Experts face off over the potential impact of ECHO

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ECHO has gained widespread support over the years, but is it living up to its hype?

Is the hype surrounding Project ECHO shrouding the limitations of the program, or are we just beginning to see its true impact? That depends on who you ask.

One of the developers of the Expanding Capacity for Health Outcomes (ECHO) model, designed to virtually connect primary care providers with specialists to improve treatment of complex health conditions, defended the program against criticism that the evidence supporting ECHO’s framework had been outpaced by the early enthusiasm, and that it may not have a substantial impact on specialized care.

In a Health Affairs Blog post, Sanjeev Arora, the director of Project ECHO, argued that although enthusiasm has “spurred tremendous momentum for ECHO,” a growing body of evidence demonstrates the model’s impact on patient care. Arora added that a manuscript is currently in preparation that will show a broader impact on Medicaid patients, adding that ongoing research will catch up to early enthusiasm.


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So far, Project ECHO has trained hundreds of doctors in 30 states and 15 countries for more than a decade.

His defense of the program came in response to criticisms outlined by Christopher Langston, vice president of healthcare services at the Aging in New York Fund. In a Health Affairs Blog post, Langston admitted to feeling like “the skunk at a party” in critiquing Project ECHO, but he questioned whether the model’s initial target—treating an outbreak of Hepatitis C cases in the 1990s—was transferrable to other illnesses.

“Despite the exciting results of the ECHO study of Hep C, it represents a very, very special case looking at outcomes of an ‘educational intervention’ among providers who had never attempted to treat a particular condition before,” he wrote. “There are good reasons to believe that ECHO will not be similarly effective when extended to most of the conditions that have been proposed.”

The model has gained momentum over the last year culminating in a new law aimed widespread adoption of the framework to improve access healthcare in rural areas by connected providers through telehealth platforms.

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