scholarly journals Innovative virtual mentoring using the Extension for Community Healthcare Outcomes model for primary care providers for the management of alcohol use disorders

2020 ◽  
Vol 151 (6) ◽  
pp. 609
Author(s):  
PrabhatKumar Chand ◽  
Jayant Mahadevan ◽  
Lekhansh Shukla ◽  
Miriam Komaromy ◽  
Pratima Murthy ◽  
...  
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Alcohol Use Disorders ◽  
Primary Care Providers ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Community Healthcare ◽  
Virtual Mentoring

scholarly journals Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Jinhee Lee ◽  
Thomas F. Kresina ◽  
Melinda Campopiano ◽  
Robert Lubran ◽  
H. Westley Clark
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Substance Use ◽  
Alcohol Use ◽  
Opioid Dependence ◽  
Alcohol Use Disorders ◽  
Primary Care Providers ◽  
Care Providers ◽  
Addictive Disorders ◽  
Care And Treatment

Substance-related and addictive disorders are chronic relapsing conditions that substantially impact public health. Effective treatments for these disorders require addressing substance use/dependence comprehensively as well as other associated comorbidities. Comprehensive addressing of substance use in a medical setting involves screening for substance use, addressing substance use directly with the patient, and formulating an appropriate intervention. For alcohol dependence and opioid dependence, pharmacotherapies are available that are safe and effective when utilized in a comprehensive treatment paradigm, such as medication assisted treatment. In primary care, substance use disorders involving alcohol, illicit opioids, and prescription opioid abuse are common among patients who seek primary care services. Primary care providers report low levels of preparedness and confidence in identifying substance-related and addictive disorders and providing appropriate care and treatment. However, new models of service delivery in primary care for individuals with substance-related and addictive disorders are being developed to promote screening, care and treatment, and relapse prevention. The education and training of primary care providers utilizing approved medications for the treatment of alcohol use disorders and opioid dependence in a primary care setting would have important public health impact and reduce the burden of alcohol abuse and opioid dependence.

Dermatology ECHO: A case presentation demonstrating benefits of specialty telementoring in primary care

2018 ◽  
Vol 25 (8) ◽  
pp. 506-509 ◽  
Author(s):  
Ryan Ladd ◽  
Mirna Becevic ◽  
Hope Misterovich ◽  
Karen Edison
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Community Healthcare ◽  
Rural Primary Care ◽  
Timely Access ◽  
New Treatment ◽  
Allergic Contact ◽  
Improve Patient

Allergic contact dermatitis (ACD) is a common dermatologic disorder that is estimated to affect 15–20% of the general population. Because of its prevalence, it may be expected that ACD should be easily recognized. However, it can present with many clinical variations that may complicate diagnosis. Although ACD is a treatable condition, patients from rural and underserved areas suffer if timely access to specialty care is limited. Dermatology Extension for Community Healthcare Outcomes (Dermatology ECHO) telemedicine sessions were created to mentor rural primary care providers (PCPs). To illustrate their benefit, we present the case of a 19-year-old female patient who suffered from worsening undiagnosed ACD for over nine months following a laparoscopic appendectomy. During that time, the surgeon and multiple PCPs treated her with antibiotics, antivirals, and Scabicide without improvement in her condition. The de-identified patient case was presented by her PCP during the Dermatology ECHO session. The Dermatology ECHO specialty team mentored and educated the PCP in the diagnosis and treatment of ACD. After making the diagnosis, the patient received new treatment and her condition improved significantly. Dermatology ECHO provides a knowledge-sharing network for participating PCPs that may improve patient outcomes and reduce patient suffering.

ECHO Autism

2016 ◽  
Vol 56 (3) ◽  
pp. 247-256 ◽  
Author(s):  
Micah O. Mazurek ◽  
Rachel Brown ◽  
Alicia Curran ◽  
Kristin Sohl
Keyword(s):  
Primary Care ◽  
Self Efficacy ◽  
Pilot Project ◽  
Primary Care Providers ◽  
Autism Spectrum ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Care Needs ◽  
Community Healthcare ◽  
Screening Guidelines

Children with autism spectrum disorder (ASD) have complex medical problems, yet they are at high risk for unmet health care needs. Primary care providers are perfectly positioned to meet these needs; however, they often lack training in ASD. This pilot project developed and tested a new model for training primary care providers in best-practice care for ASD using the Extension for Community Healthcare Outcomes (ECHO) framework. The 6-month ECHO Autism pilot project consisted of 12 biweekly clinics focused on screening and identification of ASD symptoms and management of medical and psychiatric comorbidities. Participants completed measures of practice behavior and self-efficacy in screening and management of children with ASD at baseline (pretest) and after 6 months of ECHO Autism (posttest). Statistically significant improvements were observed in self-efficacy, in adherence to ASD screening guidelines, and in use of ASD-specific resources. Participants also reported high satisfaction with the program.

