Project ECHO Program Cut Hospital Admissions Among Diabetics by 44%

A Project ECHO telementoring program that involved primary care providers resulted in a decrease in hospitalizations among Medicaid patients with diabetes, according to a new study.

Project ECHO (Extension for Community Healthcare Outcomes) is a collaborative medical education and care management model that uses video technology to train and support providers. The goal is to increase access to specialty care in rural and underserved areas.

Published in Medical Care, the study evaluated one of the Project ECHO programs operated by Rutgers Robert Wood Johnson Medical School (RWJMS) that focuses on diabetes and other endocrine diseases, known as EndoECHO. The program enables participating primary care providers to learn and collaborate on diabetes care in a virtual space.

Working independently of the RWJMS Project ECHO team, researchers at Rutgers Center for State Health Policy examined five years of New Jersey Medicaid claims data to compare outcomes of 1,776 Medicaid patients who received care from 25 providers participating in the EndoECHO program with outcomes of 9,126 Medicaid patients who received care from 119 providers who did not participate in the program.

They found a 44.3 percent drop in inpatient admissions among Medicaid patients with Project ECHO providers compared with their counterparts.

Further, researchers observed a 61.9 percent reduction in inpatient spending among Medicaid patients whose providers participated in Project ECHO compared with the control group.

"We find evidence that Project ECHO participation was associated with large and statistically significant reductions of inpatient hospitalization and spending," the study authors concluded.

To gain a more comprehensive understanding of the effectiveness of Project ECHO, future studies in this area should include larger groups of providers and patients as well as additional health conditions, according to researchers.

But "this evaluation shows promise for these programs," said Mary M. Bridgeman, PharmD, a clinical professor at Rutgers Ernest Mario School of Pharmacy and Rutgers EndoECHO program co-lead, in the news release. "Further study of the effectiveness of telementoring models for improving patient outcomes would be of great value."

Project ECHO was developed by Sanjeev Arora, MD, a liver disease specialist at the University of New Mexico Health Sciences Center in Albuquerque, in 2003, and the Robert Wood Johnson Foundation began funding the project in 2009. There are currently 175 ECHO hubs operating across 46 states in the US.

The collaborative model was also deployed to support the response to the COVID-19 pandemic.

For example, in May 2020, the Oklahoma State University Center for Health Sciences launched the Project ECHO COVID-19 service line with more than 150 participating providers. The goal was to help rural providers better understand COVID-19 care.

Further, the Agency for Healthcare Research and Quality launched the AHRQ ECHO National Nursing Home COVID-19 Action Network in partnership with the University of New Mexico's ECHO Institute and the Institute for Healthcare Improvement to provide free training and mentorship to nursing homes as the pandemic spread.