Project ECHO brings ‘disruptive innovation’ to community cancer centers

PHOENIX — If implemented in community cancer centers, the telehealth program Project ECHO could impact patients and providers by bringing education and best practices to rural communities, according to a presentation at the Association of Community Cancer Centers National Oncology Conference.

Project ECHO brings together centers of excellence and primary care clinicians via a telehealth model to educate, share cases and exponentially grow health care specialists across a variety of programs.

“Project ECHO was developed as a disruptive innovation to dramatically improve both capacity and access to specialty care for rural and underserved populations,” Thomas A. Gallo, MS, MDA, ACCC president, said.

Project ECHO exists in 33 countries and across most major cancer centers in the United States. It is also used by the VA health system and the U.S. Department of Defense.

Studies have shown the education model, which started with the treatment of hepatitis C, successfully educates PCPs and improves patient outcomes. Of the 129 per-reviewed publications about ECHO, all have been positive.

ECHO programs exist in a variety of specialties including chronic pain management, infectious diseases, rheumatology, diabetes and cancer care.

“I’m here today because I want community cancer centers to start ECHOs for your communities,” Sanjeev Arora, MD, MACP, director of Project ECHO and professor of medicine at University of New Mexico Health Sciences Center, said to a group of community cancer care providers. “You are so service focused, and you have a huge referral base. Leveraging it for better early diagnosis, better screening, preventing cancer, survivorship could be a big deal.”

Project ECHO differs from traditional telemedicine because it serves as an educational platform to train specialists outside of academic centers.

“The purpose of tele ECHO is to make people as good as us,” Arora said. “Telemedicine is giving people fish. Tele ECHO is teaching people to fish.”

Arora spoke about the rising gaps in health disparities among those who live in rural areas. Studies have shown patients with breast, cervical, colorectal, kidney, lung, oropharyngeal and skin cancers all have higher mortality rates when living in rural areas, according to Arora, and the disparity is increasing.

“It’s not a health care problem alone. If you allow this much disparity to continue there is no way we can have a stable society in the future. This is a societal problem,” he said. “This has consequences which are far beyond health care. We cannot allow these gaps to get continuously wider.”

Arora encouraged the community cancer centers to get involved in Project ECHO, whether as a part of a larger NCI-designated cancer center program, or as a leader of project.

“You could be a hub where you could train your communities in prevention of cancer, smoking cessation, HPV, whatever,” he said. “You could train your communities in early diagnosis of cancer: colorectal, breast, lung, cervical. You could start survivorship ECHOs. You could start palliative care ECHOs. There are so many things you could do to be part of this movement.” – by Cassie Homer

For more information:

Visit https://echo.unm.edu/.

Reference:

Arora S. Project ECHO: A model for moving knowledge — not patients. Presented at: ACCC National Oncology Conference; Oct. 17-19, 2018; Phoenix.

Disclosure: Arora reports no relevant financial disclosures.