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Project ECHO (Extension of Community Healthcare Outcomes)

Project ECHO® (Extension of Community Healthcare Outcomes) http://ECHO.unm.edu is a pioneering telementoring programme which was developed in the School of Medicine at the University of New Mexico (UNM). See more on ECHO origins: https://www.youtube.com/watch?v=2lBfyOlL4_s Project ECHO is a tele-mentoring programme which is designed to facilitate the sharing of specialist knowledge in order to improve the quality of care to patients. It brings GPs, nurses and other healthcare professionals together to participate in guided practice discussions via videoconference with specialist mentors. Participants benefit through case-based learning and the sharing of evidence-based, best practice guidance. Clinicians participating in ECHO sessions acquire new skills and support to treat their patients who otherwise would have to be referred to other specialists. Patients with complex chronic long term conditions including dementia, diabetes and neurological conditions can then get specialist supported care in their local communities. ECHO uses a hub and spoke model. The hub is normally a multidisciplinary team who sit together at the same location as dedicated IT support, admin support with dedicated IT equipment. Spokes generally join the ECHO sessions remotely. All participants will come together at the outset to agree curriculum topics, dates, times and case presenters. The ECHO hub and spoke model has been shown to be an effective way of improving access to specialist supported care and improving patient outcomes. The ECHO model develops knowledge and capacity by: 1. Using video conferencing technology to leverage scarce resources and create knowledge networks - Allowing participants easier access to training - Allowing access to training from your place of work at agreed dates & times - Access to recordings for network participants only - Dedicated information repository/resource library for your network 2. Improving outcomes by reducing variations in processes of care and sharing best practices - Sharing annonomised case based discussions - Teaching on guidelines/good practice - Improving collaborative decision making 3. Data/Evaluation - Support from ECHO dedicated research fellow - Uses MRC Logic Model In Northern Ireland, ECHO has now moved in to social care also and other areas such as social prescribing and safeguarding of looked after children.
Background
Geographical scope: 
International level
Countries involved:
Organisation
Organisation name: 
Health and Social Care Board
Organisation address: 
12-22 Linenhall St. Belfast BT2 8BS Northern Ireland ...
Kind of organisation: 
Regional public authorities
Viability
Time for deployment: 
Between one year and three years
Preparation of implementation: 
A team from NI was sent out to the University of New Mexico to receive specialist training in the use of the ECHO Model. Part of this training was for the team to devise their plan as to how ECHO could be adapted and used successfully in Northern Ireland. In order to make this happen, a Project...
Investment per citizen / service user / patient: 
No available calculation.
Cost calculation: 
N/a – As above – no available calculation
Evidence of practice: 
Documented evidence. Evidence is based on systematic qualitative and quantitative studies
Evidence creation: 
The evidence for Project ECHO was already available. This study, published in the New England Journal of Medicine that first caught our attention in Northern Ireland. https://www.nejm.org/doi/full/10.1056/NEJMoa1009370 CONCLUSIONS The results show that the ECHO model is an effective way to...
Maturity level: 
There is evidence that the practice is economically viable and brings benefits to the target group. Further research and development is needed in order to achieve market impact and for the practice to become routine use
Maturity level detalis: 
Project ECHO is economically viable and brings lots of benefits to the target group of Health Care Professionals (HCP’s) who are using the model for education, peer support and case based learning. This increased knowledge and support brings benefits to the patients being treated by these HCP’s...
Time of impact: 
Long term and sustainable impact – e.g. a long time after the pilot project ended and routine day-to-day operation began
Kind of impact: 
Better care integration (economic and societal)
Aspects time of impact: 
Overall, the outcomes that networks (30) hope to achieve in the short-term have included: • Improved knowledge: of a condition, symptom management, medication management, red flags. • Improved confidence: to diagnose or manage a condition, prescribe, manage patients without making a referral or...
Transferability level: 
The innovative practice has been transferred in other locations or regions or national scale in the same country
Transferability details: 
As Project ECHO originated in New Mexico, we have been able to transfer the model and processes to Northern Ireland and make the relevant tweaks to suit our organisations/regions/communities of practice. Project ECHO had also been transferred to more than 370 hubs in 38 countries for local...
Initiative
Type of Practice: 
Good practice
Stakeholders concerned: 
Hospitals
Primary care centres
Specialised physicians
General practioners
Pharmacists
Nurses
Nursing homes
Regional public authorities
Reach of initiative: 
10,000 - 99,999
Age group: 
< 18
18 – 49
50 - 64
65 - 79
80+
Baseline information: 
Project ECHO NI started in 2015-16 with a pilot of 5 ECHO Networks. Following a successful pilot, this increased to 19 networks in 2016-17 & 2017-18 increasing to 30 networks per year in 2018-19 & 2019-20. To deliver 30 ECHO Networks there is dedicated; - Clinical facilitator support -...
Source of funding: 
Regional funding