Shared Care Depression Collaborative Model: From Project Inception to Outcome Data

2008 ◽  
Vol 27 (2) ◽  
pp. 219-232 ◽  
Author(s):  
Whitney Sedgwick ◽  
Cheryl Washburn ◽  
Christie Newton ◽  
Patricia Mirwaldt
Keyword(s):  
Primary Care ◽  
Health Assessment ◽  
Pilot Project ◽  
Primary Care Providers ◽  
Outcome Data ◽  
Shared Care ◽  
Care Providers ◽  
University Of British Columbia ◽  
National College Health Assessment ◽  
The University

The University of British Columbia (UBC) has partnered with community primary care providers to implement a shared care pilot project for the management of depression. The National College Health Assessment survey conducted at UBC in 2004 identified a significant gap in the management of depression. This finding highlighted a need to better integrate existing resources and strengthen the capacity of primary care providers to effectively recognize, assess, and treat depression. This article outlines the development and evaluation of a shared care collaborative approach to the primary care of depression in the UBC campus community.

scholarly journals Shared care involving cancer specialists and primary care providers - What do cancer survivors want?

2017 ◽  
Vol 20 (5) ◽  
pp. 1081-1087 ◽  
Author(s):  
Sharon Lawn ◽  
Julia Fallon-Ferguson ◽  
Bogda Koczwara
Keyword(s):  
Primary Care ◽  
Cancer Survivors ◽  
Primary Care Providers ◽  
Shared Care ◽  
Care Providers ◽  
Cancer Specialists

scholarly journals Development of the University of Colorado Endocrine ECHO Program

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A409-A410
Author(s):  
Eleanor Lorton ◽  
Alexandra Coluzzi ◽  
Laura Maurer ◽  
Lauren Pitzer ◽  
David Saxon
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
Endocrine Disorders ◽  
Thyroid Disorders ◽  
Initial Experience ◽  
Care Providers ◽  
University Of Colorado ◽  
Bone Calcium ◽  
The University

Abstract Background: The Extension for Community Health Outcomes (ECHO) model aims to improve rural community healthcare by providing specialist-lead telementoring for primary care providers (PCPs) in a didactic and discussion-based format.1 There is a notable shortage of endocrinologists in Colorado, particularly in rural and frontier counties. Best estimate is that 14 of 64 Colorado counties have at least one practicing endocrinologist. Here we describe the development and initial experience with an endocrine-specific ECHO program. Methods: Grant-funding was obtained to develop a longitudinal endocrine ECHO program to support PCPs who care for a large proportion of patients with Medicaid insurance. Program development occurred with input from endocrinologists, primary care physicians, and ECHO Colorado staff. Program participation results in continuous medical education credit. PCP recruitment occurred through listserv emails sent to various Colorado-based medical organizations. Endocrinologists provided weekly hour-long sessions focused on 5 main topic domains: diabetes, obesity/lipids, thyroid disorders, reproductive and adrenal disorders, and bone/calcium disorders. Results: Our endocrine ECHO program started in August 2020 and consisted of 30 weekly sessions (i.e. 9 diabetes, 8 obesity/lipids, 3 thyroid disorders, 5 reproductive and adrenal disorders, 4 bone/calcium disorders, and 1 pseudo-endocrine disorders). A total of 65 clinicians registered for the ECHO series. Sessions were designed by academic endocrinologists and fellows-in-training at the University of Colorado. During block 1 (diabetes block) there were 45 participants of which 12% practice in rural or frontier designated areas, 80% serve patients with Medicaid, and 42% primarily care for an underserved population. Matched pre/post-surveys asking about PCPs’ confidence with each ECHO session were obtained and final results are currently pending completion of the full series in March 2021. Survey data will inform future iterations of this program which is slated to run annually for at least 3 years. Conclusion: Access to endocrinologists is often a scarce resource for rural communities and underserved populations. The ECHO model can serve as a means to provide longitudinal education and support for PCPs across a range of endocrine topics. Here we describe our initial experience with a 30-week endocrine ECHO program in Colorado and highlight future directions of this program.

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.

