Project ECHO: A telementoring project launched in Washington, D.C. and Maryland to fight diabetes

In areas of Washington, D.C. and Maryland the prevalence of diabetes is as high as 15 percent in adults. This, coupled with long waitlists at endocrinologist offices, helped to fuel the idea that primary care physicians with advanced training in diabetes could effectively care for complex patients living with diabetes.

Project ECHO -- short for Extension for Community Healthcare Outcomes -- is a telementoring project that targets increased workforce capacity to provide best practice specialty care and reduce health disparities. The heart of the ECHO model is its hub-and-spoke knowledge-sharing networks to conduct virtual clinics with community providers.

Through the Merck Foundation's Bridging the Gap: Reducing Disparities in Diabetes Care grant, the George Washington University (GW) in partnership with La Clínica del Pueblo, launched the first Project ECHO site in the D.C./Maryland region to improve the capacity of care teams to manage complex diabetes cases and establish team-based care review meetings focused on diabetes population health. This site launched in September 2018.

In 2017, La Clínica, a nonprofit serving as a dependable source of integrated health care and health education for more than 8,000 men, women, and children, was selected by the Merck Foundation through a national application process, to be a part of the Bridging the Gap initiative. This initiative aims to bring together the health care sector and others to support innovative approaches to diabetes treatment and management.

"Through Project ECHO, we are conducting a multidisciplinary intervention to target the Latino population to improve diabetes management by empowering primary care providers," said Nicole Ehrhardt, MD, assistant professor of medicine at the GW School of Medicine and Health Sciences and one of the GW faculty involved with the grant.

Through 14 sessions over the course of six months, participants will learn through case presentations how they can approach diabetic patients with complex diagnoses. Ehrhardt said 10 GW physician assistant students also are involved. The students are attending sessions and at the end will share how comfortable they feel about their ability to manage diabetes when they start their own independent clinical practice in a year. The goal is to offer the diabetes ECHO training sessions to many more local primary care providers in D.C. and Maryland and also more GW students over the next four years.

"ECHO will strengthen our delivery of care and ultimately help our patients," said Ricardo Fernandez, MD, chief medical officer at La Clínica.

Through this initiative, La Clínica aims to strengthen its delivery of diabetes care through practice transformation strategies, and conduct multilevel and inter-sectoral interventions to reduce health disparities and improve population health in the Latino community. Project ECHO will improve health outcomes and increase access to quality diabetes care for Latinos with Type 2 diabetes in the Washington, D.C. metropolitan area.

The D.C./Maryland program joins 14 other Project ECHO sites across the country focused on endocrinology and diabetes.

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