Implementation of the ECHO^® telementoring model for the treatment of patients with hepatitis C

Abstract

We aimed to implement the Extension for Community Healthcare Outcomes (ECHO) telementoring model for hepatitis C and to evaluate its outcomes in the health providers. Following the ECHO model, an hepatitis C teleECHO clinic was established at the Hospital Italiano in Argentina. The teleECHO clinic provides support and training to physicians from Patagonia who treat patients with hepatitis C. In order to evaluate the teleECHO clinic outcomes, physicians completed a survey focused on skills and competence in hepatitis C before and after 6 months of participating in the project. The survey consisted of 10 questions, which participants rated from 1 to 7 (1 no ability; 7 highest ability). To analyze the difference before and after participation in the project, Wilcoxon signed-rank test was used. During the first 6 months of implementation of the model, a total of 14 physicians from 12 sites in Patagonia agreed to participate in the survey. The median age of the participants was 42 years. Participants' primary specialties were Hepatology (55%), Infectious Diseases (25%), General Practice (10%), and other (10%). A significant improvement was observed in all the evaluated fields after 6 month of the participation in the teleECHO clinic, namely fibrosis staging, determining appropriate candidates for treatment, and selecting appropriate HCV treatment. In addition, their general interest in hepatitis C increased. We successfully replicated and implemented the first teleECHO clinic in Argentina. Physicians improved their ability to provide best practice care for patients with Hepatitis C. J. Med. Virol. 89:660-664, 2017. © 2016 Wiley Periodicals, Inc.

A national model of remote care for assessing and providing opioid agonist treatment during the COVID-19 pandemic: a report

“…While primary care was one of the first medical specialities to adapt to its use to manage COVID-19, a number of other specialities have reported on the use of novel remote models of care at this time [14,15,19]. Historically, OAT services have successfully used telemedicine for hepatitis C treatment and providing psychological and other supports [16][17][18]24]. Mental health services have also demonstrated success with remote care [19].…”

“…Historically, a small number of OAT services have successfully used telemedicine for hepatitis c treatment and providing psychological and other supports [16][17][18]. Mental health services have also demonstrated success with remote care and of course general practice was one of the first medical specialities to adapt to its use to manage COVID-19 [14,19].…”

The ECHO model proved to be a useful tool to increase clinicians' self‐effectiveness for care of patients with Hepatitis C in Argentina

“…One of the main purposes of ECHO is to avoid medical isolation. Another ECHO replicating model was implemented in Argentina few months before us, covering the Patagonia region . Currently there is a proliferation of online educational programmes but they do not involve face‐to‐face interactions with colleagues and do not address their professional isolation.…”

“…In order to evaluate potential improvements in providers' knowledge on HCV, a survey was sent to spokes after they had participated in 10 or more tele‐ECHO HCV clinics for at least 12 months. This survey has not been validated; however, it has been used by the University of New Mexico to evaluate participants' learning and later adapted by other tele‐ECHO clinics worldwide . The survey included items that asked respondents to rate their learning associated with their participation in ECHO.…”

Challenges and Strategies for Access to Treatment of Hepatitis C in Latin America

“…Using state-of-the-art telehealth technology, best practice protocols, and case-based learning, ECHO trains and supports primary care providers to develop knowledge and self-efficacy in hepatitis. ECHO has signed agreements in some Latin American countries which will contribute to advance the continuum of care for hepatitis C [22].…”