Telehealth program Project ECHO aims to close gaps in health disparities in rural community cancer centers

By: Akshita Singh | November 21, 2018

screen_shot_2017-04-25_at_10.37.39_amAccording to a presentation at the Association of Community Cancer Centers National Oncology Conference, the telehealth program Project ECHO is focused on delivering education and best practices to rural communities. When implemented in community cancer centers, Project ECHO allows for collaboration between primary care and cancer centers using a telehealth model that allows care teams to educate each other, share clinical cases, and cultivate deeper specialist knowledge.

Already being utilized in 33 countries, most major cancer centers in the United States, the VA health system, and the US Department of Defense, Project ECHO has become a "disruptive innovation to dramatically improve both capacity and access to specialty care for rural and underserved populations,” said Association of Community Cancer Centers president, Thomas A. Gallo.

Project ECHO differs from traditional telemedicine because it serves as a vehicle for education and is used to train specialists outside of academic centers. Studies have shown that the model, which began with hepatitis C treatment efforts, successfully educates PCPs and improves patient outcomes. ECHO programs exist in a variety of specialties including chronic pain management, infectious diseases, rheumatology, diabetes, and cancer care. “The purpose of tele ECHO is to make people as good as us,” said Sanjeev Arora, MD, MACP, director of Project ECHO and professor of medicine at University of New Mexico Health Sciences Center. “Telemedicine is giving people fish. Tele ECHO is teaching people to fish.”

“I want community cancer centers to start ECHOs for your communities,” Arora 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.” Arora addressed the increase in health disparities among individuals who live in rural areas and went on to explain that studies show patients with breast, cervical, colorectal, kidney, lung, oropharyngeal and skin cancers all have higher mortality rates when living in rural areas. He claims it is only escalating and explains, “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,” Arora encouraged community cancer centers to get involved in Project ECHO, whether as a part of a larger NCI­designated cancer center program, or as a leader of project. “This has consequences which are far beyond health care. We cannot allow these gaps to get continuously wider.”

“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.”

Learn more about telehealth collaboratives

Boston Medical Center (BMC) is a 487-bed academic medical center that is the primary teaching affiliate of Boston University School of Medicine. Working with and HRSA, BMC’s Comprehensive Epilepsy Center and Section of Pediatric Neurology leads an initiative called the Telehealth Epilepsy Care Collaborative

Similar to Project ECHO's model, BMC specialists work with and train physicians from 13 community health and clinical sites across the state of Massachusetts to better identify signs of seizures in infants, children and adolescents. BMC specialists also help lead the entire diagnosis process by providing multidisciplinary assessments, coordinated treatment planning, seizure action plans, and transition plans for children enrolled in the program. is the collaborative health hub powering this ECHO-like intervention.

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