Category: Other - Healthcare Disparities

Monitor: 34

34 - ENDO ECHO REDUCES HEALTH DISPARITIES BY BRIDGING GEOGRAPHICAL BARRIERS FOR PATIENTS WITH COMPLEX DIABETES AND OTHER ENDOCRINE CONDITIONS IN MEDICALLY UNDERSERVED AREAS

Thursday, Apr 25
12:00 PM – 12:30 PM

Objective :

Rural patients with complex diabetes are distinctly vulnerable to health disparities, a problem worsened by the national shortage of endocrinologists. Project ECHO (Extension for Community Healthcare Outcomes) is an education model that leverages videoconferencing technology to connect specialists with primary care providers (PCPs) in medically underserved communities in order to build new capacity for specialty level care through case based learning and best practices dissemination. We previously reported that application of the ECHO model to complex diabetes care (Endo ECHO) improved PCP and community health worker (CHW) self-efficacy. We now report the impact of Endo ECHO on travel distance for patients in rural New Mexico seeking endocrine care.  


Methods :

We partnered with PCPs and CHWs at 10 federally qualified health centers (FQHCs) across New Mexico who participated in weekly ECHO videoconferencing sessions. Participants presented de-identified patients over the ECHO network and received best practices guidance from a multidisciplinary team of specialists and other network peers. Presentations were tracked using iECHO software from November 2014 through June 2018 in order to estimate miles saved between the FQHC and the referral center in Albuquerque, NM. IRS medical rates and US Census median household income data were applied to estimate savings from travel cost and work productivity loss respectively.


Results :

During the evaluation period, we received 538 patient presentations over the network. On average, 300 miles of travel distance were saved per patient presentation, for a total of 159,908 miles. We estimated a savings of $28,784 from travel costs and $93,231 from work productivity loss.         


Discussion : Use of Endo ECHO to connect rural health care providers to specialists had a positive impact in reducing travel distance for patients in underserved areas. Ongoing evaluation of patients enrolled in the Endo ECHO program will determine to what extent clinical outcomes are affected by improving access to care in these communities


Conclusion : Application of the ECHO model to complex diabetes and endocrine care in New Mexico bridged geographic barriers to care for patients in medically underserved communities.

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Rachana Thapa

Endocrinology and Metabolism Fellow
Univ of New Mexico School of Medicine
Albuquerque, New Mexico

Endocrinology fellow (Yr 1) at University of New Mexico School of Medicine

Jessica Kirk

Nurse Manager
Univ of New Mexico Health Sciences Center

Nurse Manager, Endo ECHO. Univ of New Mexico Health Sciences Center

Cynthia Chavez

Community Health Worker trainer
Univ of New Mexico Health Sciences Center

Community Health Worker trainer, Univ of New Mexico Health Sciences Center

Nathan Troyer

Program Planning Manager
Univ of New Mexico Health Sciences Center

Program Planning manager, Univ of New Mexico Health Sciences Center

Matthew Bouchonville

Medical Director, Endo ECHO
Univ of New Mexico School of Medicine

Medical Director, Endo ECHO, Univ of New Mexico School of Medicine