Project ECHO

Millions of people worldwide don’t have access to health care. This problem is particularly serious in rural and underserved communities, where it is extremely difficult to recruit and retain both primary and specialty care providers. Project ECHO (Extension for Community Healthcare Outcomes) is committed to addressing these problems by equipping communities with the knowledge and capacity to expand healthcare access for underserved populations. By replicating the ECHO model™ across the world, and increasing the number of community providers participating in Project ECHO, millions more people in rural and underserved communities will be able to get the healthcare they need.  Replication of the ECHO model is achieved through the creation of ECHO® “hubs” or regional centers, in which partner sites or “spokes” connect through teleECHO™ clinics, gaining specialty expertise and knowledge. The ECHO model has been successfully replicated across the United States and around the globe.


Successful replication requires substantial training of an implementation team, and – until recently – training of hubs has been done exclusively by the ECHO Institute at the University of New Mexico. It is felt that other centers must be able to train hubs in order to continue the growth of the ECHO movement and accomplish our 1 billion lives goal.  To enable this, the concept of “superhubs” has been developed. A superhub is an organization that can train and support hubs within the ECHO model while maintaining fidelity to the ECHO model.

Guiding principles of the ECHO Community

  1. Demonopolization (democratization) of knowledge
  2. Mutual respect and intellectual honesty
  3. Non-exclusivity
  4. Fidelity to the ECHO model
  5. Empowerment of providers to perform at their maximum capacity
  6. Primacy of human relationships/mentoring/sponsorship
  7. Commitment to listening/learning
  8. Commitment to service
  9. Positive communication, motivational interviewing and empathic skills
  10. Collective data and community-based research to improve patient outcomes

Approved ECHO superhubs have the capacity to:

  1. Do outreach and education on Project ECHO, with fidelity to the model and ECHO Institute-consistent messaging, including offering events such as the ECHO “Introduction” and ECHO “Orientation” to create understanding and spread of the ECHO model.
  2. Recruit and engage individuals, groups and organizations that would like to implement Project ECHO to become ECHO hubs.
  3. Authorize prospective replication partners by signing pre-approved partnership documents (the Intellectual Property Terms of Use Agreement and the Statement of Collaboration with Replicating Partners).
  4. Train prospective replication hub partner teams in ECHO implementation best practices and resources, in order to maintain fidelity to the ECHO model.
  5. Provide access to all the ECHO resources and tools, including Box, Zoom, iECHO, ECHO Health® and any others developed in the future.
  6. Provide support and quality assurance of all replicating partners trained by superhubs to ensure fidelity.
  7. Facilitate the sharing of resources among the MetaECHO Community.
  8. Share and protect the intellectual property of the ECHO Institute and the MetaECHO Community.
  9. Maintain appropriate use of ECHO logos and trademarks.

ECHO Superhub Websites

  1. American Academy of Pediatrics
  2. ECHO India
  3. Highland Hospice
  4. Hospice UK
  5. MD Anderson
  6. Missouri Telehealth Network
  7. ECHO Ontario
  8. Universidad de la Republica – Uruguay
  9. University of Chicago
  10. University of Wyoming
  11. St. Luke’s Hospice