Project ECHO® (Extension for Community Healthcare Outcomes) is a movement to demonopolize knowledge and amplify the capacity to provide best practice care for underserved people all over the world.
Project ECHO started as a way to meet local healthcare needs. Dr. Sanjeev Arora, a liver disease doctor in Albuquerque, was frustrated that thousands of New Mexicans with hepatitis C could not get the treatment they needed because there were no specialists where they lived. The clinic where he worked was one of only two in the entire state that treated hepatitis C. Dr. Arora was determined that all patients in need of treatment should get it. In 2003, he created Project ECHO so that primary care clinicians could treat hepatitis C in their own communities. The ECHO model™ makes specialized medical knowledge accessible wherever it is needed to save and improve people’s lives. By putting local clinicians together with specialist teams at academic medical centers in weekly virtual clinics, or teleECHO™ clinics, Project ECHO shares knowledge and expands treatment capacity. The result: better care for more people.
Treatment for hepatitis C is now available at centers of excellence across New Mexico, and more than 3,000 doctors, nurses and community health workers provide treatment to more than 6,000 patients enrolled in Project ECHO’s comprehensive disease management programs for myriad conditions. A 2011 study published in the New England Journal of Medicine showed that the quality of hepatitis C care provided by Project ECHO-trained clinicians was equal to that of care provided by university-based specialists.
What’s more, Project ECHO has expanded—across diseases and specialties, across urban and rural locales, across different types of delivery services, and even across the globe. Today, Project ECHO has more than 330 specialist teams (hubs) for more than 100 diseases and conditions in 37 countries.
How ECHO Came to Ontario
Dr. Ruth Dubin, a Kingston based family physician with a focused practice in chronic pain, discovered Project ECHO in 2012 while attending a pain conference in the United States. In early 2013, she returned to meet with the ECHO team at the University of New Mexico to explore the ECHO model as a possible solution to reducing health care disparities across Ontario. Sitting in on their ECHO sessions, she was amazed to see primary care providers in remote communities managing their complex patients with powerful disease modifying drugs and specialist level skills. She shared news of the ECHO model with Ontario colleagues, also working in pain, and as a group approached the Ministry of Health and Long Term care who were considering overall pain strategies and the growing opioid crisis in Ontario. In June 2014, the MOHLTC funded the first ECHO in Canada, ECHO Chronic Pain/Opioid Stewardship, and shortly after funded ECHO for Mental Health and Addictions.
ECHO in Ontario continues to grow. There are now 25 ECHO programs across 9 organizations reaching over 1,856 healthcare providers. Through ECHO, these providers have gained access to specialist teams at some of Ontario’s leading academic urban health science centres, accelerating the spread of specialized knowledge and improving access to healthcare in Ontario, particularly for underserved populations.