Expanding access in rheumatology specialty care in New Mexico via an innovative community outreach program

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Background/Purpose: The main objective of this innovative programi s to provide training to Primary Care Clinicians (PCCs) in rural communities so they can provide best practice care to patients with rheumatologic disorders.

Methods::The Rheumatology TeleECHO Clinic uses state-of-the-art technology to link PCCs with the Rheumatology Specialist here at University of New Mexico (UNM). Weekly clinics consist of short didactics, patient case presentations, and open discussions. In order to evaluate the effectiveness of the program, PCCs were given a pre and post self-efficacy survey. Eligibility criteria to participate in the survey included: attend three or more rheumatology TeleECHO clinic sessions or attend an on-site training session with Rheumatology clinic staff, participant completed 50% of questions on either the pre or post survey, and participant is not a TeleECHO clinical facilitator.

Results: Participation in the Rheumatology TeleECHO clinic has improved access to care for patients with rheumatologic disorders as well as improved self-efficacy of PCCs providing specialty rheumatologic care. There was a small but significant increase in overall self-efficacy from pre to post survey evaluation.

Conclusion: Since the induction of the program, 18 Centers of Excellence for Rheumatology have been established throughout New Mexico. A Center of Excellence is defined as a PCC who attends the two-day clinical training at UNM Rheumatology Clinic, who presents10 individual cases to the Project ECHO™ Rheumatology TeleECHO Clinic and who is recognized in their local communities as a PCC with competence in rheumatologic care. To date, there have been 99 clinics held, with 1,265 attendees, and 644 patient case presentations. In addition,28 primary care clinicians have attended the two day training program at UNM Rheumatology Clinic. In partnership with the American College of Rheumatology, providers were given the opportunity to enroll in the Advanced Rheumatology Course (ARC). A total of 25 providers have enrolled. As of today, 16 providers have graduated; nine other clinicians are actively working to complete the 16 modules. Project ECHO’sTeleECHO Rheumatology clinic is an innovative approach that brings greater access for all patients in New Mexico.