![]() ![]() ![]() “If it’s RA, we’re using hydroxychloroquine or methotrexate, as well as the combination of biologic agents.” Once ECHO trained, a provider’s reluctance to treat is supplanted by a familiarity with dosing levels and adverse events. “We instruct on the usual paradigms for treatment,” Dr. Following this, the participant’s general medical knowledge is inculcated with rheumatology protocols. This includes a review not only of radiographic evidence but of the increasingly available but sometimes difficult to interpret molecular diagnostics associated with rheumatologic disease. Ben archer radium springs how to#So what is being taught through ECHO? “Early rheumatoid arthritis can be a subtle diagnosis, so my first emphasis is instructing on how to be able to recognize signs,” Dr. The ECHO experience would overcome that barrier. A majority of these connective tissue–disease problems, he estimated, could be handled at a distance by prescribing medications that ordinarily a general practitioner, NP, or PA would be reluctant to use. “My goal was to see to it that the most common rheumatologic patient problems (uncomplicated cases) could be treated at a distance just as well as they could be in my clinic,” Dr. Bankhurst says.Īs with HCV, training in rheumatology would be based on the rudiments of standards of care. Arora about these issues, he very graciously invited me into the ECHO network,” Dr. Bankhurst to see patients who are driving 600 miles round-trip for the privilege, and this after a months-long wait just to get in. “For the next generation, there is going to be an increasing lack of the rheumatology subspecialty most anywhere you go.” Compounding this dearth in New Mexico is distance. Regardless, the average age for rheumatologists here and nationwide is 55 to 60, he notes. Reasons for this vary, although many are financial. “Long ago I recognized the limitation of the rheumatology subspecialty practice throughout the state,” Dr. ECHO RheumatologyĮntering its fifth year in operation, and under the guidance of Arthur Bankhurst, MD, professor of medicine and chief of rheumatology at UNMHSC, the ECHO rheumatology section has made significant inroads down many an unpaved lane. The award, citing the ingenuity of this “one-to-many” knowledge network, included a $5-million grant for the continued operation and expansion of the ECHO program. In August 2007, Project ECHO was one of three winners chosen (out of 300 entrants) to receive the Disruptive Innovation in Healthcare Award, sponsored by the Robert Wood Johnson Foundation. Once word got out, interest in ECHO HCV by rural providers was immediate, the results were excellent, and wider recognition soon followed. “I thought if we could do all four, then we could provide the same level of care in a remote area that we would at the university,” Dr. Third, reinforce training with case-based learning-a mini grand rounds of sorts, but done remotely and fourth, develop tools to assess training outcomes. If they learned how to use it, they would be giving the same quality of care as me,” Dr. “I derived a protocol-the same one I use in my clinic-to share with providers in rural areas. Second, develop standards of practice protocols for the treatment. First, use technology (telephone/Internet) to leverage specialty resources-in essence, telemedicine. The idea was rather straightforward and consisted of four parts. “The question to me was, how do you bring that care to these populations without compromising quality?” The answer: Project ECHO. To do that, he realized he needed to bring nonspecialist providers into the picture. “I had to figure out a way to treat these underserved populations,” Dr. Yet, as with rheumatology, the providers simply weren’t there. “In the prison system alone, there were over 2,000 individuals that were diagnosed at that time, yet not a single one had been treated.” With 30,000 additional HCV patients statewide, the need was obvious. Arora is a gastroenterologist and initially conceived of ECHO in 2002 to address the treatment needs of patients with hepatitis C virus (HCV). This disparity is not unique to rheumatology. Systemic Lupus Erythematosus Resource Center.Axial Spondyloarthritis Resource Center. ![]()
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