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University of Idaho ECHO Program
The Power of Project ECHO in Idaho . Funded by Health Resources Service Administration (HRSA) COVID CARES and the Northwest Regional Telehealth Resource Center (NRTRC)
Project ECHO (Extension for Community Healthcare Outcomes) is a program replicated worldwide to address regional healthcare concerns. Like Project ECHO programs everywhere, the ECHO Idaho model uses spoke-and-hub video conference dissemination to connect rural FQHC physicians, nurses, counselors, pharmacists and other professionals with specialists in face-to-face, real-time collaborative sessions.
The State of Healthcare in Idaho
Idaho’s need for improved healthcare is urgent. According to the United Health Foundation, the state ranks 50th for practicing physicians per capita, and the entire state is a designated mental health workforce shortage area according to the Health Resources and Services Administration.
“The reality of limited access to specialists means primary care providers must treat patients with complicated conditions, yet, isolation in rural communities can make it difficult for providers to get professional development and support to provide care that follows the most up-to-date standards,” said Lachelle Smith, director of ECHO Idaho. “That’s the gap ECHO Idaho tries to fill.”
Rates of suicide and drug overdose deaths have steadily risen over the last 10 years and in many parts of the state are nearly double the national average, according to the Idaho Department of Health and Welfare. Compounding this landscape, many of Idaho’s healthcare professionals are nearing retirement and recruitment of young professionals to work in rural communities can be challenging.
Andy Bradbury, M.D., a physician and the chief medical officer for the Rexburg Free Clinic, has attended ECHO Idaho sessions since its inception in 2018.
“ECHO Idaho provides new perspective on difficult cases, reinforces some of my conclusions and allows me to proceed with more confidence,” Bradbury said. “I make time for it because it helps me stay in-line with evidence-based medicine rather than risk drifting due to my solo practice in a rural area.”
ECHO Heard Throughout State During Pandemic
When the COVID-19 pandemic began sweeping the nation, ECHO Idaho was already a trusted source of state-specific healthcare information. With infrastructure to host virtual meetings, an experienced staff and an engaged network already in place, ECHO Idaho was able to design a COVID-19 program within two weeks.
“We could plan a high-impact COVID-19 program quickly because of support from the CARES funding in collaborations with the Northwest Regional Telehealth Regional Center (NRTRC) and partners like the Idaho Department of Health and Welfare,” Smith said. “We were intrinsically motivated to deliver facts about the disease to Idaho’s practitioners and administrators so they could make informed decisions on treatment options, infection control, immunizations, variants and more.”
ECHO Idaho’s initial COVID-19 session exceeded attendance records; 730 healthcare providers, educators and state leaders joined virtually or called in ― including Idaho Gov. Brad Little. The series concluded on June 29, 2021 and through those 15 months ECHO Idaho’s COVID-19 series connected 1,153 rural and urban healthcare workers, lawmakers and administrators in 40 of Idaho’s 44 counties. Of those, 875 people were first-time ECHO Idaho participants. ECHO Idaho is looking ahead to introduce series that address healthcare challenges in Idaho such as pediatric autism, geriatric primary care and diabetes.
‘A Community of Knowledge’
ECHO Idaho is a simple yet innovative strategy to overcome healthcare challenges in Idaho and helps providers collaborate and support each other. Patients benefit from better care in their home community, and decreased costs can be realized through less travel time to see specialists, reductions in hospitalizations and unnecessary tests/labs.
“ECHO Idaho helps support the existing workforce to provide top-notch patient care now, helps leverage different disciplines to work together and providers develop camaraderie,” Smith said.
Jeff Seegmiller, EdD, director of the Idaho WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) Medical Education Program at the University of Idaho, echoes Smith’s sentiment.
“I love it when a rural clinician brings a challenging case for review and another ECHO participant on the virtual meeting shares what worked for them in their rural town,” Seegmiller said. “We are discovering that there is a community of knowledge in Idaho, and when clinicians participate in this program, their clinical practice improves. That is the beauty of ECHO.”
Lindsay Lodis, Marketing and Communications Manager, ECHO Idaho
Published July 2021
Oregon Office of Rural Health (ORH)
The Oregon Office of Rural Health (ORH) created an ArcGIS Story Map: Oregon Rural Health Clinic Telehealth: 2020 in partnership with the Telehealth Alliance of Oregon (TAO) and the Northwest Regional Telehealth Resource Center (NRTRC). This work contextualizes and catalogs the health care services that Oregon’s Rural Health Clinics (RHCs) are able to deliver via telehealth. Click here to see this resource.
