In our current healthcare system, the interests of hospitals and clinics don’t always align with the interests of patients, but healthcare providers shouldn’t feel penalized for doing right by those who require their services.
That was the message that UNM Hospital doctors had for U.S. Sen. Tom Udall, D-NM, during a visit on Wednesday.
The senior senator from New Mexico received an update on Project ECHO, an internet video conference-based “telehealth” service aimed at revolutionizing medical education and reducing healthcare disparities in hard-to-reach, rural areas by “moving knowledge instead of patients,” said Sanjeev Arora, the project’s founder.
“There needs to be a change in the system,” Arora said. “Getting the right knowledge is key, but we need a change in the way we think about healthcare.”
The mission is to “democratize” medical knowledge and provide quality care to underserved people “all over the world,” Arora said, adding that their goal is to “touch the lives of 1 billion people” by 2025.
Udall supported the Expanding Capacity for Healthcare Outcomes (ECHO) Act in Congress, which unanimously passed in the Senate last month, and said he will be closely monitoring the proceedings surrounding U.S. Rep. Tom Price — President-elect Donald Trump’s nominee for health secretary.
Price, R-GA, is a staunch opponent of the Affordable Care Act, and a vocal supporter of the “sketchy, chaotic” repeal-and-replace methodology, Udall said.
Arora said the primary beneficiaries of Project ECHO are people who happen to depend on federal health care assistance.
“if you take away Medicaid dollars, it has the risk of destabilizing this,” he said. “Unless another revenue stream is brought to make them whole, it’s a risky thing.”
From the start, the initiative showed a lot of potential, Udall said, adding that “a little bit of seed money can go a long way.”
Through Project ECHO, Arora said UNMH might have the leading substance abuse treatment program in the world right now, sharing his vision for treating opioid addiction in the whole country using the model.
ECHO is now in 30 states across the nation, and 20 countries around the world, mostly at universities, Arora said. There are also partnerships with the Department of Defense and Center for Disease Control, as well as dozens of others in the works.
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Healthcare providers are only going to get “a certain amount of dollars,” Udall said, “but adopting ECHO principles means you make those dollars go a lot further, right? You’re able to get better care expanded to more people.”
Arora, a liver specialist, came up with the idea when a Hepatitis C epidemic hit rural parts of New Mexico and the demand for his expertise exceeded accessibility, he said, but Project ECHO now serves 57 different types of disease, all over the world.
After first putting the project to the test, the wait time to get into his clinic was reduced from eight months to two weeks, Arora said.
Providing care through the Hepatitis C crisis helped Arora and his team in developing the model for Project ECHO, by taking expert training imparted at leading medical schools and sharing it with family doctors and community clinics in rural, underserved areas.
“We give them our software, and then we conduct these clinics,” Arora said, before demonstrating a Project ECHO video conference. “They (rural medical practitioners) become experts through a process we call learning loop — learning from us, learning from each other.”
Jovanna Ochoa, a family nurse practitioner at Presbyterian Medical Services in Alamogordo involved in cardiology, said that in her short time utilizing ECHO she found it to be “a wonderful help to have these resources out here in the middle of nowhere.”
In a survey, an overwhelming percentage of participants felt that ECHO was mutually beneficial, good for both patients and providers, he said.
In an outcome study published by the New England Journal of Medicine, Project ECHO essentially demonstrated that rural doctors could provide the same level of care as university specialists, Arora said.
Diseases like chronic pain, arthritis, substance abuse and mental health disorders, which can affect more than a quarter of our population and are lacking in expert treatment capacity, are something of a “sweet spot” for the model, he said.
“If you don’t have the right knowledge, in the right place, at the right time, there’s no chance of getting the right care,” Arora said. “We’re very happy with what we’re doing, but we’ve only scratched the surface."
Udall said he has long been a proponent of “patient-centered, team-approach” healthcare.
“All of this is in the same box, however you say it, that’s the direction we need to go,” he said of the shift away from the “fee-for-service” model of healthcare. “We want to build on what you have.”
Johnny Vizcaino is a news reporter for the Daily Lobo. He can be reached at news@dailylobo.com or on Twitter @thedailyjohnnyv.
