HCV) infections in Chicago. Read more at Science Life.
Finicia Graham, MD, practices family medicine at Beloved Community Family Wellness Center in Robbins, IL, and has participated in more than 30 ECHO-Chicago sessions.
“ECHO has been an invaluable resource for me, as it has provided a link to experts in the field and a chance to discuss common clinical questions with colleagues,” Graham said.
And that’s part of the beauty of the ECHO model, according to Johnson.
“It gets people talking,” he said. “Because you’re in a virtual conference room, it gives you the ability to look at people. When you can look at people, you can read body language. When you can read body language, you’re more likely to speak. The person becomes more familiar to you and it provides a real opportunity for working together.”
The ITM attended a recent session on hepatitis C, where about six medical providers from the Chicagoland region listened to a presentation on new treatment methods from UChicago Medicine’s Andrew Aronsohn, MD, an assistant professor, gastroenterologist and hepatologist. Then they discussed the best ways to apply that new information to treat specific patients.
“Empowering primary care doctors to be able to treat something like hepatitis C, which is very prevalent in the United States and is going to be better treated in a primary care setting, is going to make a huge impact on treating the disease,” Aronsohn said at the end of the session.
Researchers are already seeing those results. According to a 2011 study published in the New England Journal of Medicine, ECHO has enabled community primary care providers to offer chronic disease care at almost the same level as university-based sub specialists.
UChicago’s program now has a waitlist of providers who would like to join in the telehealth sessions, which are limited to less than 10 sites at a time – and it will be covering even more topics next year.
ECHO-Chicago just came to an agreement with the American Academy of Pediatrics to launch a program focused on pediatric seizures, and there are plans to start another addressing the best ways to integrate mental health care into the normal stream of health center activities.
Johnson said the ECHO-Chicago would not be where it is today without the early financial support it received from the ITM’s Pilot Award.
“The funding was spectacular,” Johnson said. “It helped us to underwrite infrastructure so that we could reach more providers.”