INITIATIVE ECHO


AS AN EVALUATION OF THE PROJECT ECHO PILOTS CONCLUDES THAT ‘ECHO SHOULD CONTINUE TO BE DEVELOPED AND IMPLEMENTED TO HELP EDUCATE HEALTHCARE PROFESSIONALS ACROSS NI IN A COST-EFFECTIVE MANNER’, PIF LOOKS AT EXACTLY WHAT PROJECT ECHO IS AND WHAT IT CAN DO FOR LOCAL HEALTHCARE.


ECHO PROVING TO BE A RESOUNDING SUCCESS


N


orthern Ireland healthcare is proving to be a rapidly evolving environment, and it’s


obvious that healthcare professionals need to have access to regular education.


This can, however, prove to be challenging within the community context where healthcare practitioners may have varying degrees of access to educational opportunities and peer review of practice.


With the constraints of limited resources and the isolated setting in which many healthcare professionals work, new, innovative or creative approaches to education and mentorship that facilitate individual and collective learning and changes in practice are required.


Now, a ‘hub and spoke’ method of education from South America is putting NI healthcare at the forefront of innovative practice in Europe.


56 - PHARMACY IN FOCUS


Project ECHO uses a collaborative model of medical education and clinical support, and aims to empower and equip healthcare professionals to provide better care to more people, right where they live.


Through ECHO, participants in the primary care setting (ie, at the ‘spokes’) receive evidence-based or best practice guidance from specialists at the ‘hub’, case-based learning from peer presentations and have opportunity for live questions and answers.


ECHO was developed in 2003, when Professor Sanjeev Arora, a liver disease specialist and social entrepreneur at the University of New Mexico, Albuquerque, in a bid to expand access to hepatitis C treatment.


Up until that point, thousands of New Mexicans with hepatitis C couldn’t get the treatment they needed because there were no specialists where they lived. The


ECHO model makes specialised medical knowledge wherever it is needed to improve people’s lives. By putting local clinicians together with specialist teams at academic medical centres in weekly virtual clinics, ECHO shared the knowledge and expanded the treatment capacity. As a result, treatment for hepatitis C is now available at centres of excellence across New Mexico, and more than 3000 doctors, nurses and community health workers provide treatment to more than 6000 patients enrolled in Project ECHO’s comprehensive disease management programmes for myriad conditions.


ECHO isn’t just for hepatitis C, however. Since its launch in 2003, the ECHO model has spread rapidly, with implementations for a variety of conditions - from mental illness to chronic pain to high-risk pregnancy - at nearly a dozen partner sites.


HOW IT WORKS


Project ECHO uses tele-conferencing and video-conferencing; internet- based assessment tools; online presentations; and telephone, fax, and e-mail communications to connect specialists with primary-care providers in the community setting and to promote the use of identified best practices.


ECHO is not telemedicine, ie, it does not deliver advice or treatment to patients. Rather, it is designed to develop network clinicians’ skills so that they can deliver the highest-quality care with less need for specialist assistance. Because specialists have limited time available, a project based only on consultations


with the UNM specialists would have limited ability to expand hepatitis C care.


ECHO uses patient case-based educational experiences to develop the skills of community providers through three main routes:


* longitudinal co-management of patients with specialists,


* shared case-management decision making with other primary-care providers in the network, and


* short didactic presentations ECHO IN NORTHERN IRELAND


Since its launch, the ECHO model has been expanded around the world and now covers more illnesses and specialties. Last year, Dr Arora visited Belfast to discuss Project ECHO and, following his visit, a Northern Ireland Project ECHO Board was set up, chaired by Dr Brendan O’Brien, to consider how this approach could be implemented locally.


The Northern Ireland Hospice became the first European Project ECHO ‘superhub’, offering training in the ECHO model for organisations across the continent.


The aim of the Northern Ireland Hospice Project ECHO is to expand knowledge and provide peer support through educational presentations and case discussions. The weekly education sessions have already covered a wide range of topics including symptom management issues, new medications, ethical and cultural challenges and particular difficulties in helping patients and families dealing with dementia.


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