The Oregon Rural Health Clinic Telehealth: 2020 Story Map will also be available through the Telehealth Alliance of Oregon’s new website when it becomes available early this summer. An announcement will be made when the new site is officially open.
The project was supported by grant number GA5RH37461 from the Office for the Advancement of Telehealth, Health Resources and Services Administration, DHHS through the 2020 Coronavirus Aid, Relief, and Economic Security (CARES) Act to carry out telehealth and rural health activities. HRSA used CARES funding to support the Telehealth Resource Center Program in preventing, preparing for, and responding to COVID-19.
To NRTRC and Program Director Nicki Perisho ,
You have been an invaluable resource for my work as an NP educator at Gonzaga University, an FNP in Idaho, and health care advocate with Nurse Practitioners of Idaho. I look forward to many more collaborations.
With warm regards and gratitude,
Dr. Melanie Nash Gonzaga University
NRTRC and WASCLA partnered to host a webinar on Feb. 11, to introduce the topics of telehealth and language access services. During the webinar, panelists explained how communication challenges were met, what some of the ongoing issues are, and the benefits of telehealth that merit being made permanent. In addition, first-hand reports were shared from hospital systems in Yakima, Southwest Washington, and metro Seattle, as well as examples from an early childhood development program and communication services for deaf and hard-of-hearing clients.
The NRTRC played an important role in helping WASCLA facilitate the webinar and outline the agenda. With more than 70 participants from across the country, this webinar put the challenges and opportunities of language access to the forefront of people’s minds. Both the NRTRC and WASCLA recognize that building connections between community-based organizations and the telehealth sector is vital to achieve health equity goals.
WASCLA is an education and advocacy organization that works to eliminate language barriers to essential services in Washington and nationally, with health and health care as a major focus. Soon after the pandemic struck, WASCLA began hearing about serious problems for residents with limited English proficiency and for deaf and hard-of-hearing people related to to the COVID-19 response. The NRTRC, WASCLA and the National Technology Telehealth Assessment Center will hold a webinar on language assistance services and telehealth platforms. March 16, 2021. For more information, see the WASCLA website at www.wascla.org.
University of Washington/ Harborview Medical Center Behavioral Health Institute (BHI)
On behalf of the University of Washington/ Harborview Medical Center Behavioral Health Institute (BHI), we gratefully acknowledge the Northwest Regional Telehealth Resource Center for its amazing support and collaboration with the BHI during this unprecedented public health crisis created by COVID-19.
To meet this healthcare challenge, front line behavioral health providers across Washington State needed to quickly pivot to provide critical ongoing telemental health and substance use disorder treatment and support. To help these providers be prepared to provide quality telemental health care, the BHI quickly initiated a series of trainings for behavioral health providers designed to provide a telemental health foundation from which these providers would be able to provide a wide range of telemental health services for a broad patient population, especially Medicaid and underserved groups.
For these telemental health trainings to be successful, the BHI Telehealth Training team quickly realized it needed to partner with the NRTRC, who welcomed this partnership and generously offered resources such as subject matter expert guidance and the telemental health toolkit. Without the support of the NRTRC, these initial telemental health trainings would not have succeeded. Because of their support, hundreds of behavioral health providers completed this training and are providing critical mental health care to their patients.
It has been a delight to work with the NRTRC staff. We so appreciate how helpful, incredibly responsive, enthusiastic, and generous with their time they have been in supporting our mutual goals, mentoring BHI leadership, and seeking future opportunities for collaboration.
The Behavioral Health Institute Telehealth Training Team
The Washington State Telehealth Collaborative
The NRTRC has been an invaluable partner to the Washington State Telehealth Collaborative in 2020. In addition to offering support and resources to telehealth practitioners across Washington the NRTRC stepped in and offered their resources to support a state-mandated telehealth training for Washington health professionals. While the Washington State Telehealth Collaborative had the expertise to develop the training content, they did not have the infrastructure to make the training available to health professionals across the state as mandated. When the NRTRC learned of the challenges facing the Collaborative, they generously offered a partnership to help create a training that would meet the stipulations outlined in the bill.
The NRTRC and Washington State Telehealth Collaborative plan to continue working together as partners to support telehealth growth and sustainability in Washington and the Northwest into the future.
The Washington State Telehealth Collaborative
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