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ECHO Care: Providing Multidisciplinary Specialty Expertise to Support the Care of Complex Patients.

Published on Jan 1, 2020in Journal of General Internal Medicine4.606
· DOI :10.1007/S11606-019-05205-1
Miriam Komaromy1
Estimated H-index: 1
(BMC: Boston Medical Center),
Judy Bartlett1
Estimated H-index: 1
(UNM: University of New Mexico)
+ 6 AuthorsSanjeev Arora25
Estimated H-index: 25
(UNM: University of New Mexico)
Abstract
Background Programs for high-need, high-cost (HNHC) patients can improve care and reduce costs. However, it may be challenging to implement these programs in rural and underserved areas, in part due to limited access to specialty consultation.
  • References (14)
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References14
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#1Michael Hochman (SC: University of Southern California)H-Index: 3
#2Steven M. Asch (Stanford University)H-Index: 67
Starfield and colleagues have suggested four overarching attributes of good primary care: “first-contact access for each need; long-term person- (not disease) focused care; comprehensive care for most health needs; and coordinated care when it must be sought elsewhere.” As this series on reinventing primary care highlights, there is a compelling need for new care delivery models that would advance these objectives. This need is particularly urgent for high-needs, high-cost (HNHC) populations. By...
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#1Janice L. Clarke (Jefferson College)H-Index: 2
#2Scott BournH-Index: 1
Last. Daniel J. CastilloH-Index: 2
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Abstract Although the health care reform movement has brought about positive changes, lingering inefficiencies and communication gaps continue to hamper system-wide progress toward achieving the overarching goal—higher quality health care and improved population health outcomes at a lower cost. The multiple interrelated barriers to improvement are most evident in care for the population of patients with multiple chronic conditions. During transitions of care, the lack of integration among variou...
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#1Maria C. Raven (UCSF: University of California, San Francisco)H-Index: 13
#2Margot Kushel (UCSF: University of California, San Francisco)H-Index: 38
Last. Andrew B. Bindman (UCSF: University of California, San Francisco)H-Index: 47
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Study objective Previous reviews of emergency department (ED) visit reduction programs have not required that studies meet a minimum quality level and have therefore included low-quality studies in forming conclusions about the benefits of these programs. We conduct a systematic review of ED visit reduction programs after judging the quality of the research. We aim to determine whether these programs are effective in reducing ED visits and whether they result in adverse events. Methods We identi...
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Five foundations aim to improve care for high-need, high-cost patients by building U.S. capabilities in three vital areas: clarifying the needs of such patients, elucidating the best ways of caring for them, and assisting with the spread of proven approaches.
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#1Danielle F. Loeb (University of Colorado Denver)H-Index: 8
#2Elizabeth A. Bayliss (University of Colorado Denver)H-Index: 28
Last. Ingrid A. Binswanger (University of Colorado Denver)H-Index: 31
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Background Complex patients are increasingly common in primary care and often have poor clinical outcomes. Healthcare system barriers to effective care for complex patients have been previously described, but less is known about the potential impact and meaning of caring for complex patients on a daily basis for primary care providers (PCPs). Our objective was to describe PCPs’ experiences providing care for complex patients, including their experiences of health system barriers and facilitators...
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#1Miriam Komaromy (UNM: University of New Mexico)H-Index: 15
#2Dan Duhigg (UNM: University of New Mexico)H-Index: 1
Last. Sanjeev Arora (UNM: University of New Mexico)H-Index: 25
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ABSTRACTBackground: Project ECHO (Extension for Community Healthcare Outcomes) trains and mentors primary care providers (PCPs) in the care of patients with complex conditions. ECHO is a distance education model that connects specialists with numerous PCPs via simultaneous video link for the purpose of facilitating case-based learning. This article describes a teleECHO clinic based at the University of New Mexico Health Sciences Center that is focused on treatment of substance use disorders (SUD...
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#1Clemens S. Hong (Harvard University)H-Index: 9
#2Allison L. SiegelH-Index: 1
Last. Timothy G. FerrisH-Index: 35
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Provider groups taking on risk for the overall costs of care in accountable care organizations are developing care management programs to improve care and thereby control costs. Many such programs target “high-need, high-cost” patients: those with multiple or complex conditions, often combined with behavioral health problems or socioeconomic challenges. In this study we compared the operational approaches of 18 successful complex care management programs in order to offer guidance to providers, ...
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#1David W. Bates (Harvard University)H-Index: 141
#2Suchi Saria (Johns Hopkins University)H-Index: 18
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The US health care system is rapidly adopting electronic health records, which will dramatically increase the quantity of clinical data that are available electronically. Simultaneously, rapid progress has been made in clinical analytics—techniques for analyzing large quantities of data and gleaning new insights from that analysis—which is part of what is known as big data . As a result, there are unprecedented opportunities to use big data to reduce the costs of health care in the United States...
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#1Joanna G. Katzman (UNM: University of New Mexico)H-Index: 11
#2George ComerciH-Index: 7
Last. Sanjeev AroraH-Index: 25
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Introduction Project ECHO Pain, the innovative telementoring program for health professionals, was developed in 2009 at the University Of New Mexico Health Sciences Center to fill considerable gaps in pain management expertise. Substantive continuing education for clinicians who practice in rural and underserved communities convenes weekly by means of telehealth technology. Case-based learning, demonstrations, and didactics are incorporated into the interprofessional program that helps to improv...
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#1Danielle F. Loeb (CU: University of Colorado Boulder)H-Index: 8
#2Elizabeth A. Bayliss (CU: University of Colorado Boulder)H-Index: 28
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BACKGROUND Mental illness is common and associated with poor outcomes for co-occurring medical illness. Since primary care physicians manage the treatment of complex patients with both mental and medical illnesses, their perspectives on the care of these patients is vital to improving clinical outcomes.
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