Air force diabetes center of excellence Project ECHO: Successful telemedicine with a global reach

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779-P - Air Force Diabetes Center of Excellence Project ECHO: Successful Telemedicine with a Global ReachView session detail Author Block: RICHARD DAVIS, TOM SAUERWEIN, CONNIE MORROW, NINA WATSON, MARK TRUE, San Antonio, TX The U.S. Air Force Medical Service (AFMS) provides primary and specialty care to > 50,000 active duty, retired, and family members worldwide with diabetes. Only nine active duty staff endocrinologists are available to provider specialty support to the primary provider force. Because of the geographic separation of Military Treatment Facilities (MTFs) -including remote locations - and frequent provider reassignment, standardized education and continuity care can be difficult. In 2012, the U.S. Air Force Diabetes Center of Excellence (DCoE) created a continuing telemedicine education venue based on the Project Extension for Community Healthcare Outcomes (ECHO) model. It provides up to date provider education on a variety of diabetes care topics and real time patient case management. Following three years of feedback and a 22% annualized growth rate, our program now reaches 54 independent MTFs in 25 states and several international sites. Using a participant questionnaire based on a Likert scale (0 - strongly disagree, 5 - strongly agree), we assess clinical knowledge and confidence of a given topic pre- and post-presentation. We also use this scale to determine likelihood for practice change, appropriateness of education delivery, and presentation quality. Individual participant feedback Likert scores were averaged following each presentation since program inception. Annualized averaged knowledge and confidence score improvements were consistently greater than 20%, peaking at 34% in 2013. Paired one-tailed hypothesis t-testing showed significance at a p value < 0.00001. Annualized averaged likelihood for practice change scores were consistently > 4.08, appropriateness of delivery > 4.61, and presentation quality > 4.82. Given the limited number of AFMS endocrinologists and routine provider turnover, our implementation of the ECHO model improves the providers’ knowledge and confidence by delivering both live diabetes education and case discussion to a growing global network.