Project ECHO demonopolizes knowledge from expert specialists in academic centres to healthcare professionals in rural areas

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Physicians working in rural areas face challenges to keep up-to-date knowledge and skills, to form a community of practice to share resources, and to collaborate interprofessionally. Continuous medical education is available to doctors in the form of conferences, small group discussions, self-learning, and online accredited activities. However, these are usually not directly and immediately applicable to the complex problems that physicians encounter in practice. Project Extensions for Community Healthcare and Outcomes (ECHO) uses weekly sessions of videoconferences where an interprofessional group of specialists (the hub) is available to healthcare professionals working in rural, remote, and underserved areas (the spokes) to exchange knowledge. During these sessions, one member of the hub gives a short didactic presentation, followed by spokes who present their most challenging cases to the whole community for discussion and recommendations. ECHO was developed at the University of New Mexico for treatment of hepatitis C virus infection in 2004, and started in Canada for chronic pain and opioid stewardship in 2014. Research has shown that ECHO is effective in improving spokes’ knowledge and to increase access to specialist care in remote areas. ECHO has expanded to 150 partners in the United States, 14 in Ontario, and internationally to 33 countries.