Project ECHO: Enthusiasm Overtakes Evidence

Project ECHO (Extension for Community Healthcare Outcomes) is a popular model for improving patient outcomes through provider education, which has grown rapidly since its initial success in the treatment of Hepatitis C. Recently, the U.S. Senate passed the ECHO Act, calling for the Secretary of Health and Human Services to examine the model and implicitly to spread it through existing programming. Unfortunately, the evidence of the benefits of ECHO appear to be far more limited than is generally understood and we are in substantial danger of making public policy decisions without adequate clinical results, much less cost-effectiveness information. Continuing education as a path to improved health outcomes is an attractive theory, especially to experts in a field who have gone through years of additional training to get their expertise. They imagine that if others had gone through their training, that things would get better. However, the evidence for the benefits of continuing education on outcomes is less than clear. More subtle and less modifiable forces also play a role — interest, design of the practice setting, and incentives. In my career at health foundations seeking to improve the health of older Americans, again and again we assumed that “if we built it (an educational program), they would come,” and they didn’t. And, even when they did, translating new knowledge into action in a complex medical practice was daunting, and sustaining change in the face of ...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Featured Health Professionals hepatitis C Physicians Primary Care Project ECHO Source Type: blogs