Improving Pediatrician’s Behavioral Health Competencies Through the Project ECHO Teleconsultation Model

2020 ◽  
Vol 59 (12) ◽  
pp. 1049-1057
Author(s):  
Cody A. Hostutler ◽  
Jahnavi Valleru ◽  
Heather M. Maciejewski ◽  
Amy Hess ◽  
Sean P. Gleeson ◽  
...  
Keyword(s):  
Primary Care ◽  
Behavioral Health ◽  
Workforce Development ◽  
Primary Care Providers ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Community Healthcare ◽  
Project Echo ◽  
Underserved Patients ◽  
Development Approach

Project ECHO (Extension for Community Healthcare Outcomes) is a teleconsultation model for enhancing the treatment of underserved patients in primary care. Previous behavioral health (BH) adaptations of Project ECHO have primarily focused on adults or specific diagnoses and have relied on self-reported outcomes. The purpose of this pilot was to adapt Project ECHO to support pediatric primary care providers in addressing common BH needs and to conduct an initial evaluation of its effectiveness. Overall, participants reported high levels of satisfaction and a statistically significant improvement in their overall knowledge and skills ( P = 0.001). Participation was also associated with a reduction in the use of psychotropic polypharmacy. This pilot adds to a growing body of literature suggesting that Project ECHO is a promising workforce development approach to build competencies for the management of BH issues in primary care.

scholarly journals Project ECHO-Geriatrics: Training Future Primary Care Providers to Meet the Needs of Older Adults

2018 ◽  
Vol 10 (3) ◽  
pp. 311-315 ◽  
Author(s):  
Katherine A. Bennett ◽  
Thuan Ong ◽  
Aimee M. Verrall ◽  
Michael V. Vitiello ◽  
Zachary A. Marcum ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Family Medicine ◽  
Primary Care Providers ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Specific Knowledge ◽  
Community Healthcare ◽  
Family Medicine Residency ◽  
Project Echo

ABSTRACT Background  Geriatrics training is essential for future primary care providers. The Extension for Community Healthcare Outcomes (ECHO) model improves access to specialty care via case-based videoconferencing, but Project ECHO has not previously been designed to target residents. Objective  We designed Project ECHO-Geriatrics to deliver geriatrics education to primary care trainees using the ECHO model and evaluated self-rated geriatrics competency of trainees from the University of Washington Family Medicine Residency Network programs who participated between January 2016 and March 2017. Methods  We assessed outcomes of Project ECHO-Geriatrics through anonymous surveys. Participants rated didactics, case discussions, and geriatrics-specific knowledge before and after sessions on a 5-point scale (1, low, to 5, high). Participants were asked whether they planned to do anything differently in their practice and, if yes, to describe this change. Results  Fifteen sessions were held with 204 unique participants from 12 sites, with an average of 28 (range, 13–41) participants per session. From the 9 of 29 (31%) Family Medicine Residency Network programs that enrolled, 63% percent (116 of 184) of eligible residents attended. Sessions were highly rated (89% of responses were 4 or 5). Self-reported geriatrics-specific knowledge increased significantly (before 3.3 [SD = 0.89] versus after 4.0 [SD = 0.60], P < .001). Sixty-five percent (118 of 181) of participants reported plans to change their practice. Conclusions  Project ECHO-Geriatrics is an innovative, feasible way to train the future primary care workforce in geriatrics and grow the capacity to provide high-quality care to older adults.

Differences in Perceptions of and Practices Regarding Treatment of Alcohol Use Disorders Among VA Primary Care Providers in Urban and Rural Clinics

2018 ◽  
Vol 34 (4) ◽  
pp. 359-368 ◽  
Author(s):  
Jessica P. Young ◽  
Carol E. Achtmeyer ◽  
Kara M. Bensley ◽  
Eric J. Hawkins ◽  
Emily C. Williams
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Alcohol Use Disorders ◽  
Primary Care Providers ◽  
Care Providers ◽  
Rural Clinics

Treatment of Unhealthy Alcohol Use

2019 ◽  
Author(s):  
Stephen R Holt ◽  
David A Fiellin
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Behavioral Therapy ◽  
Primary Care Providers ◽  
Similar Efficacy ◽  
Motivational Enhancement Therapy ◽  
Behavioral Strategies ◽  
Care Providers ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol

