The Department of Veterans' Affairs has launched the Specialty Care Access Network – Extension for Community Healthcare Outcomes (SCAN-ECHO). The program will leverage cutting-edge telehealth technology to provide specialty, comprehensive care to veterans regardless of where they live.
The VA’s implementation marks the first nationwide extension of ECHO.
Sanjeev Arora, MD, an innovator and liver disease specialist at the University of New Mexico Health Sciences Center in Albuquerque, helped launch the ECHO project. As a provider of chronic illness care for rural patients, he said his treatment was often stalled as patients struggled to commute to doctor appointments and pay for transportation. “I had the thought that if these patients had just come to me earlier, I would have been able to treat them better,” he explained at a recent conference.
Arora began working with other providers to leverage telehealth technology and share expertise. Soon ECHO projects spanned 19 different areas in New Mexico, he said, and treatment quality showed “dramatic improvement.”
Enter the VA, whose system of veterans seeking care in the states includes many members in rural areas. “Rural veterans are less likely to have access to health services, particularly in the special care services that they may need,” explained VA Under Secretary for Health Robert Petzel.
Petzel says the SCAN-ECHO program to generate communication and expertise across practices and extend that quality to patients – wherever they are – presents a strong opportunity “to help veterans lead healthier, more fulfilling lives,” adding that “patients with complex problems like heart failure, chronic pain (and) diabetes can get high-level specialty care closer to their home.”
At the crux of this care enhancement, Arora said, is the sharing of information: “The primary purpose in ECHO is not to treat individual patients; it’s to generate expertise.”
Telehealth as a one-on-one interaction between a doctor and patient won’t be realized in this case. Rather, the model connects specialist care teams to primary care providers in local communities. Through weekly virtual clinics, specialists and community providers will share expertise, treatment strategies, results and the latest medical research to analyze their patient cases and develop solutions.
Naomi Clancy, a rural health doctor in New Mexico, was featured in a video shown during a recent VA webcast. Her practice has been using Project ECHO conferences to better diagnose and cure patients. In particular, Clancy has been grappling with rheumatology, an area in which she said she’s gained confidence since working with experts through the Project ECHO model.
”It’s a giant mind-center of collaboration,” she said of her Project ECHO team. “This opened up a whole new field of medicine for me.”
Eleven VA medical centers have implemented the Project ECHO model to target and tailor treatment for veterans through SCAN-ECHO. The Robert Wood Johnson Foundation is assisting Project ECHO with a five-year grant, with an eye on expanding the model nationwide.
“Case-based learning can occur over distances. You can improve the quality and care in underserved communities,” said John Lumpkin, MD, senior vice president and director of RWJF's healthcare group. “We believe that ECHO has this new approach to innovation that will become the new normal in the healthcare system and help transform health care in this system.”