Perspectives Among Primary Care Providers and Hematologist/Oncologists in the Coordination of Care for Patients with Hematologic Malignancies

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3156-3156
Author(s):  
Haleh Kadkhoda ◽  
Clare Karten ◽  
Kevin C. Oeffinger ◽  
Kanti R. Rai ◽  
S. Frieda Pearce ◽  
...  
Keyword(s):  
Primary Care ◽  
Hematologic Malignancies ◽  
Primary Care Providers ◽  
Shared Care ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Care Providers ◽  
Roles And Responsibilities

Abstract Abstract 3156 Introduction Clinicians have different expectations and perceptions regarding the role of primary care providers (PCPs) and hematologist/ oncologists (Hem/Oncs) in the provision of follow-up and survivorship care for patients with hematologic malignancies, and for the cancer survivor in general [Cheung JCO 2009]. The continuing decline in the number of specialists will require PCP involvement in the care of the patients with hematologic malignancies in particular, as well as cancer survivors in general. An outcomes study investigated barriers to shared care/ co-management of patients with hematologic malignancies and current practices of PCPs and Hem/Oncs regarding communication, provider roles and responsibilities and resources needed to implement effective cancer survivorship care plans. Methods: Internet polling surveys within an educational activity developed by the Leukemia & Lymphoma Society (LLS) and Medscape LLC with outcomes assessment by CE Outcomes, LLC. The activity learning objectives centered on roles and communication touch points for PCPs and Hem/Oncs, strategies and tools for optimal patient care, and recommendations for care of survivors with hematologic malignancies. Case-based education was delivered by an expert panel of hematologist/oncologist and primary-care physicians to illustrate critical communication points between Hem/Onc and PCP. The activity addressed regional variations in care, fragmentation of care, and helped define healthcare provider roles in the shared–care model. Electronic health records (EHR) and a treatment summary form were discussed as methods for effectively communicating a survivorship care plan among healthcare providers. More than 4, 000 physicians participated in the activity; 170 specialists and 587 PCPs were respondents to the survey. Polling questions and outcomes survey addressed barriers and current practices in shared care of patients with hematologic malignancies. Responses of PCPs and Hem/Oncs were aggregated and compared to identify gaps in continuity of care between specialties. Results: A summary of interactivity responses of PCPs (N=587) and Hem/Oncs (N=170) shows the most significant barrier to co-management of patients with hematologic malignancies was “lack of defined roles and responsibilities for PCPs vs specialists” (51.5% Hem/Onc vs 53.2% PCP). Confusion over roles is evident as 55.6% of Hem/Onc respondents expect the oncology specialist to follow the patient during the “watch and wait' period, while 45.8% of PCPs expect the PCP to follow the patient, and 35.4% expect the PCP and specialist to follow the patient together. More than half of PCPs and specialists report that they should co-manage follow up for cancer recurrence. The majority of PCPs and specialists report that standardized communication tools are from “very to extremely important” yet only approximately one third of PCPs and specialists are currently using EHR resources, with a third in the process of implementing EHR in their practices. Conclusions: Barriers to the provision of shared care and co-management of the cancer survivor can be addressed by more clearly defining individual clinician roles and responsibilities. Bridging gaps in the survivorship care plan requires improved communication between Hem/Oncs and PCPs to coordinate “watch and wait” care and follow-up screening, and effective methods to transfer patient records and history including Treatment Summary Forms and EHR. Disclosures: No relevant conflicts of interest to declare.

The University of Pittsburgh CancerCenter Primary Care Provider Workforce Integration Initiative: An institutional model—Design, process, status, and implications.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 41-41
Author(s):  
G J. Van Londen ◽  
Jill Weiskopf Brufsky ◽  
Ira Russell Parker
Keyword(s):  
Primary Care ◽  
Focus Groups ◽  
Cancer Care ◽  
Information Exchange ◽  
Geriatric Medicine ◽  
Primary Care Providers ◽  
Care Providers ◽  
University Of Pittsburgh ◽  
The University ◽  
Workforce Integration

