Telementoring With Project ECHO: A New Era in Diabetes-Related Continuing Education for Primary Care to Address Health Disparities

Author:

Ehrhardt Nicole1ORCID,Bouchonville Matt2,Peek Monica E.3,Thomas Celeste C.4,Zou Tracy1,Cuttriss Nicolas5ORCID,Desimone Marisa6,Weinstock Ruth S.7ORCID,Baer Linda G.8ORCID,Gabbay Robert A.9

Affiliation:

1. Division of Endocrinology, Diabetes and Metabolism, University of Washington Diabetes Institute, Seattle, WA, USA

2. Division of Endocrinology, Diabetes, and Metabolism, School of Medicine, University of New Mexico, Albuquerque, NM, USA

3. Section of General Internal Medicine, Chicago Center for Diabetes Translation Research, The MacLean Center for Clinical Medical Ethics, and The University of Chicago, Chicago, IL, USA

4. Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism, The University of Chicago, Chicago, IL, USA

5. ECHO Diabetes Action Network, ENDO Diabetes & Wellness, Washington, DC, USA

6. Endocrinology, Diabetes and Metabolism, Joslin Diabetes Center, and SUNY Upstate Medical University, Syracuse, NY, USA

7. Endocrinology, Diabetes and Metabolism, Clinical Research Unit and Joslin Diabetes Center, and SUNY Upstate Medical University, Syracuse, NY, USA

8. ECHO Diabetes Action Network, Cambridge, MA, USA

9. American Diabetes Association, Arlington, VA, USA

Abstract

Project ECHO® is a telementoring workforce development model that targets under-resourced communities lacking access to specialty care. The model builds virtual communities of practice, including specialists and community primary care professionals (PCPs) to combat clinical inertia and health disparities. While the ECHO model has gained global recognition, implementation of the model related to diabetes is lagging compared to other specialty conditions. This review highlights diabetes-endocrine (ENDO)-focused ECHOs using data reported in the ECHO Institute’s centralized data repository (iECHO) and the learning collaborative for diabetes ECHOs. It also describes the implementation of diabetes ECHOs and their evaluation. Learner and patient-centered outcomes related to diabetes ECHOs are reviewed. Program implementation and evaluations have demonstrated utility of the ECHO model for diabetes programs to (1) address unmet needs of diabetes care in the primary care setting, (2) improve knowledge and confidence in managing complex diabetes and change provider prescribing habits, (3) improve patient outcomes, and (4) address diabetes quality improvement practices in primary care. More studies with broader collaboration among sites are needed to evaluate the model related to diabetes, especially applied to addressing therapeutic inertia, adoption of diabetes technology, and reducing health disparities.

Funder

Merck

NIDDK P30 grant:

Merck Company Foundation

Novo Nordisk Foundation Center for Basic Metabolic Research

Leona M. and Harry B. Helmsley Charitable Trust

Publisher

SAGE Publications

Subject

Biomedical Engineering,Bioengineering,Endocrinology, Diabetes and Metabolism,Internal Medicine

Reference67 articles.

1. Changes in Diabetes-Related Complications in the United States, 1990–2010

2. Centers for Disease Control and Prevention. National diabetes statistics report 2020 [Internet]. Department of Health and Human Services. Date unknown. https://www.cdc.gov/diabetes/data/statistics-report/index.html. Accessed September 24, 2022.

3. HEDIS Measures. Comprehensive diabetes care [Internet]. National Committee for Quality Assurance. https://www.ncqa.org/hedis/measures/comprehensive-diabetes-care/. Date unknown. Accessed September 24, 2022.

4. American Diabetes Association. Overcoming therapeutic inertia [Internet]. Date unknown. https://www.therapeuticinertia.diabetes.org. Accessed September 24, 2022.

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