Taking Telemedicine to the Next Level in Diabetes Population Management: a Review of the Endo ECHO Model

Abstract

Worldwide increases in diabetes prevalence in the face of limited medical resources have prompted international interest in innovative healthcare delivery models. Project ECHO (Extension for Community Healthcare Outcomes) is a "telementoring" program which has been shown to increase capacity for complex disease management in medically underserved regions. In contrast to a traditional telemedicine model which might connect a specialist with one patient, the ECHO model allows for multiple patients to benefit simultaneously by building new expertise. We recently applied the ECHO model to improve health outcomes of patients with complex diabetes (Endo ECHO) living in rural New Mexico. We describe the design of the Endo ECHO intervention and a 4-year, prospective program evaluation assessing health outcomes, utilization patterns, and cost-effectiveness. The Endo ECHO evaluation will demonstrate whether and to what extent this intervention improves outcomes for patients with complex diabetes living in rural New Mexico, and will serve as proof-of-concept for academic medical centers wishing to replicate the model in underserved regions around the world.

ISPAD Clinical Practice Consensus Guidelines 2018: Diabetes technologies

“…294 Ongoing assessment of this model is being conducted in those with diabetes, with the primary clinician working in consort with a multi-disciplinary team, with longitudinal assessment of this approach planned. 294…”

“…Building on the traditional telemedicine model, Project ECHO ( E xtension for C ommunity H ealthcare O utcomes) employs primary care clinicians who receive “telementoring” from a specialist to guide the management of their own patients with complex medical conditions . Ongoing assessment of this model is being conducted in those with diabetes, with the primary clinician working in consort with a multi‐disciplinary team, with longitudinal assessment of this approach planned …”

COVID-19 specialized diabetes clinic model for excellence in diabetes care: scientific perspective

“…Grand rounds and small group meetings will do the utmost to encourage practices within and outside an agency. In Pennsylvania there is a Chronic Health Program, which funds and promotes training primary care procedures in the PCMH model and extension of the Public Healthcare Outcomes program, that supports the tele-mentoring of PCPs by diabetics, details of these partnerships [16,17].…”

Diabetes technology: improving care, improving patient‐reported outcomes and preventing complications in young people with Type 1 diabetes

“…One telemedicine model, Project Extension for Community Health Outcomes (ECHO), trains local primary care providers to deliver specialty care in underserved areas. This model is now expanding to include diabetes . The Project ECHO model will allow individuals with diabetes to receive improved care closer to home.…”