Skip to main content
Top
Published in: Current Osteoporosis Reports 6/2019

01-12-2019 | Care | Quality of Care in Osteoporosis (S Silverman and J Curtis, Section Editors)

Bone Health TeleECHO: a Force Multiplier to Improve the Care of Skeletal Diseases in Underserved Communities

Authors: E. Michael Lewiecki, Avery Jackson III, Anne F. Lake, John J. Carey, Zhanna Belaya, Galina A. Melnichenko, Rachelle Rochelle

Published in: Current Osteoporosis Reports | Issue 6/2019

Login to get access

Abstract

Purpose of Review

This review describes the global development of a model of technology-enabled collaborative learning for healthcare professionals called Project ECHO (Extension for Community Healthcare Outcomes) and its applications for the management of patients with skeletal diseases.

Recent Findings

The prototype Bone Health TeleECHO was established in 2015, with others now operational in the USA and other countries, and more expected to follow soon. Each teleECHO program, in the right language and convenient time zone, provides a virtual community of practice for healthcare professionals to benefit from real-time interactive case-based learning and brief didactic presentations on topics of interest.

Summary

Bone Health TeleECHO elevates the level of knowledge of participants and improves self-confidence in managing patients with skeletal diseases. The development of many teleECHO programs worldwide serves as a force multiplier, with the potential to narrow the osteoporosis treatment gap and enhance the effectiveness of fracture liaison services.
Literature
1.
3.
go back to reference Herath C, Zhou Y, Gan Y, Nakandawire N, Gong Y, Lu Z. A comparative study of interprofessional education in global health care: a systematic review. Medicine (Baltimore). 2017;96(38):e7336.CrossRef Herath C, Zhou Y, Gan Y, Nakandawire N, Gong Y, Lu Z. A comparative study of interprofessional education in global health care: a systematic review. Medicine (Baltimore). 2017;96(38):e7336.CrossRef
7.
go back to reference Arora S, Kalishman S, Dion D, Som D, Thornton K, Bankhurst A, et al. Partnering urban academic medical centers and rural primary care clinicians to provide complex chronic disease care. Health Aff (Millwood). 2011;30(6):1176–84.CrossRef Arora S, Kalishman S, Dion D, Som D, Thornton K, Bankhurst A, et al. Partnering urban academic medical centers and rural primary care clinicians to provide complex chronic disease care. Health Aff (Millwood). 2011;30(6):1176–84.CrossRef
8.
go back to reference • Arora S, Thornton K, Murata G, Deming P, Kalishman S, Dion D, et al. Outcomes of treatment for hepatitis C virus infection by primary care providers. N Engl J Med. 2011;364(23):2199–207. This is the original teleECHO proof-of-concept study with hepatitis C that supported the continuing development of this model of learning. CrossRef • Arora S, Thornton K, Murata G, Deming P, Kalishman S, Dion D, et al. Outcomes of treatment for hepatitis C virus infection by primary care providers. N Engl J Med. 2011;364(23):2199–207. This is the original teleECHO proof-of-concept study with hepatitis C that supported the continuing development of this model of learning. CrossRef
9.
go back to reference Dubin RE, Flannery J, Taenzer P, Smith A, Smith K, Fabico R, et al. ECHO Ontario chronic pain & opioid stewardship: providing access and building capacity for primary care providers in underserviced, rural, and remote communities. Stud Health Technol Inform. 2015;209:15–22.PubMed Dubin RE, Flannery J, Taenzer P, Smith A, Smith K, Fabico R, et al. ECHO Ontario chronic pain & opioid stewardship: providing access and building capacity for primary care providers in underserviced, rural, and remote communities. Stud Health Technol Inform. 2015;209:15–22.PubMed
10.
go back to reference Kauth MR, Shipherd JC, Lindsay JA, Kirsh S, Knapp H, Matza L. Teleconsultation and training of VHA providers on transgender care: implementation of a multisite hub system. Telemed J E Health. 2015. Kauth MR, Shipherd JC, Lindsay JA, Kirsh S, Knapp H, Matza L. Teleconsultation and training of VHA providers on transgender care: implementation of a multisite hub system. Telemed J E Health. 2015.
11.
go back to reference Katzman JG, Comerci G Jr, Boyle JF, Duhigg D, Shelley B, Olivas C, et al. Innovative telementoring for pain management: project ECHO pain. J Contin Educ Health Prof. 2014;34(1):68–75.CrossRef Katzman JG, Comerci G Jr, Boyle JF, Duhigg D, Shelley B, Olivas C, et al. Innovative telementoring for pain management: project ECHO pain. J Contin Educ Health Prof. 2014;34(1):68–75.CrossRef