Unhealthy alcohol use represents the fifth leading cause of morbidity and mortality globally, and the first leading cause among persons 18 to 45 years of age. Despite the global impact of unhealthy alcohol use, the adoption of evidence-based treatments has been sluggish. Behavioral strategies for lower level drinking include the brief motivational interview, designed to be within the scope of any healthcare provider, and more specialist-driven approaches for those with alcohol use disorder (AUD) such as cognitive behavioral therapy and motivational enhancement therapy. Benzodiazepines remain the mainstay treatment for inpatient alcohol withdrawal treatment, whereas other medications have similar efficacy in managing patients in the outpatient setting with milder forms of withdrawal. For maintenance treatment of AUD, four FDA-approved medications exist, with efficacy in treating AUD, as well as several non–FDA-approved medications that have been found to be effective in promoting abstinence and reducing drinking. The use of medication to treat many patients with AUD falls within the scope of primary care providers. This review contains 6 tables and 54 references. Key Words: addiction, alcohol, counseling, drinking, pharmacotherapy, primary care, psychotherapy, relapse, treatment

scholarly journals Using Project Echo Telementoring to Improve Sickle Cell Disease Care in the Midwest

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5923-5923
Author(s):  
Lisa Marie Shook ◽  
Christina Bennett Farrell ◽  
Karen A. Kalinyak ◽  
Stephen C Nelson ◽  
Brandon M. Hardesty ◽  
...  
Keyword(s):  
Primary Care ◽  
Sickle Cell Disease ◽  
Medical Care ◽  
Sickle Cell ◽  
Research Funding ◽  
Primary Care Providers ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Cell Disease ◽  
Project Echo

Abstract Sickle Treatment and Outcomes Research in the Midwest (STORM) is a regional sickle cell network, funded by the Health Resources and Services Administration Treatment Demonstration Project (HRSA U1EMC27863), established to improve outcomes for individuals with sickle cell disease (SCD) living in Indiana, Illinois, Michigan, Minnesota, Ohio and Wisconsin. The STORM network is led by pediatric and adult hematologists who coordinate network activities in each state, along with a Regional Coordinating Center that organizes efforts throughout the Midwest. The goal of the STORM network is to increase the number of pediatric and adult primary care providers (PCP) who are knowledgeable about the management and treatment of SCD, and who are willing to prescribe and manage hydroxyurea therapy as a means to improve medical care for the approximately 15,000 individuals living with SCD in the Midwest. One PCP engagement strategy that has been implemented to increase provider knowledge in the region is replication of the Project ECHOTM (Extension for Community Healthcare Outcomes) telementoring model. Project ECHO was developed by the University of New Mexico to utilize low-cost, high-impact video technology to link expert inter-disciplinary specialist teams with primary care providers to improve management of chronic diseases. This guided practice telementoring model delivers complex specialty medical care to underserved areas, reduces health disparities, and increases workforce capacity. Project ECHO's methodology is based on 1) using telehealth technology to build healthcare resources where they are scarce; 2) sharing best practices to reduce variation in clinical care; 3) utilizing practice-based learning to develop specialty expertise among providers; and 4) monitoring and evaluating provider outcomes. Project ECHO has demonstrated improved healthcare outcomes in Hepatitis C and several other chronic diseases, and is now being piloted by STORM to test its feasibility and applicability for SCD by using a regional approach with CME accreditation. STORM network site physician leads in each state are recruiting multi-disciplinary primary care teams to participate as "spokes" in monthly SCD TeleECHO clinics. The "hub" led by the STORM Regional Coordinating Center, located at Cincinnati Children's Hospital Medical Center, coordinates implementation and evaluation of the telementoring clinics, delivered through monthly teaching sessions. STORM TeleECHO participants log onto an internet-based virtual meeting site, using a webcam to interact during the session. STORM TeleECHO clinics include brief didactic presentations from nationally-recognized SCD content experts with topics and curriculum based on the National Heart Lung and Blood Institute Evidence-Based Management of Sickle Cell Disease guidelines released in 2014. TeleECHO teaching clinics also include 1-2 de-identified, HIPAA protected case discussions (pediatric and adult) presented by providers who would like medical and psychosocial feedback on management of challenging clinical scenarios. Providers participating in the STORM TeleECHO complete an initial survey assessing knowledge and comfort levels, practice behaviors (including hydroxyurea prescribing practices) and clinic demographics. Satisfaction surveys are sent to participants after each session as part of the CME-credit evaluation. Follow-up surveys at 6 months and 1 year will assess satisfaction, knowledge, comfort level and changes in practice. STORM's TeleECHO was launched in March 2016. Preliminary data indicate an interest in STORM TeleECHO teaching sessions by both pediatric and adult providers across the Midwest region. Future efforts will expand the network to more PCPs in the region, while improving the applicability and utility of STORM TeleECHO in SCD through provider assessment. Disclosures Ware: Global Blood Therapeutics: Consultancy; Biomedomics: Research Funding; Bristol Myers Squibb: Research Funding; Addmedica: Research Funding; Nova Laboratories: Consultancy; Bayer Pharmaceuticals: Consultancy.

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