Reflections on project ECHO: qualitative findings from five different ECHO programs

Authors

Jon Agley, Prevention Insights, Department of Applied Health Science, School of Public Health Bloomington, Indiana University Bloomington, Bloomington, Indiana, USA
Janet Delong, Prevention Insights, Department of Applied Health Science, School of Public Health Bloomington, Indiana University Bloomington, Bloomington, Indiana, USA
Andrea Janota, IUPUI ECHO Center & Center for Public Health Practice, Richard M. Fairbanks School of Public Health, Indiana University, Purdue University, Indianapolis (IUPUI), Indiana, USA
Anyé Carson, IUPUI ECHO Center & Center for Public Health Practice, Richard M. Fairbanks School of Public Health, Indiana University, Purdue University, Indianapolis (IUPUI), Indiana, USA
Jeffrey Roberts, Prevention Insights, Department of Applied Health Science, School of Public Health Bloomington, Indiana University Bloomington, Bloomington, Indiana, USA
Gerardo Maupome, Richard M. Fairbanks School of Public Health, Indiana University, Purdue University, Indianapolis (IUPUI), Indiana, USA

Document Type

Article

Publication Date

2021

Abstract

Project ECHO (Extension for Community Healthcare Outcomes) was developed in 2003 as an innovative model to facilitate continuing education and professional development. ECHO emphasizes ‘moving knowledge, not people.’ To accomplish this, ECHO programs use virtual collaboration and case-based learning to allow practitioners, including those in rural and underserved areas, to receive specialist training. The ECHO model has expanded rapidly and is now used in 44 countries. Preliminary research on ECHO’s efficacy and effectiveness has shown promising results, but evidence remains limited and appropriate research outcomes have not been clearly defined. To improve the evidence basis for ECHO, this study of 5 ECHO programs (cancer prevention/survivorship, integrated pain management, hepatitis C, HIV, and LGBTQ+ health care elucidated actionable insights about the ECHO programs and directions in which future evaluations and research might progress. This was a qualitative study following COREQ standards. A trained interviewer conducted 10 interviews and 5 focus groups with 25 unique, purposively sampled ECHO attendees (2 interviews and 1 focus group for each of the 5 programs). Data were transcribed verbatim and analyzed using the general inductive approach, then reviewed for reliability. We identified four major categories (reasons to join ECHO, value of participating in ECHO, ways to improve ECHO, and barriers to participation) composed of 23 primary codes. We suggest that thematic saturation was achieved, and a coherent narrative about ECHO emerged for discussion. Participants frequently indicated they received valuable learning experiences and thereby changed their practice; rigorous trials of learning and patient-level outcomes are warranted. This study also found support for the idea that the ECHO model should be studied for its role in convening communities of practice and reducing provider isolation as an outcome in itself. Additional implications, including for interprofessional education and model evolution, were also identified and discussed.

Comments

Data availability: Please contact the authors regarding availability of the raw data in text format only. Sharing any transcript will be possible pending complete de-identification on behalf of both the participants and the interviewer, as well as removing other details. For reasons of confidentiality, video recordings of interviews and focus groups will not be made available.

Recommended Citation

Jon Agley, Janet Delong, Andrea Janota, Anyé Carson, Jeffrey Roberts & Gerardo Maupome (2021) Reflections on project ECHO: qualitative findings from five different ECHO programs, Medical Education Online, 26:1, 1936435, DOI: 10.1080/10872981.2021.1936435