12.
go back to reference Mitruka K, Thornton K, Cusick S, Orme C, Moore A, Manch RA, et al. Expanding primary care capacity to treat hepatitis C virus infection through an evidence-based care model--Arizona and Utah, 2012-2014. MMWR Morb Mortal Wkly Rep. 2014;63(18):393–8.PubMedPubMedCentral Mitruka K, Thornton K, Cusick S, Orme C, Moore A, Manch RA, et al. Expanding primary care capacity to treat hepatitis C virus infection through an evidence-based care model--Arizona and Utah, 2012-2014. MMWR Morb Mortal Wkly Rep. 2014;63(18):393–8.PubMedPubMedCentral
13.
go back to reference Scott JD, Unruh KT, Catlin MC, Merrill JO, Tauben DJ, Rosenblatt R, et al. Project ECHO: a model for complex, chronic care in the Pacific Northwest region of the United States. J Telemed Telecare. 2012;18(8):481–4.CrossRef Scott JD, Unruh KT, Catlin MC, Merrill JO, Tauben DJ, Rosenblatt R, et al. Project ECHO: a model for complex, chronic care in the Pacific Northwest region of the United States. J Telemed Telecare. 2012;18(8):481–4.CrossRef
14.
go back to reference Lewiecki EM, Bilezikian JP, Carey JJ, Dell RM, Gordon CM, Harris ST, et al. Proceedings of the 2017 Santa Fe Bone Symposium: insights and emerging concepts in the management of osteoporosis. J Clin Densitom. 2018;21(1):3–21.CrossRef Lewiecki EM, Bilezikian JP, Carey JJ, Dell RM, Gordon CM, Harris ST, et al. Proceedings of the 2017 Santa Fe Bone Symposium: insights and emerging concepts in the management of osteoporosis. J Clin Densitom. 2018;21(1):3–21.CrossRef
15.
go back to reference Bennett KA, Ong T, Verrall AM, Vitiello MV, Marcum ZA, Phelan EA. Project ECHO-geriatrics: training future primary care providers to meet the needs of older adults. J Grad Med Educ. 2018;10(3):311–5.CrossRef Bennett KA, Ong T, Verrall AM, Vitiello MV, Marcum ZA, Phelan EA. Project ECHO-geriatrics: training future primary care providers to meet the needs of older adults. J Grad Med Educ. 2018;10(3):311–5.CrossRef
16.
go back to reference Hager B, Hasselberg M, Arzubi E, Betlinski J, Duncan M, Richman J, et al. Leveraging behavioral health expertise: practices and potential of the project ECHO approach to virtually integrating care in underserved areas. Psychiatr Serv. 2018;69(4):366–9.CrossRef Hager B, Hasselberg M, Arzubi E, Betlinski J, Duncan M, Richman J, et al. Leveraging behavioral health expertise: practices and potential of the project ECHO approach to virtually integrating care in underserved areas. Psychiatr Serv. 2018;69(4):366–9.CrossRef
17.
go back to reference Carlin L, Zhao J, Dubin R, Taenzer P, Sidrak H, Furlan A. Project ECHO telementoring intervention for managing chronic pain in primary care: insights from a qualitative study. Pain Med. 2018;19(6):1140–6.CrossRef Carlin L, Zhao J, Dubin R, Taenzer P, Sidrak H, Furlan A. Project ECHO telementoring intervention for managing chronic pain in primary care: insights from a qualitative study. Pain Med. 2018;19(6):1140–6.CrossRef
18.
go back to reference Sockalingam S, Arena A, Serhal E, Mohri L, Alloo J, Crawford A. Building provincial mental health capacity in primary care: an evaluation of a project ECHO mental health program. Acad Psychiatry. 2018;42(4):451–7.CrossRef Sockalingam S, Arena A, Serhal E, Mohri L, Alloo J, Crawford A. Building provincial mental health capacity in primary care: an evaluation of a project ECHO mental health program. Acad Psychiatry. 2018;42(4):451–7.CrossRef
22.
go back to reference • Lewiecki EM, Rochelle R, Bouchonville MF 2nd, Chafey DH, Olenginski TP, Arora S. Leveraging scarce resources with bone health TeleECHO to improve the care of osteoporosis. J Endocr Soc. 2017;1(12):1428–34. This first report of favorable outcomes with Bone Health TeleECHO. CrossRef • Lewiecki EM, Rochelle R, Bouchonville MF 2nd, Chafey DH, Olenginski TP, Arora S. Leveraging scarce resources with bone health TeleECHO to improve the care of osteoporosis. J Endocr Soc. 2017;1(12):1428–34. This first report of favorable outcomes with Bone Health TeleECHO. CrossRef
24.
go back to reference US Department of Health and Human Services. Bone health and osteoporosis: a report of the Surgeon General. Rockville: US Department of Health and Human Services, Office of the Surgeon General; 2004. US Department of Health and Human Services. Bone health and osteoporosis: a report of the Surgeon General. Rockville: US Department of Health and Human Services, Office of the Surgeon General; 2004.
