A Novel Adaptation to the Extension for Community Healthcare Outcomes (ECHO) Model

Allison Costello; Ariel Kiyomi Daoud; Cleveland Piggott; Mark Earnest

doi:10.1370/afm.2691

THE INNOVATION

We formed a research team to work alongside ECHO (Extension for Community Healthcare Outcomes) Colorado, to meet the Colorado primary care community’s need for up-to-date information about COVID-19. ECHO is a model that connects experts in academic medicine with community primary care counterparts.¹ By facilitating dynamic question-and-answer (Q&A) sessions, data collection, and rapid turnaround presentations, we, as the research team, allow ECHO Colorado to provide real-time responsive learning to clinicians on the front lines of the pandemic.

WHO AND WHERE?

A group of 3 medical students, 4 family medicine residents, and 2 residency faculty from the University of Colorado created a research team to work alongside ECHO Colorado. Our support occurs remotely as the 3-times-a-week sessions are delivered via videoconference.

HOW?

Our team has 4 objectives: facilitating Q&A for each session, creating 1-page summaries of each session, collecting data from post-session surveys to inform future topics, and researching particular topics and presenting the results.

Question and Answer

For each session, members of our team gather and synthesize audience member questions and facilitate a question and answer session with the presenters. Our team members also identify unanswered questions, follow-up with the presenters, or conduct additional research to ensure the answer is documented in the post-session summary.

One-Page Summaries

The research team posts 1-page session summaries of the meeting content, including the session’s questions and answers. The overviews are disseminated to all ECHO registrants along with relevant resources.

Data Collection

The ECHO team poses in-session questions to participants about their clinical practice and experiences related to the daily topic. After each session, participants request future topics via a brief survey and our team analyzes these data to identify current learning needs of the primary care community. This analysis is used by the ECHO team to determine future session topics.

Presentations

When participants request topics where the urgency for accurate information supersedes our ability to find a subject matter expert (eg, personal protective equipment, health inequities during COVID, universal masking), our research team performs literature reviews, and presents emerging data and analysis.

The addition of a research team to the traditional ECHO format enables the larger ECHO team to be agile in an ever-changing environment. The team allows ECHO Colorado to quickly assess the evolving learning needs of primary care clinicians across the state, and then rapidly respond to those needs by adjusting the schedule, engaging content experts, and presenting emerging data in real time. As of September 14, 2020, there have been 55 sessions with an average of 150 participants.

LEARNING

As the COVID pandemic continues, clinical learning opportunities for learners may wax and wane. Incorporating learners into the ECHO process provides an experience well-aligned with modern adult learning theories.² It is self-directed, experiential, and problem-centered. It also allows learners to further hone educational milestones set forth by the Association of American Medical Colleges (AAMC) in their Core Entrustable Professional Activities (EPAs) and the Accreditation Council for Graduate Medical Education (ACGME) Milestones. While not every school or region has an ECHO program on which to build, we anticipate there may be analogous opportunities through other existing continuing education programs where medical learners can learn, grow, and meaningfully contribute.

Footnotes

Conflicts of interest: authors report none.
For additional related data, including author affiliations, references, key words, and acknowlegments, see https://www.AnnFamMed.org/content/19/4/371/suppl/DC1/.