FAME (Fundamentals of addiction medicine teleECHO clinic): Expanding SUD treatment access

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ntroduction: Substance use disorders (SUDs) are rampant in primary care and general psychiatry patients, yet many providers feel ill-prepared to address these problems effectively. The ECHO Institute and ASAM, with support from the Center for Substance Abuse Treatment, conducted a 16-week pilot national teleECHO program using the ECHO model (video-conferencing and case-based learning) to train and mentor these providers in the treatment of SUDs.

Methods: The FAME teleECHO clinic was facilitated by an Internist/Addiction Medicine faculty member (MK) and an addiction counselor/social worker (AM) at the University of New Mexico Health Sciences Center in Albuquerque. Learners and guest faculty joined via secure video conferencing software to participate in 16 2-hour weekly learning sessions. ASAM Addiction Medicine faculty joined the teleECHO clinic from around the US and Canada to provide brief didactic presentations and act as guest case discussants. Learners were recruited from among participants in ASAM's day-long Fundamentals of Addiction Medicine precourse that was offered at the 2014 and 2015 Annual Meetings. Twenty-six of these invited learners participated in the teleECHO program, presenting de-identified patient cases from their practices and participating in a group discussion of cases presented by others. Learners included physicians, NPs, PA's and counselors. The invited learners brought 17 additional colleagues and trainees with them. Participants came from all over the US and from Canada. They joined a mean of 7 2-hour weekly sessions (range 1-15), and each participant presented at least 1 case. Participants who claimed CME credit were asked to complete several brief questions about their experience.

Results: Among participants who reported presenting a patient case during that day's teleECHO clinic, 90% reported that the input they had received had changed their care plan for the patient they presented. They rated the value of the clinical input they received as 4.6 on a 5-point scale. When asked about the impact of the group discussion regarding patients presented by other participants, 89% said they learned something new during the discussion, and 84% said it would be useful in caring for their patients. Participants reported learning about a wide range of topics including accurate diagnosis, use of medication therapies, communication/brief counseling techniques, and stigma.

Conclusions: The FAME teleECHO clinic engaged experts and learners from across North America. It is a popular and effective way to engage primary care providers and general psychiatrists in improving their ability to treat SUDs.