Project ECHO (Extension for Community Healthcare Outcomes): A New Model for Educating Primary Care Providers about Treatment of Substance Use Disorders

Implementing Treatment of Opioid-Use Disorder in Rural Settings: a Focus on HIV and Hepatitis C Prevention and Treatment

“…Project Extension for Community Healthcare Outcomes (ECHO) links primary care providers with inter-disciplinary expert consultation and training through an Internet-based audiovisual network [73] and has been adapted to support rural primary care providers in buprenorphine treatment of OUD [74]. It may be considered a rural adaptation of the hub and spoke model (see below) with “hub” centers linked via weekly educational conferences to rural primary care “hubs.” A typical one-hour, weekly ECHO curriculum consists of a brief (15 minute) didactic followed by primary care provider presentation of recent cases and feedback discussion from an expert panel composed of physicians, behavioral health counselor, and sometime a peer with lived experience of their own substance use disorder.…”

“…This model is well-suited for enhancing rural primary care provider capacity to treat patients with OUD. Implementation of an ECHO model to support buprenorphine prescribing was associated with a marked increase in DATA 2000-waiver buprenorphine prescribers in rural New Mexico [74]. Similarly, ECHO demonstrations have been used to support HCV [75–78] and HIV [79] treatment among rural primary care providers.…”

Inpatient Management of Opioid Use Disorder: A Review for Hospitalists

“…46 To address this problem, new models of care delivery are being developed, including models incorporating telemedicine to support rural primary care management of OUD. 47 The Future of Medication-Assisted Treatment Currently, MAT is initiated and managed by outpatient addiction specialists. However, evidence supports initiation of MAT as an inpatient.…”

Integrated Care: A Disruptive Innovation for Extending Psychiatric Expertise to Primary Care Practices

“…In these learning networks, aggregated sparse and distributed anonymized data from process and outcome measures allow for the identification of trends in delivery system gaps and the insights gained can be used to foster business-to-business practices and/or business-to-customer offerings 13 . Some business-to-business practices aimed at building the capacity of PCPs to treat behavioral health conditions include the use of psychiatrist specialist hub and multiple primary care spokes for didactics, consultative, and case-based learning to foster continuous professional development 28, 29. In addition, the insights gained from the large amount of data stored within these platforms can create new clinical support tools for point-of-care decision making for PCPs 27, 30.…”