Assessing and Expanding the Evidence Base for Project ECHO and ECHO-Like Models

Findings of a Technical Expert Panel

Published in: Journal of General Internal Medicine, Volume 35, pages 899–902 (2020). doi: 10.1007/s11606-019-05599-y

Posted on RAND.org on June 03, 2020

by Laura J. Faherty, Adam J. Rose, Andre Chappel, Caroline Taplin, Monique Martineau, Shira H. Fischer

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Background

In 2003, Project ECHO (Extension for Community Healthcare Outcomes) began using technology-enabled collaborative models of care to help general practitioners in rural settings manage hepatitis C. Today, ECHO and ECHO-like models (EELM) have been applied to a variety of settings and health conditions, but the evidence base underlying EELM is thin, despite widespread enthusiasm for the model.

Methods

In April 2018, a technical expert panel (TEP) meeting was convened to assess the current evidence base for EELM and identify ways to strengthen it.

Results

TEP members identified four strategies for future implementors and evaluators of EELM to address key challenges to conducting rigorous evaluations: (1) develop a clear understanding of EELM and what they are intended to accomplish; (2) emphasize rigorous reporting of EELM program characteristics; (3) use a wider variety of study designs to fill key knowledge gaps about EELM; (4) address structural barriers through capacity building and stakeholder engagement.

Conclusions

Building a strong evidence base will help leverage the innovative aspects of EELM by better understanding how, why, and in what contexts EELM improve care access, quality, and delivery, while also improving provider satisfaction and capacity.

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