The mission of
Project ECHO is to develop
the capacity to safely and
effectively treat chronic, common, and complex
diseases in rural and
underserved areas, and to monitor outcomes of this
treatment.
As a physician at UNM Hospital and one of the few hepatitis
specialists in New Mexico in 2002, Sanjeev Arora, MD, had become increasingly
frustrated with his inability to provide care to the thousands of New Mexicans
who suffer from hepatitis C.
“I could only treat 70-90 hepatitis C patients per year in my
clinic and there were more than 30,000 people with the disease in the state,” he
says, adding that there was a six-month waiting list for patients to see him.
And these were the lucky patients the ones who lived near Albuquerque or could
afford the luxury of traveling to see a specialist on a monthly basis for the
year-long treatment.
Treating hepatitis C is a complicated process; it takes many
years to develop this special expertise and very few physicians in New Mexico
have it. In rural and medically underserved areas, proximity to specialists, a
limited number of specialty providers and inadequate medical insurance severely
limit a patient’s ability to seek specialty care. This meant that thousands of
rural patients across the state who did not have access to a specialist or the
means to gain access would largely go untreated.
To Arora, this was unacceptable. “I asked myself if there was
something I could do to make a difference,” he says. The answer he came up with
was simple: A significant change in the way we treat common, chronic, complex
diseases was needed.
How Project ECHO Works
Using the example of a rural patient who was just diagnosed
with Hep C. First the patient’s PCP would present that patient’s information
during Project ECHO’s Hep C clinic. The patient themselves are not presented to
the specialist. This would be done using video conferencing equipment or the
telephone. Based on many factors of the patient, such as; alcohol usage, weight,
smoking, and other health issues the provider is given a plan for the patient.
These plans range from starting Hep C treatment to waiting for other
complicating issues to get resolved (6 months of sobriety, weight loss, etc.).
Once cleared the patient can start treatment, the provider follows the Hep C
treatment protocol and presents the patient’s treatment status at important mile
stones or when a health related issue may impede treatment. The specialist then
may change the treatment plan to maximize the patient’s chance of cure.
Project ECHO is continually looking for rural providers (MDs, PAs, and NPs) throughout New Mexico to participate in any of our telehealth
clinics. Here is a list of current diseases and conditions being treated by
Project ECHO.
