Democratizing Access to Best Practice Cancer Care in Low-Resource Settings: Project ECHO

PURPOSE The aim of this study was to understand how telementoring and training through the ECHO model can build the cancer workforce and bring best practice cancer care to low-resource settings. METHODS The ECHO Institute launched a 5-year project to expand the use of the ECHO model to improve the capacity of local providers to bring cancer prevention, diagnostic, treatment, and survivorship knowledge to rural and underserved populations. The ECHO model leverages technology, telementoring, and case-based learning to connect rural populations to specialty cancer care, improve access to evidence-based therapies and practices, and provide state-of-the-art training and mentorship to build the cancer workforce, particularly in underserved regions. Through the ECHO model, local providers are paired with experts and doctors at National Cancer Institute–designated Comprehensive Cancer Care Centers and academic medical centers for ongoing training, technical assistance, and mentorship. Although originally developed to bring best practice care for hepatitis C to rural communities, the ECHO model is now being used to treat 70 conditions or topics globally. RESULTS Since 2016, the ECHO model has been replicated by 73 partner hubs in 13 countries that are operating 130 cancer programs focused on diverse cancer prevention and treatment topics, including increasing clinical trial enrollment, cancer control and best practices, cervical cancer prevention and treatment, tobacco cessation, and more. To date, 21 peer-reviewed publications have documented the ECHO model’s efficacy in improving the use of best practices in cancer care and expanding access to care in low-resource settings. CONCLUSION Use of the ECHO model to train and mentor local providers is building the cancer workforce and increasing capacity to address critical topics in cancer screening, diagnosis, care, and survivorship. The ECHO Institute is successfully strengthening the cancer health system and accelerating the transmission of best practice cancer care from cancer centers to health care workers in underserved communities.