Rheumatic Care in Under-Resourced Areas Using the Extension for Community Healthcare Outcomes Model

Objective To demonstrate the effectiveness of the Extension for Community Healthcare Outcomes (ProjectECHO) in educating primary care clinicians (PCCs) to provide best practice rheumatic care to patients in under-resourced communities in New Mexico. Methods Attendee data for weekly teleECHOsessions, lectures, grand rounds, and mini-residency trainings were evaluated from June 2006 to June 2014. Participant feedback was evaluated from January 2009 to December 2014, when the program was approved for continuing medical education (CME) credits. Retrospective review of diagnoses associated with case presentations was conducted from June 2006 to June 2014 to evaluate the types of cases presented. A focus group was conducted with a convenience sample of 8 New MexicoPCCs who participated inECHORheumatology (ECHORheum) for 1 year or longer. Results Over the course of 9 years,ECHORheum educated 2,230 clinicians, consisting primarily of physicians (53%) and nurse practitioners (22%). A total of 1,958CMEcredits were awarded to those who participated. There were 1,173 cases presented; 85% of the cases reflected the 3 most common diagnoses: rheumatoid arthritis (n = 715), fibromyalgia (n = 241), and systemic lupus erythematosus (n = 54). In addition,ECHORheum conducted 15 two-day mini-residencies involving 30PCCs; 21 of these clinicians subsequently completed the American College of Rheumatology online certification. Conclusion Results from this study demonstrate that participation inECHORheum provides clinicians in under-resourced areas access to best-practice knowledge and training in rheumatology.