25.
go back to reference Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2007;22(3):465–75.CrossRef Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2007;22(3):465–75.CrossRef
26.
go back to reference Miller PD. Underdiagnosis and undertreatment of osteoporosis: the battle to be won. J Clin Endocrinol Metab. 2016;101(3):852–9.CrossRef Miller PD. Underdiagnosis and undertreatment of osteoporosis: the battle to be won. J Clin Endocrinol Metab. 2016;101(3):852–9.CrossRef
27.
go back to reference • Lewiecki EM, Wright NC, Curtis JR, Siris E, Gagel RF, Saag KG, et al. Hip fracture trends in the United States, 2002 to 2015. Osteoporos Int. 2018;29(3):717–22. A study finding a disturbing rate of hip fractures at levels higher than projected in the USA, highlighting the importance of the osteoporosis treatment gap. CrossRef • Lewiecki EM, Wright NC, Curtis JR, Siris E, Gagel RF, Saag KG, et al. Hip fracture trends in the United States, 2002 to 2015. Osteoporos Int. 2018;29(3):717–22. A study finding a disturbing rate of hip fractures at levels higher than projected in the USA, highlighting the importance of the osteoporosis treatment gap. CrossRef
28.
go back to reference • American Society for Bone and Mineral Research. Call to action to address the crisis in the treatment of osteoporosis. 2016. Available from https://www.asbmr.org/call-to-action.aspx. Accessed 11 Jan 2017. This is a call to action to urgently initiate measures to address the crisis in osteoporosis care and reduce the burden of osteoporotic fractures. • American Society for Bone and Mineral Research. Call to action to address the crisis in the treatment of osteoporosis. 2016. Available from https://​www.​asbmr.​org/​call-to-action.​aspx. Accessed 11 Jan 2017. This is a call to action to urgently initiate measures to address the crisis in osteoporosis care and reduce the burden of osteoporotic fractures.
29.
go back to reference Lewiecki EM, Boyle JF, Arora S, Bouchonville MF 2nd, Chafey DH. Telementoring: a novel approach to reducing the osteoporosis treatment gap. Osteoporos Int. 2017;28(1):407–11.CrossRef Lewiecki EM, Boyle JF, Arora S, Bouchonville MF 2nd, Chafey DH. Telementoring: a novel approach to reducing the osteoporosis treatment gap. Osteoporos Int. 2017;28(1):407–11.CrossRef
30.
go back to reference Lewiecki EM. Bone Health TeleECHO for orthopedists and rheumatologists. Ortho Rheum Open Access. 2017;7(4):555716. Lewiecki EM. Bone Health TeleECHO for orthopedists and rheumatologists. Ortho Rheum Open Access. 2017;7(4):555716.
31.
go back to reference Lewiecki EM, Bouchonville MF 2nd, Chafey DH, Bankhurst A, Arora S. Bone Health ECHO: telementoring to improve osteoporosis care. Womens Health (Lond Engl). 2016;12(1):79–81.CrossRef Lewiecki EM, Bouchonville MF 2nd, Chafey DH, Bankhurst A, Arora S. Bone Health ECHO: telementoring to improve osteoporosis care. Womens Health (Lond Engl). 2016;12(1):79–81.CrossRef
36.
go back to reference Conway R, Kavanagh R, Coughlan RJ, Carey JJ. Expanding access to rheumatology care: the rheumatology general practice toolbox. Ir Med J. 2015;108(2):48–50.PubMed Conway R, Kavanagh R, Coughlan RJ, Carey JJ. Expanding access to rheumatology care: the rheumatology general practice toolbox. Ir Med J. 2015;108(2):48–50.PubMed
Metadata
Title
Bone Health TeleECHO: a Force Multiplier to Improve the Care of Skeletal Diseases in Underserved Communities
Authors
E. Michael Lewiecki
Avery Jackson III
Anne F. Lake
John J. Carey
Zhanna Belaya
Galina A. Melnichenko
Rachelle Rochelle
Publication date
01-12-2019
Publisher
Springer US
Published in
Current Osteoporosis Reports / Issue 6/2019
Print ISSN: 1544-1873
Electronic ISSN: 1544-2241
DOI
https://doi.org/10.1007/s11914-019-00543-9

Other articles of this Issue 6/2019

Current Osteoporosis Reports 6/2019 Go to the issue

Quality of Care in Osteoporosis (S Silverman and J Curtis, Section Editors)

Quality Measures and Quality Improvement Initiatives in Osteoporosis—an Update

Muscle and Bone (L Bonewald and M Hamrick, Section Editors)

Exosomes and Extracellular RNA in Muscle and Bone Aging and Crosstalk

Kidney and Bone (I Salusky and T Nickolas, Section Editors)

Bone Health in Glomerular Kidney Disease

Quality of Care in Osteoporosis (S Silverman and J Curtis, Section Editors)

Pragmatic Clinical Trials in Osteoporosis