Project ECHO: Using telehealth to maintain a ready medical force
By Shireen Bedi, Air Force Surgeon General Public Affairs
/ Published March 05, 2019
FALLS CHURCH, Va. -- The Air Force Medical Service uses telehealth to make it easier for primary care providers to consult with specialists, creating additional learning opportunities for medical Airmen and improving patient care.
Project ECHO (short for Extension for Community Healthcare Outcomes) was developed by the University of New Mexico. The AFMS began using a modified version in 2012 to improve the ability to connect medical Airmen with specialty providers at other military treatment facilities.
The goal is to expand so-called “curb-side consultation” for primary care providers.
“We are using telehealth technology to bring back grand rounds, which is the traditional way health care professionals receive mentoring and training,” said Lt. Col. Antonio Eppolito, Air Force telehealth chief and project manager of Project ECHO. “It’s the model used in medical schools and residency programs where you get to present a case and you get input from panel experts on ways to manage the case.”
With virtual access to specialists, primary care providers can connect to experts at other military treatment facilities and receive specialized care mentorship and consultation they may otherwise not have access to.
Providers from across the AFMS can access ECHO sessions, which each focus on a specific aspect of a specialty or disease. Sessions typically start with 20-30 minutes of instruction focusing on the topic of the week. Then the presenter goes in-depth to examine specific patient cases participants send prior to the session.
“Through instruction and discussing specific cases, all participants learn from each other,” said Eppolito. “Even if you spend the entire year never presenting your own case, you will have had numerous in-depth consultations on a variety of complex cases that you may see in your own practice.”
In addition to receiving virtual consultation from specialty providers, participants can also receive Continuing Medical Education, or CME, credits through these ECHO sessions.
The AFMS’s oldest and most robust ECHO focuses strictly on diabetes, broadcast from the Diabetes Center for Excellence at Wilford Hall Medical Center at Joint Base San Antonio-Lackland, Texas.
“Our goal with the diabetes and prevention ECHO sessions is to extend the specialty care knowledge we have at the Diabetes COE across the DoD,” said Connie Morrow, Diabetes COE training program administrator. “We have a multidisciplinary team with providers from various specialties who can offer extensive insight into specific diabetes topics.”
Since starting the diabetes ECHO program seven years ago, the Diabetes COE added prevention-focused ECHO sessions in January 2017.
“These prevention-focused sessions are important for primary care providers and their patients, especially active duty patients who can benefit from comprehensive preventative diabetes care,” said Morrow. “When provider teams are equipped with the right skills and resources, and are familiar with diabetes standards of care, they are better prepared to manage even the most complex cases.”
According to Eppolito, Project ECHO is a vital tool to maintain full spectrum readiness, broadening expertise in medical Airmen, and keeping the fighting force fit and healthy to perform downrange.
“With Project ECHO’s virtual consultations, we help Air Force providers deliver more specialty care right in their own clinic, maintaining continuity of care for the patient,” said Eppolito. “Medical Airmen must manage a range of patient concerns, even the more complicated ones. It is vital that these providers have access to specialists to improve upon their own knowledge and skills to provide comprehensive patient care.”