Article submitted by Dr Dana Newcomb, Medical Director – Integrated Care at Children’s Health Queensland
Children’s Health Queensland Hospital and Health Service (CHQ) has cemented itself as a leader in health service innovation by establishing a Project ECHO® Hub site at the Lady Cilento Children’s Hospital in Brisbane. Through the ECHO® Hub, CHQ trains general practitioners (GPs) and other health care providers in the management of chronic and complex paediatric conditions.
Project ECHO® is an innovative model of telementoring and case-based learning, designed to ‘democratise medical knowledge’ and deliver contemporary, best practice medical care to patients in communities that lack ready access to specialists. Whether the difficulty accessing specialists is due to remoteness, poverty, cultural barriers or other factors, ECHO® helps to address the inequity faced by those patients.
Through videoconference technology and a structured case-presentation format, local healthcare providers including nurses, community health workers and GPs are mentored by experts in metropolitan centres to deliver specialist-level care.
The ECHO model™ is new to Australia, but has been in use overseas since 2003. It was originally developed at the University of New Mexico to train rural community healthcare workers to treat patients with hepatitis C. It was hugely successful, and in 2011 a landmark study published in the New England Journal of Medicine showed that hepatitis C treatment delivered by ECHO®-trained primary care providers was as safe and effective as that provided by specialists in academic medical centres.
This ground-breaking research led to the spread of the ECHO model™ to other complex medical conditions, and other regions of the world. From the original Hub in Albuquerque, New Mexico, ECHO® now operates from over 170 Hub sites, in 23 countries, for the management of more than 50 complex conditions including substance misuse, mental health disorders, diabetes and end-of-life care.
How does it work?
ECHO® is a hub and spoke model of education, based on the principles of ‘all teach and all learn”. A specialist team at the ‘hub’ mentors primary care providers, including GPs, at the ‘spokes’, and all participants learn from each other. The GPs share their deep knowledge of local social and cultural considerations, and an understanding of realistic approaches to care within their specific community. The specialists offer complementary content expertise.
Over time a virtual ‘community of practice’ or ‘knowledge network’ develops and the knowledge and self-efficacy of GPs to manage complex conditions increases.
Can it work in Australia?
Children’s Health Queensland Hospital and Health Service (CHQ) is a replication partner of the University of New Mexico, and the only organisation authorised to employ the ECHO model™ in the care of children and young people in Australia.
In May 2017, CHQ launched its first teleECHO™ series to train GPs to manage children and young people with ADHD. That series has continued, and as of April 2018, CHQ had trained 40 GPs, as well as several nurse practitioners and allied health providers. Pilot data shows the model is effective, with a statistically significant increase in GP knowledge and confidence in all aspects of ADHD management.
GPs also report a high degree of satisfaction with the model and enjoyment of this form of learning. Participants are able to access continuing medical education points, and GPs who present a case to the expert panel can claim a Medicare case conference item number.
In February 2018, CHQ launched two further teleECHO™ series: a paediatric overweight and obesity series for GPs and a world first paediatric foot anomalies series, training regional and rural physiotherapists to manage babies with congenital foot anomalies.
Given the challenge of providing high quality, safe and effective medical care across Queensland, Project ECHO® is set to continue to expand, improving outcomes for children and young people in all corners of the state.
Interested primary care providers are warmly welcome to contact the Project ECHO® hub to explore opportunities to participate in the growing communities of practice that ECHO® creates.
When are the next Project ECHO series commencing?
- ADHD: Tuesdays 8-9:30 am
- Series 5: 17 April 2018 to 19 June 2018
- Series 6: 17 July 2018 to 18 September 2018
- Series 7: 9 October 2018 to 11 December 2018
- Childhood Overweight and Obesity: Thursdays 8-9am
- Series 2: 19 April to 7 June 2018
- Series 3: 19 July to 6 September 2018
- Series 4: 11 October to 29 November 2018