41 Background: Due to increasing numbers of individuals diagnosed with cancer, a burgeoning cohort of cancer survivors with significant medical co-morbidities, and oncology workforce “supply-demand” challenges, the optimal integration of Primary Care Providers (PCPs) into the comprehensive cancer care paradigm is of timely importance. The objective is to describe those specific planning and implementation issues impacting the establishment of a cancer care delivery model targeting the interface between Oncology and Primary Care. Methods: The University of Pittsburgh CancerCenter PCP Workforce Integration Initiative received authorization to proceed in December of 2014. Immediate actions were then undertaken: 1) Establishment of an “Advisory/Working Group” [Fifteen stakeholders representing the interests of Oncology, Patient Advocacy, Nursing, Primary Care (Family Medicine, Geriatric Medicine, Internal Medicine, and Gynecology); Administration, Information Technology, and Research]; 2) Conduct of focus groups and individual, fact-finding conversations; 3) Programmatic planning of a “pilot” intervention; and 4) Planning of a full-day, continuing medical/nursing education symposium focusing upon the specific training and empowerment needs of PCPs with regard to their evolving roles in the comprehensive cancer care paradigm (November/2015). Results: Focus groups demonstrated an overall acknowledgement of the importance of the issue and a willingness to participate. Specific identification of those unique provider roles and competencies necessary to address a patient’s individual “survivorship” risk profile and the development of a system to best enhance communication and information exchange among the providers and patients were made evident. The results of a survey (knowledge, attitudes, beliefs, and practices) conducted to the attendees of the Symposium will be discussed. Conclusions: To best optimize the interface between Oncologists and PCPs with regard to best practices cancer care, well-planned competency training and “system development” will be necessary.

scholarly journals Sharing Cancer Survivorship Care between Oncology and Primary Care Providers: A Qualitative Study of Health Care Professionals’ Experiences

2020 ◽  
Vol 9 (9) ◽  
pp. 2991
Author(s):  
Karolina Lisy ◽  
Jennifer Kent ◽  
Jodi Dumbrell ◽  
Helana Kelly ◽  
Amanda Piper ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Qualitative Study ◽  
Health Care Professionals ◽  
Primary Care Providers ◽  
Shared Care ◽  
Policy Implications ◽  
Suitable Model ◽  
Survivorship Care ◽  
Care Providers

Survivorship care that is shared between oncology and primary care providers may be a suitable model to effectively and efficiently care for the growing survivor population, however recommendations supporting implementation are lacking. This qualitative study aimed to explore health care professionals’ (HCPs) perceived facilitators and barriers to the implementation, delivery and sustainability of shared survivorship care. Data were collected via semi-structured focus groups and analysed by inductive thematic analysis. Results identified four overarching themes: (1) considerations for HCPs; (2) considerations regarding patients; (3) considerations for planning and process; and (4) policy implications. For HCPs, subthemes included general practitioner (GP, primary care physician) knowledge and need for further training, having clear protocols for follow-up, and direct communication channels between providers. Patient considerations included identifying patients suitable for shared care, discussing shared care with patients early in their cancer journey, and patients’ relationships with their GPs. Regarding process, subthemes included rapid referral pathways back to hospital, care coordination, and ongoing data collection to inform refinement of a dynamic model. Finally, policy implications included development of policy to support a consistent shared care model, and reliable and sustainable funding mechanisms. Based on study findings, a set of recommendations for practice and policy were developed.

scholarly journals Shared Care for Adults with Sickle Cell Disease: An Analysis of Care from Eight Health Systems

2019 ◽  
Vol 8 (8) ◽  
pp. 1154
Author(s):  
Arch G. Mainous ◽  
Benjamin Rooks ◽  
Rebecca J. Tanner ◽  
Peter J. Carek ◽  
Vandy Black ◽  
...  
Keyword(s):  
Primary Care ◽  
Sickle Cell Disease ◽  
Health Systems ◽  
Sickle Cell ◽  
Primary Care Providers ◽  
Shared Care ◽  
Care Group ◽  
Care Providers ◽  
Cell Disease ◽  
Lower Likelihood

Adult sickle cell disease (SCD) patients frequently transition from pediatric hematology to adult primary care. We examined healthcare utilization for adult patients with SCD with shared care between hematologists and primary care providers (PCP). We analyzed the OneFlorida Data Trust, a centralized data repository of electronic medical record (EMR) data from eight different health systems in Florida. The number of included adults with SCD was 1147. We examined frequent hospitalizations and emergency department (ED) visits by whether the patient had shared care or single specialty care alone. Most patients were seen by a PCP only (30.4%), followed by both PCP and hematologist (27.5%), neither PCP nor hematologist (23.3%), and hematologist only (18.7%). For patients with shared care versus single specialist care other than hematologist, the shared care group had a lower likelihood of frequent hospitalizations (OR 0.63; 95% CI 0.43–0.90). Similarly, when compared to care from a hematologist only, the shared care group had a lower likelihood of frequent hospitalizations (OR 0.67; 95% CI 0.47–0.95). There was no significant relationship between shared care and ED use. When patients with SCD have both a PCP and hematologist involved in their care there is a benefit in decreased hospitalizations.

