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ECHO: Expanding community-based treatment for opioid use disorder

projectechoWith the breakneck speed at which health care research is advancing, it’s logical to argue that medical knowledge is outpacing medical practice, especially in behavioral health. That’s why it’s important for Beacon Health Options (Beacon) to seek out the tools health professionals need to stay abreast of the latest advancements in evidence-based care.

That pursuit led Beacon to become a partner in one of the more innovative health care projects in the country – Project ECHO (Extension for Community Healthcare Outcomes).

Recently, we traveled to Albuquerque, New Mexico, to Project ECHO’s home. During a three-day ECHO orientation and immersion program held at the University of New Mexico (UNM), I and two colleagues sat shoulder-to-shoulder with health professionals from across the globe. Together, we learned about the health care model recognized as a national model for delivering care in underserved communities with the November 29th passage of the Expanding Capacity for Health Outcomes Act.

What is Project ECHO?

Initially founded at UNM to bring Hepatitis C care to community clinics in rural New Mexico, Project ECHO revolutionizes how community providers manage specialty conditions. Its mission is to disseminate knowledge previously held only by specialists so community-based providers can better treat specialty conditions, especially in those areas where access to care is limited.

At its core, the ECHO model is this: Interdisciplinary teams of experts connect with primary care or other community clinicians through teleECHO clinics, in which the experts mentor participating clinicians in a “case-presentation” model – a model that relies on the clinicians’ actual cases to illustrate best practice through mentoring, guidance, feedback and traditional lectures. As a result, participating clinicians gain the knowledge and skills to manage complex cases and deliver evidence-based care in their own health centers.

Where can the ECHO model be applied?

Since its initiation in 2003, ECHO has expanded to include many partners to address many disease areas. Our immersion session alone boasted a diverse set of geographical participants: health professionals from Washington to Mississippi, and as far-reaching as sub-Saharan Africa and the Australian Outback.

The target disease areas were no less diverse: osteoporosis, youth mental health, ADHD, and the Zika virus are just some of the conditions for which groups are seeking to improve community care. Because ECHO is an ongoing learning network – not a patient care clinic – the clinics are all different based on the focus, style, and individual team members and needs of participants.

How will Beacon use ECHO?

Beacon is excited to leverage ECHO in improving access to evidence-based treatment for opioid use disorder (OUD) in community settings, with a focus on medication-assisted treatment. It’s innovative and groundbreaking, and the time is right. Landmark events in 2016, such as the launch of the U.S. Surgeon General’s Turn the Tide campaign and the signing of the Comprehensive Addiction and Recovery Act (CARA), position our health care system so that commitment and capacity to treat those with OUD are aligned at an all-time high.

Still, there are significant barriers and knowledge gaps that prevent providers from prescribing medications with treatment. A study in the Journal of Substance Abuse Treatment found that the average physician with a waiver to prescribe buprenorphine was currently treating only 26 patients, and some waivered physicians took on no patients at all. By launching an ECHO hub focused on training primary care providers and other community practitioners, Beacon strives to grow the network of clinicians who can effectively manage the holistic treatment of these complex patients.

We won’t make a dent in the opioid epidemic without the commitment from primary care and behavioral health clinicians alike to treat patients with OUD. Beacon’s commitment is to provide the mentorship and support they need to do so effectively. ECHO provides a proven, innovative model for doing just that.

To learn more about Project ECHO, watch this two-minute introduction or this TED talk by founder Dr. Sanjeev Aurora.

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