Interactive Case-based Postgraduate Medical Education with Bone Health TeleECHO

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Background: Bone Health TeleECHO is a non-profit collaborative medical educational project developed at ECHO Institute at the University of New Mexico Health Sciences Center in association with the Osteoporosis Foundation of New Mexico. It uses videoconferencing technology to link healthcare professionals interested in achieving an advanced level of knowledge about the evaluation and treatment of osteoporosis and metabolic bone diseases. Weekly online sessions have been held since October 2015. Participants use videoconferencing technology with a computer or smartphone for discussion of real de-identified patient cases, with brief didactic presentations on topics of interest. Bone Health TeleECHO has been shown to improve self-confidence of healthcare professionals treating patients with osteoporosis. The ECHO model of learning aims to improve the care of patients with osteoporosis and reduce the osteoporosis treatment gap.

Methods: Online registration captures the demographics of Bone Health TeleECHO participants. Attendance is tracked for each session. Electronic queries record anticipated changes in the clinical practice. A self-efficacy assessment questionnaire retrospectively evaluated the effect of the intervention on confidence in managing patients with osteoporosis.

Results: During the first 24 months of weekly Bone Health TeleECHO, 224 individuals attended at least 1 online session. Of those who attended at least once, 115 (51.3%) were classified as physicians (MD, DO, DC), 53 (23.7%), advanced practice providers (PA, CNP, RN, CNM), 43 (19.2%), other (PT, OT, PhD), and 13 (5.8%) unknown. Number of Bone Health TeleECHO clinics attended ranged from 1 to 79, with a mean of 10.2. There were 36 learners (excluding faculty) who attended more than 20 TeleECHO clinics and 29 who attended more than 30. Attendees were located in 37 US states plus 8 other countries. Two additional TeleECHO programs devoted to skeletal health, based in Michigan and Washington, DC, were established in 2017.

Summary: Bone Health TeleECHO educates healthcare professionals to provide better care, closer to home, with greater convenience, and lower cost than referral to a specialty center. It relieves professional isolation that may occur in urban as well as rural settings. Bone Health TeleECHO can be scaled to any level through replication in other US states and other countries.