For patients suffering from opioid use disorder, and for the physicians in small towns across Pennsylvania who are their first level of care, Project ECHO offers hope. The effort aims to give primary care physicians the tools they need to treat the growing group of Pennsylvanians addicted to opioids—many of whom live in regions with no specialized addiction resources. It’s a win-win: patients get a doctor who can treat them close to home, and physicians get to expand their knowledge, their professional network and their relationship with their patients.
The concept comes from a physician at the University of New Mexico who wanted to shorten the wait list at his gastroenterology clinic. Now, more than 220 institutions around the world use Project ECHO for at least 90 disease topics. And Penn State Health researchers hope to influence them all.
“Research evaluating the project hasn’t kept pace with growth of the movement clinically,” says Dr. Jennifer Kraschnewski, director of Project ECHO at Penn State College of Medicine and a Penn State Health primary care clinician-investigator who studies community health interventions. “It is our goal to create an evidence base to support the model and its ability to mentor primary care providers outside of urban academic hubs. We also aim to learn how to best grow and use Project ECHO as an intervention.”
Penn State expert clinicians are halfway through their first cohort of the Opioid Use Disorder Project ECHO, funded by a grant from the Substance Abuse and Mental Health Services Administration.
“What most excites me is that Project ECHO gets to the heart of the challenges of treating some of a physician’s toughest patients,” says Dr. Sarah Kawasaki, director of the Opioid Use Disorder Project ECHO at the College of Medicine. She is also director of Addiction Services for Pennsylvania Psychiatric Institute. “We’re creating a community to support and educate physicians and improve the chances that they can provide the care their patients need, rather than sending them to a specialist for first-line treatment.”
The program series includes 12 sessions, each of which is attended by up to 20 clinicians plus Kawasaki and her Project ECHO team. The Penn State team is comprised of other addiction experts from the College of Medicine and partner organizations. It serves as the hub, with each participating clinic a spoke learner. At each session, they discuss a complex patient case that has been deidentified and sent in by a participating clinician. They then listen to a short lecture. The project rolls from one group to the next, growing a network of specially trained physicians. In time, it should exponentially build the state’s ability to bring best-practice care to all patients.
Two attendees from The Wright Center for Community Health, a state-designated Center of Excellence in addiction and recovery, were part of the first Project ECHO group in November. Like Kawasaki’s program, The Wright Center is one of the state’s eight hubs for the Pennsylvania Coordinated Medication-Assisted Treatment (PAC-MAT) program. Another two physicians in the first group are from spokes of The Wright Center’s PAC-MAT program.
“Providing care in the addiction and recovery space for less than three years, we have an insatiable desire to learn and develop courses to support our physician-led care teams,” says Dr. Linda Thomas-Hemak, chief executive officer of The Wright Center. “That is why we signed up for ECHO.” Thomas-Hemak is also board-certified in internal medicine, pediatrics and addiction medicine.
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