scholarly journals Strengthening the Health Workforce through the ECHO Stages of Participation: Participants’ Perspectives on Key Facilitators and Barriers

2019 ◽  
Vol 6 ◽  
pp. 238212051882092 ◽  
Author(s):  
Suzuho Shimasaki ◽  
Erin Bishop ◽  
Michelle Guthrie ◽  
John F (Fred) Thomas
Keyword(s):  
Primary Care ◽  
Health Workforce ◽  
Curriculum Design ◽  
Underserved Populations ◽  
Primary Care Providers ◽  
Health Science ◽  
Care Providers ◽  
Key Factors ◽  
Science Center ◽  
The University

Introduction: Project Extension for Community Health Outcomes (ECHO) was originally developed by the University of New Mexico’s Health Science Center (UNMHSC) to build the capacities of primary-care providers and to increase specialty-care access to rural and underserved populations. ECHO Colorado, a replication site at the University of Colorado Anschutz Medical Campus (CUAMC), was developed with the same purpose and to help build the health workforce of Colorado. The CUAMC and its community-based partners recognized that by reducing unnecessary referrals to the medical campus and building primary-care capacity in communities, both would increase their scope and expand overall capacity. This study examines the key factors that influence participant engagement, how participants value the ECHO experience, and the utility of the ECHO Colorado experience according to participants. Methods: This study used a mixed-methods approach including 42 interviews and 34 completed surveys. Transcribed interview recordings were coded in NVivo 11, and codes were queried in NVivo and Excel to identify key themes. Survey responses were analyzed in SPSS. Data were examined between and across four attendance groups and triangulated to assess the reliability of the data and validity of overall findings. Findings: Key factors increasing registrant engagement included relevant and practical curriculum content; strong and supportive relationships among learners, ECHO faculty, and workplace colleagues; and innovative learning approaches that included opportunities for active, virtual participation through technology, participant management activities, and ECHO’s unique curriculum design. Conclusion: Findings from this study validated many of the important elements of ECHO Colorado that make it unique from other iterations of the model being implemented nationally and internationally and identified participant-driven strategies for further amplifying its impact.

scholarly journals HOW TO PREPARE PHYSICIAN ASSISTANTS FOR THE CARE OF OLDER ADULTS? PARTNER WITH GERONTOLOGY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S298-S298
Author(s):  
Jacqueline Eaton ◽  
Trenton Honda
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Adult Population ◽  
Physician Assistants ◽  
Primary Care Providers ◽  
Student Interest ◽  
Care Providers ◽  
University Of Utah ◽  
Program Of Study ◽  
The University

Abstract Approximately 80% of older adults have chronic illness which requires complex care. Primary care providers require special training to improve the care they provide older adults. As primary care shortages increase, and the older adult population swells, physician assistants (PA) will increasingly be relied upon to provide care and advocacy for older adults. The purpose of this presentation is to describe the development of a dual degree program that facilitates enhanced gerontological training for students pursuing a Masters of PA Studies degree. The Gerontology Interdisciplinary Program and the PA Program at the University of Utah collaborated to assess program objectives, competencies, and coursework, while identifying student interest in this dual MS venture. Students were interested in increasing their skills to meet the growing need for geriatric care while also saving time and money. In addition, it was important that the combined program of study did not overburden students and accommodated participants off-site. Faculty and administrative buy-in was sought from within departments and colleges. Revisions to the proposed program of study included altering course offerings, changing program start dates, and removing course overlap. A 30-month dual MS was developed that incorporates 87 PA Program credits, 25 Gerontology Credits, and 6 credits shared through practicum, geriatric content, and evidence based practice. Students who graduate will complete a Gerontology focused Masters Project that combines their work from the two programs. This dual MS program prepares students to be competitive in the job market, while also targeting an area of need in primary care.

Sign in / Sign up

Export Citation Format

Share Document