Health care providers across the state are now being trained to provide residents in their communities with more specialized treatment for diabetes care, hepatitis C, childhood asthma, dermatology, chronic pain management and autism.

The Missouri Telehealth Network has received $1.5 million in state appropriations to develop and launch the Show-Me Extension for Community Healthcare Outcomes (ECHO) program. ECHO projects are being formed throughout the country, but Missouri is the first state to provide funding allowing for numerous ECHO programs to be offered statewide with a centralized training hub at the University of Missouri.

An ECHO program works by having a panel of experts in various chronic diseases use video conferencing to train and support primary care providers throughout the state.

“ECHO is an added layer to the existing telehealth services in Missouri,” said Karen Edison, M.D., medical director of the Missouri Telehealth Network, director of the Center for Health Policy and chair of the MU School of Medicine’s Department of Dermatology. “By training primary care providers, we are not only increasing access but also the number of patients who will receive treatment. This allows patients in rural areas to receive care without needing to leave their own community.”

Keeping patients close to home for treatment provides added economic benefits for communities. Patients can stay in their local area to have medical tests and lab work completed, or have their medications filled at a local pharmacy, all activities that keep health care dollars local.

The Missouri Telehealth Network is partnering with other health systems and academic medical centers in the state to provide the most robust programs with experts on a variety of health conditions.

The Show-Me ECHO project is a replication of the Project ECHO model developed at the University of New Mexico. Project ECHO has well documented success rates and numerous national and global replication sites.

“In many cases, the patients will now be able to see one physician and get specialized treatment — reducing the variation in care. It is beneficial for both the rural and underserved areas of the state and also urban areas, where there can be a long wait to get an appointment with a specialist,” said Edison. “We’ve also seen that physicians appreciate the interaction with colleagues and access to specialty consultation.”

Because it already has the operation setup in place, the Missouri Telehealth Network will be the training hub for the experts and oversee operational and technical coordination of the project. Trained teams will then lead the ECHO program via video conferencing and the primary care providers will be able to stay in their own communities to take part.

Starting in July, the Missouri Telehealth Network is forming expert teams for six ECHO programs. All of the program topics were chosen based on criteria that highlighted them as common, but complex, chronic and costly diseases.

The chronic pain ECHO project began in October 2014, and the autism project began in March as pilot programs. The endocrinology, dermatology, hepatitis C and childhood asthma projects are all expected to be operational by October.

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