Project ECHO NI
Introduction: Project ECHO® (Extension for Community Healthcare Outcomes) http://ECHO.unm.edu is a pioneering telementoring programme developed in the School of Medicine at University of New Mexico (UNM). ECHO model is designed to address the growing demand for secondary care services and is focussed on increasing capacity within primary care, through de-monopolisation of specialist knowledge.
Aims and objectives: Project seeks to develop clinician capacity to safely and effectively treat common, chronic and complex diseases in rural and underserved areas and to monitor outcomes. With the use of video-conferencing technology, participants benefit by sharing evidence-based, best practice guidance, and case-based learning. This hub (multidisciplinary team of experts) and spoke (primary care providers) model has been shown to be an effective way of improving access to specialist supported care and improving patient outcomes.
The ECHO Institute has developed and trained superhubs, who can successfully replicate the ECHO model. In 2014, Northern Ireland Hospice (NIH) was granted the licence to provide this service within Europe and has trained several NI and UK organisations.
Following a successful pilot in 2014-15 with NIH community staff, the NIH is working in collaboration with the Health and Social Care Board (HSCB) in NI to pilot the use of the Project ECHO model in the following areas;
- GP Trainees – Dermatology
- Palliative Care – Nursing Homes
- Palliative Care (Carers)
Results: NIH Community Evaluation Report:
HSC evaluation report; http://echonorthernireland.co.uk/2016/05/echo-ni-evaluation-report/
The quantitative and qualitative findings from both these studies support the use of ECHO in NI by demonstrating statistically significant improvements in knowledge and self-efficacy, replicating findings in other ECHO knowledge networks in the US.
The ECHO model has been proven to be an effective cross-sectoral collaboration tool, building learning communities for services such as palliative care that include private nursing homes.
Project ECHO NI is currently running 20 ECHO Knowledge Networks in 2016-17. They are;
- Acute Eye
- Regional quality improvement & patient/Client safety
- Practice Based Pharmacists via GP Federations
- Nursing Home In Reach
- Prison Healthcare (NI, UK & Ireland)
- Marie Curie
- Outpatient Reform - Dermatology
- Outpatient Reform - Cardiology
- Pain in Palliative Care/ Cancer Pain Northern Ireland & Liverpool
- Mental Health Trauma Network
- Regional Child & Adolescent Mental Health Services
- Outpatient Reform – Gynaecology
- Palliative Care – SE Trust
Conclusions: As a low-cost high-impact model, ECHO can be adapted to meet the needs of different communities and populations. At a time when healthcare providers are under mounting pressure to do more and spend less, this model provides an affordable solution to addressing growing need in the UK in training and supporting healthcare professionals.
Project ECHO is a tool which can support change in service delivery and systems integration and is a safe space to share knowledge and experience and could therefore be a powerful tool for creating new governance and learning opportunities.
McMullan Á, Watson M. Project ECHO NI. International Journal of Integrated Care. 2017;17(5):A468. DOI: http://doi.org/10.5334/ijic.3788