Project ECHO: Bringing palliative care consultation to rural New Mexico through a novel telemedicine format

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Objectives 1. Discuss feasibility of a telemedicine curriculum to educate rural primary care providers about palliative care. 2. Present results on provider satisfaction, patient outcomes and feasibility. 3. Discuss applicability to other regions in the country. Background. NewMexicoisanethnicallydiverse, poor state, and access to hospice and palliative care in rural settings is limited. The Extension for Community Healthcare Outcomes (ECHO) model was developed by the University of New Mexico (UNM) Health Sciences Center as a platform for both delivery of services and outcomes research, with the goal of improving access to care for underserved populations with complex health problems. With the use of video-conferencingtechnology,theECHOprogramtrainsprimary care providers to treat complex diseases. Outcomes of healthcare provided through ECHO are similar to outcomes of care provided inacademicsettings.Thisformatisbeingusednationally and internationally as a new model for providing highqualitycostefficientcare, offering access to specialty care that is usually restricted to urban areas with academic centers, and reducing isolation of providers in rural settings. Research Objectives 1. Determine feasibility provider of a Palliative Care ECHO Clinic. 2. Determine provider satisfaction and assess changes in self efficacy. Method. A Palliative Care ECHO clinic was initiated at UNM in April 2011. An interdisciplinary team broadcasts a two-hour conference every other week involving multidisciplinary health care providers through the state of New Mexico, consisting of a short didactic, case presentations from participating providers, and case discussion and recommendations provided by the UNM IDT. Result. Feasibility was demonstrated. Provider satisfaction was high. Self-efficacy improved. Sense of isolation decreased. Conclusion. The Palliative Medicine ECHO clinic at the University of New Mexico has demonstrated a new model for training rural primary care providers in care for patients at end of life. Implications for Research, Policy, or Practice. This program can serve as a model for training of mid-career clinicians dealing with patients at end of life, and expansion of this model to other regions in the country will be discussed.